Interstitial Cystitis (IC) or Bladder Pain Syndrome (BPS) is a disorder that frequently causes pressure, loss, or distortion of the bladder and pelvic structures while also causing some form of pain in these areas. What easily distinguishes IC/BPS from other bladder syndromes that are due to bacterial infections in the urinary tract system, is the lack of clear discernible cause of IC/BPS.
As a result, it complicates the procedure to diagnose, create an appropriate admission plan, and provide necessary treatment for an individual suffering from this disorder. This means that the daily routine activities can be overlying with pain whilst having an aggressive desire even to void urine with an urge to do so at least several times of the day.
This blog seeks to create awareness on the condition interstitial cystitis explaining in detail its symptoms expected to be seen, what might have caused the condition and how the condition can be treated for a better understanding of the condition that is always misunderstood.
what happens in Interstitial Cystitis(IC)/Bladder Pain Syndrome?
Interstitial Cystitis (IC), also known as Bladder Pain Syndrome (BPS), is a chronic condition characterized by persistent discomfort or pain in the bladder and pelvic region. Unlike typical urinary tract infections, IC/BPS does not result from bacterial infections and does not respond to standard antibiotic treatments.
Key Features of IC/BPS
- Bladder Pain: Individuals experience varying degrees of pain, ranging from a dull ache to sharp, piercing sensations, often intensifying as the bladder fills and alleviating after urination.
- Increased Urinary Frequency: A frequent need to urinate, including nocturia (urination during the night), is common, sometimes leading to urination up to 60 times a day in severe cases.
- Urgency: A persistent sensation of needing to urinate immediately, even after just emptying the bladder.
- Discomfort During Sexual Activity: Many individuals report pain during sexual intercourse, which can affect intimate relationships.
Potential Causes
The exact cause of IC/BPS remains unclear, but several factors may contribute:
- Defective Bladder Lining: A compromised bladder lining may allow irritating substances in urine to penetrate and inflame the bladder wall.
- Autoimmune Response: The body’s immune system may mistakenly attack bladder tissues.
- Nerve Hypersensitivity: Increased sensitivity of bladder nerves can amplify pain signals.
Diagnosis
Diagnosing IC/BPS involves ruling out other conditions with similar symptoms, such as urinary tract infections or bladder cancer. Healthcare providers may use:
- Medical History and Symptom Assessment: Detailed evaluation of symptoms and their duration.
- Urinalysis: Laboratory analysis of urine to exclude infections.
- Cystoscopy: A procedure using a cystoscope to visually inspect the bladder’s interior for abnormalities.
The Treatment of Interstitial Cystitis(IC)/Bladder Pain Syndrome
While there is no definitive cure, various treatment strategies aim to alleviate symptoms and improve quality of life.
- Lifestyle and Behavioral Modifications
- Dietary Changes: Eliminating foods and beverages that may irritate the bladder, such as caffeine, alcohol, and acidic foods, can help reduce symptoms.
- Bladder Training: Techniques to gradually increase the intervals between urination to improve bladder capacity.
- Stress Management: Implementing stress-reduction techniques, such as mindfulness and relaxation exercises, may alleviate symptom severity.
- Physical Therapy
- Pelvic floor physical therapy can help relax pelvic muscles and reduce pain associated with IC/BPS.
- Medications
- Oral Medications: Options include pain relievers, antihistamines, and pentosan polysulfate sodium, which may help restore the bladder lining.
- Bladder Instillations: Introducing therapeutic solutions directly into the bladder can provide relief. Combinations may include lidocaine, heparin, and sodium bicarbonate, believed to help repair the bladder lining.
- Neuromodulation Therapy
- Techniques such as sacral nerve stimulation can modulate nerve impulses to the bladder, reducing symptoms.
- Botulinum Toxin Injections
- Intradetrusor onabotulinumtoxin A (Botox) injections can be used to treat IC/BPS symptoms, either alone or in combination with hydrodistension.
- Surgical Interventions
- Considered in severe, refractory cases, options include substitution cystoplasty or urinary diversion with or without cystectomy.
It’s essential to work closely with a healthcare provider to develop a personalized treatment plan, as responses to therapies can vary among individuals. Regular follow-ups and adjustments to the treatment regimen may be necessary to achieve optimal symptom management.
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