Interstitial Cystitis (IC)
is a condition causing discomfort and pain in the bladder and surrounding pelvic region. Interstitial cystitis is a challenging disease that is difficult to define, since a general consensus has not been reached as to how it is to be diagnosed. The National Institute of Arthritis, Diabetes, Digestive and Kidney Diseases (NIADDK) established criteria for diagnosis in 1987 but they were not meant to define the disease, but rather to ensure that groups of patients studied would be relatively comparable. There is no agreed upon pathologic finding with which to diagnosis a person as having IC.
IC can have a devastating effect upon a person's life. It has been reported that using well-developed quality of life indicators, IC patients scored extremely low- in fact, even lower than a sample of patients with chronic renal failure undergoing dialysis.What are some of the symptoms of IC?
The symptoms of IC vary from person to person and even over time in the same individual. People suffering from IC often experience flare-ups and remissions. Symptoms include the following: Severe Bladder Pain or Pressure
Intense Pelvic and/or Lower Abdominal Pain
Excessive Frequency of Urination
Urgency of Urination
Reduced Bladder Capacity
Tenderness in Pelvic / Genital Area
How Common Is Interstitial Cystitis?
A mentioned above, there is no agreed upon pathologic finding with which to diagnosis a person as having IC. Accordingly, the true prevalence of IC is hard to determine. Patients presenting to physicians with the symptoms mentioned are often given a different diagnosis, such as a urinary tract infection or prostatitis. It is felt that at least 700,000 people in the United States have IC. IC affects people of all races and ages, and is more common in women than in men.
What Causes IC?
Despite ongoing research into Interstitial Cystitis, the cause remains unknown. Different theories exist as to the origin of the disease. No bacteria, fungi, viruses or other pathogens have been definitively linked to IC, but some investigators still believe it is caused by an organism we have not yet been able to isolate and identify. Others feel that toxic substances in the urine may be responsible, while some feel it may be a type of auto-immune disease. Evidence has been presented that the protective lining of the bladder-known as the GAG (glycosaminoglycan) layer- is deficient in patients with IC, leading to the symptoms seen in the disease.
How Do I Know if I Have IC?
Since the symptoms of IC are similar to those of other disorders of the urinary tract, and since there is no definitive test to check for IC, physicians must first be sure other conditions do not exist before considering a diagnosis of IC. These conditions include urinary tract infections, pelvic infections, sexually transmitted diseases, bladder cancer, kidney stones, and vaginal infections in women and prostate infections in men.
Physicians will typically look in the bladder with a small telescope, a procedure known as cystoscopy. When done under anesthesia, the bladder will be distended and the bladder wall will be examined for ulcers or a blood vessel pattern known as glomerulations. A biopsy may also be obtained. As mentioned, there is no one single definitive test for IC, but these examinations can provide clues as well as excluding other diseases.
What Treatments are Available?
Unfortunately, we do not yet have a cure for Interstitial Cystitis. Because we do not know the cause of the disease, treatments are aimed at relieving the symptoms. Numerous treatment regimens are in use, including:
Bladder Stretching Under Anesthesia
Instillation of Various Solutions Into the Bladder
Transcutaneous Electrical Nerve Stimulation
Implantable Electrical Nerve Stimulation
Physical Therapy / Myofascial Techniques
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