Interstitial Cystitis

What Is IC?

Interstitial Cystitis (IC) is a chronic inflammation of the bladder wall. Its cause is unknown and so is its cure. “Common” cystitis is a urinary tract infection caused by bacteria and is usually successfully treated with antibiotics. Unlike common cystitis, IC is believed not to be caused by bacteria and does not respond to conventional antibiotic therapy. It is important to note, however, that IC is not a psychosomatic disorder nor is it caused by stress.


Who Is Affected?

IC can affect people of any age, race or sex. It is, however, most commonly found in women. A 1987 epidemiological study estimated that 450,000 people may be affected by the disease.

Symptoms
Some or all of these symptoms may be present:

Frequency
Day and/or night frequency of urination (up to 60 times a day in severe cases). In early or very mild cases, frequency is sometimes the only symptom.

Urgency
The sensation of having to urinate immediately may also be accompanied by pain, pressure or spasms.

Pain
Can be in the abdominal, urethral, or vaginal area. Pain is also frequently associated with sexual intercourse.

Other Disorders
Some patients also report experiencing symptoms such as muscle and joint pain, migraines, allergic reactions, colon and stomach problems, as well as the more common symptoms of IC described above. At this time, it is not known if there is any connection between IC and these other ailments.


Diagnosis

Most IC patients have difficulty obtaining a diagnosis. To make a proper diagnosis of IC, a urologist must follow these steps:

  • Take urine cultures to determine if there is a bacterial infection present.
  • Rule out other diseases and/or conditions that have symptoms resembling IC. These diseases may include bladder cancer, kidney problems, tuberculosis, vaginal infections, sexually transmitted disease, endometriosis, radiation cystitis, and neurological disorders.
  • Perform a cystoscopy if no infection is present and no other disorder is discovered. Cystoscopy during a routine office visit may not reveal the characteristic abnormalities of IC. It usually is necessary to distend the bladder under general anesthesia in order to see the pinpoint hemorrhages on the bladder wall that are the hallmark of this disease. A biopsy of the bladder wall may be necessary at this time to rule out bladder cancer and to assist in the diagnosis of IC.

Treatment

At this time there is no cure for IC nor is there an effective treatment which works for everyone. The treatments listed below have been used to relieve the symptoms of IC in some people:

Bladder Distension
The bladder is stretched by filling it with water under general anesthesia.

Oral Medications
These include anti-inflammatory drugs, antispasmodic drugs, antihistamines and muscle relaxants.

DMSO (Dimethyl Sulfoxide)
This medication is instilled directly into the bladder. It is believed to work as an anti-inflammatory agent and therefore reduces pain.

Elmiron (Sodium Pentosanpolysulfate)
This medication is administered orally and/or through bladder instillation. It is believed to work by coating the bladder wall with a protective lining. This drug is not yet approved by the FDA but is available on a compassionate use basis.

Nalmefene
This oral medication is believed to help IC by stopping the release of histamine and other related substances which may be released within the bladder wall through mast cell activation. This drug is currently in clinical trials and is not yet approved by the FDA.

Antidepressant
Taken orally, certain antidepressant drugs such as amitriptyline appear to have anti-pain properties.

Diet
Eliminating certain foods may decrease the severity of IC symptoms.

Tens Unit
Transcutareous Electrical Nerve Stimulation. This device, which is worn externally, relieves bladder pain in some people.

Silver Nitrate
This medication is instilled directly into the bladder.

Clorpactin WCS-90 (Oxychlorosene Sodium)
This medication is instilled directly into the bladder.

Surgery
Several types of surgery have been used to treat IC including bladder augmentation and, in severe cases, urinary diversion.


The Interstitial Cystitis Association

The Interstitial Cystitis Association (ICA) is a nationwide organization working on behalf of all IC patients. Its goals are:

  • To provide IC patients with the most up-to-date information on IC.
  • To provide IC patients, their families and friends with a support network in their community.
  • To attract the attention of the medical community to the seriousness of IC and to educate the public.
  • To help establish a National Registry so the facts about IC can be gathered and studied.
  • To support research to find an effective treatment and cure for IC.
  • If you would like more information about Interstitial Cystitis write to:

ICA
P.O. Box 1553
Madison Square Station
New York, New York 10159

The Leading Urological Group of Central Illinois Since 1945