Interstitial cystitis (IC) is an incurable, chronic inflammation of the bladder that can become a debilitating condition for many patients. Patients with IC experience both frequent urination and urinary urgency. In addition, patients often experience lower abdominal or pelvic pain. In women, the symptoms can often become more severe just prior to their menstrual period.
IC is considered to be one of the most difficult conditions for a urologist to diagnose because a patient can experience flare ups. In up to one-half of the patients with IC, remission can last as long as 6 years.
IC has two forms, ulcerative and nonulcerative. Ninety percent of IC patients are diagnosed with nonulcerative IC.
WHAT ARE THE SYMPTOMS?
IC can cause a variety of symptoms, some of which differ between men and women. In most patients the symptoms include:
- Urinary urgency and frequency;
- Frequent nighttime urination;
- Painful urination;
- Pain in lower abdomen, urethra, or pelvic region;
- Pain frequently associated with sexual intercourse;
- Increasing pain as the bladder fills and decreasing pain as the bladder empties; and
- An increase in symptoms during menstruation.
In addition to most of the above listed symptoms, men may also experience:
CAUSES AND RISK FACTORS
- Pain in the testicles;
- Anal pain;
- Scrotal pain; and
- Painful ejaculation.
The cause of IC is unknown.
A diagnosis of IC is a diagnosis of exclusion. Some of the conditions that physicians must rule out include:
- Bladder cancer;
- Bladder inflammation or infection;
- Kidney stones;
- Sexually transmitted diseases;;
- Vaginal infections;
- Enlarged prostate (in men);
- Bacterial prostatitis (in men); or
- Non-bacterial prostatitis (in men).
To help diagnose IC, the physician will usually conduct a patient history and physical exam, which may include a pelvic exam in women and a digital rectal exam in men. The physician usually instructs the patient to record the frequency of urination in a 24-hour period in a log.
Along with the log, urine cultures and cytology may help the physician exclude conditions that may cause symptoms similar to IC symptoms.
Other tests that may help a physician diagnose IC include:
- Culture for prostate secretions;
- Cystocscopy with hydrodistention;
- Biopsy; and
- Potassium sensitivity test.
There are no standard, successful treatments for IC. There is no cure for IC. The primary goals of IC treatments are to ease the symptoms and improve the patient's quality of life. The physician will usually begin by suggesting that the patient attempt lifestyle changes such as dietary management, behavioral therapies (such as urinating on a schedule), and stress management.
Lifestyle factors can affect the IC patient. Certain foods or beverages can exacerbate symptoms of IC. Some of these items include:
- Coffee and tea;
- Carbonated drinks;
- Spicy foods;
- Chocolate; and
- Citrus fruits and other fruits (such as apples , bananas, and tomatoes) and certain vegetables (such as onions).