What is Interstitial Cystitis?
Interstitial cystitis (IC) is a chronic, clinical syndrome characterized by
the urgent and frequent need to urinate in combination with the sensation of
pelvic pain in the absence of any identifiable infection or other cause. Many
women also have painful intercourse, or pain immediately following sexual intercourse.
Women can be affected by this condition at any age, but the average age of onset
is 40. Twenty-five percent of patients with IC, however, are under the age of
Estimates have been that it may affect up
to 700,000 Americans, 90% of whom are women. However, many more women may
be affected than previously identified. A recent study in the Women's
Health Care: A Practical Journal for Nurse Practitioners (July 2005) surveyed
over 1,600 women nurse practitioners to identify the prevalence of IC in this
group. Their results were based upon the self-reported scores of the PUF
questionnaire, a validated questionnaire for IC which assesses pelvic pain
and urinary urgency/frequency. According to this study, 6% of the respondents
were likely to have IC and up to 23% of the nurse practitioners themselves
were "possible" IC patients.
The cause is IC unknown and it is difficult
to identify. This contributes to significant psychological, social and hygienic
problems for patients with IC. The good news is that there is are ways to
diagnose, manage and treat IC. While there is no cure for IC, the majority
of patients who are properly diagnosed and treated may obtain relief.
Proper diagnosis is the challenge. IC is
frequently misdiagnosed as an acute urinary tract infection (cystitis), a
disorder that can be successfully treated with antibiotics. While many patients
describe IC as "the worst bladder infection of my life" or as "the bladder
infection that wouldn't go away", IC characteristically does not respond to
antibiotics. While IC is the most common cause of chronic pelvic pain, it
is frequently confused with other causes of chronic pelvic pain, including
endometriosis and irritable bowel syndrome. Of course, the diagnosis is further
complicated by the fact that many patients may have IC in addition to one
of these other conditions.
Several treatment options that may help relieve
symptoms of IC include:
- The IC Diet: Keep diet low in acidic foods, and avoid caffeine (coffee,
tea, carbonated colas) and alcohol.
- Prelief®, a dietary supplement, may help to reduce the symptoms of
IC by reducing the acids in foods and beverages.
- Stress reduction techniques, such as biofeedback and pelvic floor
- Bladder retraining, once pain is under control
- Bladder hydrodistention
- Elmiron® (pentosan polysulfate sodium): the only FDA approved oral
medication specifically to treat IC
- Other oral medications such as tricyclic antidepressants, antispasmodics,
anti-inflammatories and antihistamines
- Opioid analgesics - for severe IC pain
- DMSO (dimethyl sulfoxide) - medication instilled into the bladder
Created: 8/8/2005  - Donnica Moore, M.D.