Interstital Cystitis is a condition that causes recurring discomfort or pain in the bladder and/or pelvic area.

Symptoms vary from case to case and even in the same individual.  People experience mild discomfort, pressure, tenderness or intense pain in the bladder and pelvic area.  Symptoms may include an urgent need to urinate (urgency), a frequent need to urinate (frequency), or a combination of these symptoms.  Pain may increase as the bladder fills with urine and again as the bladder empties.  Women's symptoms oten get worse during menstration and they can sometimes experience pain with vaginal intercourse.  People with severe cases of IC/PBS may urinate as many as 60 times a day including frequent nighttime urination called nocturia.

Because IC symptoms and severity vary so much most researchers believe that it is not one, but several diseases.  In recent years, scientists have started to use the term painful bladder syndrome (PBS) to describe cases with painful urinary symptoms that may not meet the strictest definition of IC. The term IC/PBS incudes all cases of urinary pain that con not be attributed to other causes, such as infection or urinary stones.

In IC/PBS, the bladder wall may be irritated and become scarred or stiff.  Glomerulations (pinpoint bleeding caused by recurrent irritation) often appear on the bladder wall.  Hunner's ulcers are present in 10% of patients with IC.

IC/PBS is more common in women.  It is estimated that the prevalence is 1 in 4.5 women. Common concurrent diseases include:  Irritable Bowel Syndrome (IBS), migraine headaches, fibromyalgia, chronic fatigue syndrome, endometriosis, vulvadynia, and vestibules vaginitis.  These associations suggest a common link; perhaps an inflammatory disorder.

Causes of IC/PBS:  some symptoms of IC/PBS resemble those of bacterial infection, but medical tests reveal no organisms in the urine of patients with IC/PBS.  FUrthermore, patients with IC/PBS do not respond to antibiotic therapy.  Researchers are working to understand the causes of IC/PBS and to find effective treatments.
Currenty, the best evidence suggests that an initial pelvic insult such as a bladder infection, trauma like surgery or emotional trauma like sexual abuse, causes a "wind up" of the pelvice floor muscles.  These levator muscles go into spasms causing pain.  That pain "winds up" the bladder causing increased sensitivity, urgency and frequency.  Eventually nerve changes in the spinal cord result in even worse urgency and frequency and leads eventually to more pain.  This vicious cycle continues and escalates unless therapies aimed at one of more of the pathways of neurological wind up are employed.

Symtoms of IC are similar to those of other disorders of the urinary bladder and there is no definitive test to diagnosis IC/PBS.  Therefore doctors must rule out other treatable conditions before considering a diagnosis of IC/PBS>   The most common of these diseases in both geners are urinary tract infections and bladder cancer.  IC/PBS is not associated with any increased risk of developing cancer.  In men, common diseases to exclude, include chronic prostatitis or chronic pelvic pain syndrome.  There is substantial overlap in these conditions.

Diagnostic tests and tools include:   Validated patient questionnaires, standard lab work up, review of diet, cystoscopy, and biopsy.

Non Surgical Treatment includes: Bladder instillation therapy, oral drug management, neuromodulation therapy, diet modification, smoking cessation, exercise, bladder training and acupuncture.  We recommend an evaluation with our naturopathic physicians.
           
Surgical Treatment includes:  Fulguration and resection; augmentation; sacral nerve root stimulation, cystectomy.

If you believe you have IC or PBS, please contact our office to schedule an appointment for an evaluation.  Our office phone number is 425-5555