Facts women need to know about interstitial cystitis

Interstitial cystitis (IC) is a bacterial infection of the bladder usually caused by a urine infection and is clearly a condition primarily affecting women.  Of the more than 700,000 Americans who have interstitial cystitis, as many as 90% are women.   There are three cardinal symptoms associated with IC – pain, frequency and urgency. For women, the intense pelvic pain as well as the urge to urinate frequently will justify a trip to the doctor to get it treated as soon as possible.

Urine infections typically are due to bacteria that enter the urethra and then go into the bladder.  The bacteria take up residence in the bladder leading to an infection but the infection does carry the risk of also spreading to the kidneys.

Generally, bacteria are eliminated from the body when we urinate.  Sometimes, though, the bacteria will cling to the walls of the urethra or bladder. 

Why are women more likely to develop interstitial cystitis?

Although IC can affect women, men and children, it has traditionally been considered a “woman’s disease.”  Women are more susceptible to cystitis than men because their urethra is shorter and closer to the anus.  There are certain other factors that can also increase the risk for a woman developing a bladder infection which includes:

·      Sexual intercourse

·      Using a diaphragm for birth control

·      Whenever a urinary catheter is inserted in the bladder

·      Loss of bowel control

·      Blockage of the bladder or urethra

·      Older age

·      Pregnancy

·      Problem fully emptying your bladder

·      Procedures that involve the urinary tract

·      Being immobile for a long period of time (such as recovery from hip surgery)

Symptoms

Symptoms of interstitial cystitis differ from person to person.  Some experience only minor symptoms while others have symptoms that affecting their lives for weeks on end.  Some of the general symptoms a cystitis include:

·      Urinary frequency – some people may experience day and or/night frequency of urination of up to 60 times a day in severe cases.

·      Urinary urgency – may be accompanied by pain, pressure, or spasms

·      Pain – this will vary from person to person but women generally feel pain in the lower abdominal or vaginal area.  Pain is often associated with sexual intercourse.

·      Low fever

·      Pain or burning with urination

·      Cloudy or bloody urine which may have a strong odor

Diagnosing interstitial cystitis

Diagnosing IC in women can be challenging because its symptoms overlap with other more common conditions in women, especially urinary tract infections (UTIs).  IC symptoms can also overlap with those of overactive bladder (OAB), endometriosis, pelvic congestion syndrome, pelvic floor dysfunction, and other conditions.  In addition, women may have one or more of these conditions in addition to having IC.

Because IC symptoms are similar to those of other disorders of the bladder, there is no definitive test to identify IC.   The diagnosis of IC is based on the presence of pain related to the bladder along with frequency and urgency and the absence of other diseases that could cause the symptoms.    

To help better determine if a woman has interstitial cystitis, a urine sample is usually collected to perform the following tests:

·      Urinalysis – this is a test to evaluate a sample of urine and is used to detect and assess a wide range of disorders including urinary tract infections.

·      Urine culture or clean catch - this is a noninvasive procedure for a urine culture or urinalysis.  The clean catch method aims to prevent bacteria from the skin of the penis or vagina from contaminating the urine specimen.

Treatment

The goal of treatment is to relive pain and reduce inflammation.  The approaches for this can include use oral medications such as an antibiotic to prevent the infection from spreading to the kidneys and bladder instillations – drugs that are introduced into the bladder by a catheter and held for 15 minutes.  If a woman is experiencing burning pain, she may also be prescribed medication to relieve that symptom. 

Other options for treatment might include stress reduction, exercise, biofeedback, or warm tub baths to help improve symptoms. Bladder training – learning to urinate only at specific times despite the urge to go – can help reduce urinary frequency. 

Advice to drink plenty of water will be given as well as drinking cranberry juice to help decrease the concentration of bacteria in the urine.