Interstitial Cystitis is also known as painful bladder syndrome (PBS), bladder pain syndrome (BPS) and chronic pelvic pain (CPP).
Interstitial Cystitis is a chronic bladder syndrome in which there is the presence of pelvic pain, bladder pain or pressure, and urinary frequency or urgency. The pain can range in severity from mild to severe.
Your bladder is a hollow, muscular organ that stores urine. The bladder expands until it is full and then signals your brain that it is time to urinate, communicating through the pelvic nerves. This creates the urge to urinate for most people.
With IC, these signals get mixed up – you feel the need to urinate more often and with smaller volumes of urine than most people.
IC most often affects women and can have a long- lasting impact on quality of life.
The signs and symptoms of interstitial cystitis vary from person to person. If you have interstital cystitis, your symptoms may also vary over time, periodically flaring in response to common triggers, such as menstruation, sitting for a long time, stress, exercise and sexual activity.
Interstitial Cystitis signs and symptoms include –
• Pain in your pelvis or between the vagina and anus in women
• Pain between the scrotum and anus in men (perineum)
• A persistent, urgent need to urinate
• Frequent urination, often of small amounts, throughout the day and night (up to 60 times a day)
• Pain or discomfort while the bladder fills and relief after urinating
• Chronic pelvic pain
• Pain during sexual intercourse
Although signs and symptoms of IC may resemble those of a chronic urinary tract infection, there’s usually no infection. However, symptoms may worsen if a person with interstitial cystitis gets a urinary tract infection.
The exact cause of IC is not known, but researchers claim that several factors may damage the lining of the bladder and therefore trigger the disorder. These include-
• trauma to the bladder lining
• weakened or dysfunctional pelvic floor muscles
• excessive stretching of the bladder, usually due to long periods without a bathroom break
• repeated bacterial infections
• hypersensitivity or inflammation of pelvic nerves
• autoimmune disorders
• spinal cord trauma
Risk factors –
There factors are associated with a higher risk of interstitial cystitis –
Women are diagnosed with IC more often than men.
• Skin and hair colour –
Having fair skin and red hair has been associated with a greater risk of IC.
Most people with IC are diagnosed during their 30s or older.
• Having a chronic pain disorder –
Interstitial cystitis may be associated with other chronic pain disorder, such as irritable bowel syndrome or fibromyalgia.
• Reduced bladder capacity due to stiffening of the bladder wall
• Lower quality of life as a result of frequent urination and pain
• Sleep disturbances
• Barriers to relationships and sexual intimacy
• Issues with self-esteem and social embarrassment
• Anxiety and depression
There is no test for interstitial cystitis. If you go to your doctor complaining about bladder pain along with frequency and the urgency to urinate, the next step is to rule out what else it could be.
Both men and women would first need to rule out urinary tract infections, bladder cancer, sexually transmitted diseases and kidney stones. In women, endometriosis is another possibility. For men, IC can be mistaken for an inflamed prostrate or chronic pelvic pain syndrome.
The following may be helpful in diagnosing interstitial cystitis –
• Medical history & bladder diary
• Pelvic exam
• Urine test
• Urine cytology
• Potassium sensitivity test
The treatment of IC is complex and can involve many approaches .
Potential treatments include –
• Physical therapy –
Working with a physical therapist may relieve pelvic pain associated with muscle tenderness, restrictive connective tissue or muscle abnormalities in your pelvic floor.
• Oral Medications-
¤ Nonsteroidal anti inflammatory drugs such as naproxen sodium or ibuprofen, to relieve pain.
¤ Tricyclic antidepressants such as amitriptyline or imipramine, to help relax your bladder and block pain.
¤ Antihistamines such as loratadine,which may reduce urinary urgency
¤ Pentosan polysulfate sodium(Elmiron), it may restore the inner surface of the bladder,which protects the bladder wall from the substances in urine that could irritate it.
• Nerve stimulation techniques-
¤ Transcutaneous electrical nerve stimulation (TENS)
¤ Sacral nerve stimulation
• Bladder distention –
It is the stretching of the bladder with water. If you have long term improvement, the procedure may be repeated.
• Medications instilled into the bladder –
In bladder instillation, your doctor places the prescription medication dimethyl sulfoxide (DMSO) into your bladder through a thin, flexible tube (Catheter) inserted through the urethra.
• Surgery –
Doctors rarely use surgery to treat IC because removing the bladder doesn’t relieve pain and can lead to other complications.
According to Ayurveda, IC is due to imbalancing of vata and pitta dosha. Aggravated vata and pitta dosha produce the toxic substances in kidney, urethra and pelvic area. Vata regulates all moves in human body and brain.Apan Vata can be found in thelow pelvic area and accounts for good filtration process through urine, stool,menstruation process.Another dosha which is included is pitta, it symbolises heat. Painful sensation is a burning sense of annoyed pitta dosha and also an indicator of aggravated vata dosha. Accumulation of toxic substances causes the frequent and painful urination. The Ayurvedic description because of this disorder is termed as Ushna vata.
Beneficial Herbs –
• Shallaki –
• Gokshura –
• Chandanadi Vati
• Moti Pisti
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