What Is Painful Bladder Syndrome?

Have you ever experienced a urinary tract infection (UTI)? 

If you are a woman, more likely than not you have at least had one UTI in your life.  Men get UTIs much less frequently but they are more likely to suffer the condition after age 50．

In any case, imagine feeling as though you have a UTI every day without a cure.  That’s how people with a chronic medical condition referred to as Interstitial Cystitis, or Painful Bladder Syndrome, describe their symptoms.  This medical condition can truly diminish quality of life, so let’s find out exactly what it is and how to treat it.

What Is Interstitial Cystitis (IC)?

Anything ending in “-itis” in medicine refers to inflammation.  And “cystitis” is the inflammation of the bladder.  “Interstitial” cystitis refers to the inflammation of the cells that line the bladder wall. 

The condition can affect both men and women, but is more commonly diagnosed in women.  It is said that about 2% – 6% of women in the U.S. currently suffer from IC, and although patients can suffer from chronic symptoms, most patients have flare ups of the condition where symptoms are exacerbated. Patients often report a constellation of the following symptoms:

• Burning with urination
• Frequency of urination
• Urgency with urination
• Pelvic pain or discomfort
• Bladder pressure
• Pain with intercourse

Needless to say, it’s no party for those living with IC. 

Diagnosis of IC

When first describing symptoms to the doctor, it may seem as though patients with IC have a urinary tract infection.  However, patients with IC often have normal urine testing, with a normal urine analysis and urine culture for bacteria.  But it’s important to rule out infection, since symptoms can often mimic each other. 

When symptoms become chronic or recurrent, your doctor may refer you to a urologist to get a “cystoscopy.” In this procedure, a very small camera is threated through the urethra (where urine exits) and up into the bladder to look around for anatomic issues that can also mimic symptoms.  However, a cystoscopy is not always necessary to make the diagnosis of IC.

Treatment of IC

Symptoms pf IC may come and go and can be made worse by stress and certain bladder irritants. These include:

• Caffeine
• Alcohol
• Carbonated beverages
• Tomatoes
• Spicy foods
• Chocolate
• Acidic fruits:  cranberries, grapes, peaches, pineapples, plums, strawberries, cantaloupes, and citrus fruits

Therefore, good stress management and food trigger avoidance is sometimes enough to control symptoms for some patients. For those who cannot reduce symptoms with diet and lifestyle changes alone, sometimes medications are necessary.  Some of medication options include:

• Pentosan polysulfate sodium, which acts on the bladder wall to decrease irritation.
• Nortriptyline or amitriptyline, which act on the nerves that attach to the bladder. These are available in generic form.
• Hydroxyzine and cimetidine, which act on the immune system to calm down bladder irritation.
• Pyridium, which helps to numb the discomfort in the urinary tract.
• Muscle relaxants, which relax the bladder wall.

Although these medications have not been rigorously studied, sometimes simply one or even a combination of the above may provide relief.  If not, your doctor may be able to refer you to a urologist for more invasive ways to treat IC, including injections into the bladder or bladder irrigation treatments.

Resources

Interstitial Cystitis Association

Interstitial Cystitis Network

Please note that all content here is strictly for informational purposes only.  This content does not substitute any medical advice, and does not replace any medical judgment or reasoning by your own personal health provider.  Please always seek a licensed physician in your area regarding all health related questions and issues.

Bladder pain and UTI images courtesy of Shutterstock.