Interstitial cystitis symptoms, diagnosis and treatment

Interstitial cystitis (IC) is a urological disease characterized by burning sensation during urination, blood in the urine (hematuria), discomfort and pain in the perineum, urethra.

The symptoms are nonspecific for the condition and this makes diagnosis difficult. It is important, in the presence of the listed clinical signs, not to self-medicate and seek medical attention in time.

There are two types of interstitial cystitis: ulcerative and non-ulcerative. The first type is characterized by bleeding ulcers that are located along the entire bladder. It occurs in 10-20% of patients.

The diagnosis is based on the presence of one or more inflammatory ulcers. About 90% of cases are non-specific non-ulcer type of cystitis. The prevalence of CI is significantly higher in women than in men. This is due to the anatomical features of the structure of the urethra, in women it is shorter.

Causes

The exact cause of IC has not been established, but there are several theories about what may affect the development of this disease. It:

  • Infectious, inflammatory diseases of the bladder of a viral, bacterial, fungal nature.
  • Traumatic injuries to the organs of the urinary system.
  • Hereditary predisposition (the disease is detected in the history of first-line relatives).
  • Autoimmune diseases.
  • Neurogenic disorders (inflammation of the pelvic nerves, spinal cord injury).
  • Stretching of the bladder wall (weakening or dysfunctional work of the pelvic floor muscles).
  • Irritable bowel syndrome.
  • Fibromyalgia.

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    Symptoms

    One or more of the following symptoms may occur:

    • Pain in the pelvic region.
    • Feeling of discomfort.
    • Frequent painful urination day and night.
    • Pain during intercourse.
    • Frequent urge to urinate falsely.

    Acute pains have a sudden onset and last for a shorter period of time than chronic pains. There may be cramps, a burning sensation in the urethra. Painful sensations appear during urination and/or immediately before and after it, and are able to suppress sudden urge to urinate.

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    Chronic pain is more frequent and persists for a longer period of time, and may appear a week before menstruation.

    The listed clinical signs can change from day to day and there are light intervals without any complaints. But there may also be a deterioration in well-being, an aggravation of the clinical situation caused by the following factors:

    • Physical or emotional stress.
    • Long, inconvenient public transport journeys.
    • Cold weather.
    • Eating irritating food or drink.

    Diagnostics

    There are no specific specific diagnostic tests for an accurate diagnosis of interstitial cystitis. Therefore, many cases of this condition remain undiagnosed.

    The main stages of diagnosis:

  • Study of complaints and anamnesis of the patient, physical examination.
  • Appointment of standard research methods (clinical blood test, general urine analysis, urine culture on culture media, ultrasound of the OBP, cystoscopy with biopsy).
  • Differential diagnostics.

    In the clinical analysis of blood, leukocytosis may be present, which indicates an inflammatory process. In the general analysis of urine, there will not be any specific changes, as well as in HOW the number of leukocytes can be increased. When urine is cultured on culture media, it is possible to find out what bacteria caused interstitial cystitis in the case of bacterial etiology.

    Differential diagnosis plays an important role in the diagnosis. Interstitial cystitis should be differentiated from the following diseases:

    • Infectious diseases of the urinary tract.
    • Bladder cancer.
    • Chronic prostatitis (in men)
    • Endometriosis (in women)
    • Chronic pelvic pain syndrome (in men).

    Treatment

    Therapy is aimed at reducing the severity of symptoms. In many patients, after lifestyle changes and starting medication, clinical signs regress.

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    Diet and lifestyle changes

    There are foods that irritate the lining of the bladder. These include: soy, coffee, spicy foods, sour fruits and drinks. Foods that soothe the bladder: water, blueberries, fish, milk, squash, eggs, chamomile or mint tea. Urologists recommend keeping a diary of food intake and symptoms in order to determine what may aggravate the clinical manifestations of IC.

    Moderate physical activity has a beneficial effect on the work of the urinary system. It is recommended to exercise regularly to help reduce painful symptoms. Walking and stretching can help reduce the severity of clinical signs of illness, while also helping to relax the body and reduce stress levels.

    Medication Therapy

    Medicines are selected strictly individually. Prescribed drug groups:

  • Tricyclic antidepressants (Amitriptyline, Melipramine): relieve pain, also help the patient cope with psychological stress associated with a chronic painful condition.
  • Antihistamines (Hydroxyzine): Reduces nocturia, pain during urination.
  • Anticholinergics (Detrol, Oxybutynin): relieve urge to urinate and urinary incontinence.

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    Surgery

    Treatment with folk remedies

    Althea root

    It has anti-inflammatory, soothing effects. Protects the bladder wall, helps with urinary incontinence. Consume throughout the day in small portions in the form of tea (4 teaspoons per 1 liter of water, cook for 10-20 minutes).

    Horsetail herb tones up and removes toxins. Horsetail is an astringent and mild diuretic with healing properties.

    The soothing and anti-inflammatory effects of aloe can reduce the severity of symptoms. Its cooling effect relieves pain and irritation. Usage: Half a cup of aloe juice by mouth 2 times a day, you can add honey or lemon to remove the bitterness.

    Intercurrent cystitis after clotrimazole

    Taking Clotrimazole without medical advice threatens the development of intercurrent cystitis, a disease that is difficult to treat. This form of cystitis is more severe than infectious. The inflammatory process is localized in the bladder and can spread to the vagina. Treatment is no different from that for interstitial cystitis. An important and first stage of therapy is the abolition of Clotrimazole.

    Prevention

    Preventive measures include:

  • Avoiding physical and psychological stress.
  • To give up smoking.
  • Compliance with the regime of work and rest.
  • Healthy food.

    If the slightest symptoms appear, it is advisable to see a doctor immediately.

  • Svetlana Borszavich

    General practitioner, cardiologist, with active work in therapy, gastroenterology, cardiology, rheumatology, immunology with allergology.
    Fluent in general clinical methods for the diagnosis and treatment of heart disease, as well as electrocardiography, echocardiography, monitoring of cholera on an ECG and daily monitoring of blood pressure.
    The treatment complex developed by the author significantly helps with cerebrovascular injuries and metabolic disorders in the brain and vascular diseases: hypertension and complications caused by diabetes.
    The author is a member of the European Society of Therapists, a regular participant in scientific conferences and congresses in the field of cardiology and general medicine. She has repeatedly participated in a research program at a private university in Japan in the field of reconstructive medicine.

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