Throughout history, women have faced adversity when trying to receive proper medical care. As little as 10 years ago, many women with bladder or urinary pain were thought to be exaggerating their symptoms. Urinary pain is nothing to be ignored, as it can be incredibly uncomfortable and cause unnecessary stress.
With common conditions such as urinary tract infections (UTIs) causing discomfort, burning, bleeding and urgency, women presenting with these symptoms may be assumed to have a UTI. However, these symptoms when occurring long-term may be indicative of another condition: interstitial cystitis.
Interstitial cystitis (IC) is diagnosed out of exclusion. This means when other possibilities like UTIs and cancers are ruled out, a doctor may decide IC is the logical diagnosis.
When there is inflammation in the bladder, this is called cystitis. Interstitial cystitis occurs when the pain in the bladder is chronic and a cracked urothelial bladder lining is also present. After several months of persistent symptoms of cystitis and if pain is not relieved by an antibiotic, then IC may be considered.
Intake questions with a urologist will be extremely important. An appointment with a urologist may reveal tenderness in the bladder or important family history information.
IC is diagnosed in different grades – mild, moderate or severe. Other components needed to give an official diagnosis include a night-time component (urgency during the night and/or disrupted sleep); discomfort more than eight times a day; no active infection, sign of herpes, stones or radiation.
When diagnosed, there are several options to treat IC. A physician will choose a treatment plan that includes one or a combination of behavioral therapy, physical therapy, medicine and minimally invasive procedures.
Behavioral therapy may include stress management and diet management. Diet goes hand-in-hand with IC symptoms. The lining of the bladder is directly affected; if there are cracks in the lining of the bladder, the byproducts that are stored in the bladder can irritate the urinary tract. Food products such as tomato-based foods, citric acid, caffeine and spicy foods travel directly through the kidneys and irritate the bladder.
It is crucial for the patient that not only is the cause of their IC addressed, but that their pain is also properly managed.
Physical therapy treatments include internal physical pelvic therapy, with medical intervention including bladder installations like Botox, or pelvic injections like a long-acting numbing agent mixed with a steroid. In extremely severe cases where the bladder has contracted down and the pain is constant, an augmentation enteroplasty (where a piece of bowel is applied to the bladder) or bladder removal may be considered.
If you are experiencing lingering bladder or urinary pain, be sure to get in touch with your physician and ask about interstitial cystitis.