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Interstitial
Cystitis Q - What is interstitial cystitis? A - Interstitial cystitis ( IC ) is a condition in which the inner lining of the urinary bladder becomes inflamed, causing nerve endings to be easily irritated by elements in urine. New research is suggesting that IC may not be a disease but a response of the bladder to changes in oxygen in the tissue. IC may be caused by unsuspected endometriosis, viral infections, hormone problems, nerve injury or spinal instability. Q - What are the symptoms of IC? A - The most common symptom is pelvic pain: pain before or after urination which is relieved by urination. The pain may be a burning feeling in the pelvis or it may be a cramping feeling in the low pelvic region. Pressure in the lower abdomen may also occur. There may be pain during or after intercourse. You may feel the urgent need to urinate. The vagina and urethra may be tender to touch and feel swollen. Riding in automobiles may make symptoms worse. Some patients complain of pelvic burning from the time of ovulation up until the moment of menstruation. Q - Who gets IC? A - IC does not discriminate according to age or sex. However, it is most often diagnosed in women. Men may be misdiagnosed as suffering from chronic prostatitis in the absence of infections. Children may present with symptoms following an upper respiratory infection. Q - What tests can diagnose IC? A - IC is a clinical diagnosis of exclusion. It is important that your physician eliminate other causes for pelvic pain, such as endometriosis, changes in potassium levels, thyroid disorders, hypoglycemia and back problems. The only way to know for sure if you have IC is to have a cystoscopy under anesthesia. Your doctor will refer you to a urologist or urogynecologist who will look inside your bladder with a microscopic light. He or she may perform several tests, including a measurement of your bladder capacity and take some tiny bites of tissue for examination. Q - What is the treatment for IC? A - The treatment for IC depends upon each individual's cause for their pelvic pain. Symptoms can be improved by taking small amounts of antidepressant medication, such as Elavil. Instillations of medication into the bladder may help to heal the injured tissue. Dietary restriction can also decrease the degree of pain. A new medication, Elmiron, is available by prescription. Specialized nerve conduction tests can help your doctor locate the site of nerve injury. If the problem is inside your pelvis, a new surgical treatment using operative laparoscopy with a laser can disconnect the pain nerves from the bladder, resulting in improved circulation to the injured tissue. Spinal problems can be treated by physical therapy or flexion/distraction chiropractic therapy. Some patients my need back surgery to correct their problem if the instability is significant. Your doctor can help you choose the treatment plan which is best suited for your particular symptoms.
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