Interstitial cystitis

What is Interstitial Cystitis?

Interstitial Cystitis (I/C) is a “symptom complex”, which means in medical terms it is often called many names, but the patient suffers the same symptoms. The new “all inclusive” term is “Pelvic Pain Syndrome”. It is thought to be the end pathway of a range of problems and should only be diagnosed after other specific diseases have been eliminated.

The symptoms which most people with I/C suffer from are:

  • Frequency – the need to pass urine many times in a short period.

  • Urgency – the inability to delay the passing of urine for any time.

  • Pain – mostly felt just above the pubic bone, though can be felt down the thighs, in the perineum or the lower back.

These symptoms are those of cystitis caused by an infection and many people are initially treated with antibiotics. These do not relieve the problem, but there is often confusion – as the symptoms often spontaneously get better over any given period of time.

What happens?

The disease mostly progresses very slowly, but the most important thing to accept about it is that there is no cure, though mostly symptoms can be brought into some degree of control for varying lengths of time.

The exact cause of I/C is not known, and there are a numbers of theories, each of which have some value. The immune system is probably involved at some level, but how is not presently known. There is thought to be a defect in the mucus lining of the bladder that allows chemicals in the urine to leak back into the bladder wall causing pain and irritation. What triggers this is not known and this could be anything from a direct allergic reaction to some type of nerve sensitivity. Inflammation seems to be the bottom line.

It is important that you try not to give into the urge for frequent voiding - the bladder readily becomes used to such an empty state and in a sense “shrinks”. It is also quite common for you to have “good” and “bad” days, and the bad days are often preceded by one of your “triggers”.

Flares

I/C has a tendency to have flares (a sudden increase in symptoms) that can be caused by many different factors. One of the most important things for you to do if you suffer from I/C is to learn to recognize those things in your life that act as triggers for your disease. Stress of all types can often be trigger - travelling, exercise, sexual intercourse etc. often bring on an “attack” of I/C.

It is important to realise that triggers do NOT cause I/C, but rather aggravate it. They do not increase progression or increase the severity.

Many people who suffer from I/C find they have allergic problems that can often cause a flare of their I/C. It is important that these allergies be cared for as well, and many people will find they can keep their I/C under better control if they take a regular anti-histamine tablet, and avoid those things that cause the allergic reaction.

What can you do?

There are a number of things that you can do to help control your Interstitial Cystitis:

  • Probably one of the most important is one of attitude – MIND OVER BLADDER!

  • Try not to pass your urine too frequently - it is possible to train your bladder and you can start by trying to delay voiding by 15 minutes, and gradually increase this time.

  • There are no specific rules to follow with regards to your diet, however you will recognize certain foods that seem to act as a trigger for your I/C - these are the foods that are best to avoid. Some of the foods that seem to be more frequent triggers are:

    • Citrus fruits.

    • Tomatoes, pineapples.

    • Hot or spicy foods (e.g. Thai etc.).

    • Alcohol (more often red than white wine).

  • An anti-histamine tablet daily often helps (e.g. Atarax 50-75mg at bedtime).