Interstitial Cystitits

Interstitial cystitis is a chronic bladder condition caused by damage to the protective lining of the bladder. Patients experience symptoms of urinary frequency, urinary urgency or pain in the areas between the navel and the inside of the thighs that can be mild or severe and occasional or constant. Approximately 90 percent of patients diagnosed with this condition are women.

 

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Causes and Risk Factors of Interstitial Cystitis

Causes of Interstitial Cystitis may include:

  • A urinary substance that damages the bladder.
  • A defect in bladder epithelial tissue (lining of the bladder) which allows irritating substances found in the urine to penetrate the bladder.
  • A change in the nerves running through the bladder to induce pain that was not felt before.
  • Release of histamine or other chemicals by an inflammatory cell.
  • An autoimmune response whereby the body’s immune system attacks the bladder.

Often, these causes may effect each other and increase the symptoms one is experiencing.

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Diagnosis

In the case of interstitial cystitis, several tests can be used to determine an accurate diagnosis. First, patients will undergo a medical history, physical exam and urine tests. A urologist may also use a cystoscopy test, a procedure where the inside of the bladder is visualized, to reveal any areas of bleeding or ulcers.

In addition to cystoscopies, a urodynamics evaluation may also be used to diagnose interstitial cystitis. This test measures bladder pressure as the bladder fills and empties. Having a small bladder capacity and pain with filling are signs of interstitial cystitis.

Potassium sensitivity tests involve the placement of potassium solution and water into the bladder one at a time to compare pain and urinary urgency levels. Patients with normal bladders cannot feel a difference between the two solutions, while patients with interstitial cystitis feel more pain and urgency with the potassium solution.

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Treatments

While not curable, interstitial cystitis may be treated with a variety of medications.

Oral Pentosan Polysulfate (Elmiron)

One oral treatment given is oral pentosan polysulfate (elmiron). This medication may build and restore the protective coating on the bladder epithelium and decrease inflammation with minimal side effects.

Dimethyl Sulfoxide

Patients suffering from interstitial cystitis may also be given dimethyl sulfoxide into their bladder through a catheter once a week for six weeks. This medication treats the condition by blocking inflammation, decreasing pain and removing tissue-damaging free radicals. Other treatments of interstitial cystitis may include, oral hydroxyzine, oral amitriptyline and the insertion of heparin into the bladder through a catheter.

Oral Hydroxyzine

Oral hydroxyzine is an anti-histamine medication that causes sedation, allowing patients to sleep through the night and urinate less frequently.

Oral amitrptyline is classified as an anti-depressant that also treats interstitial cystitis symptoms. This medication also serves as an anti-histamine, decreases bladder spasms and slows nerves carrying pain messages. Possible side effects with this form of medication are sedation, constipation and weight gain. Heparin placed in the bladder through a catheter works to build and restore the protective coating on the bladder epithelial cells. Side effects are rare.

More Information: http://tucc.kramesonline.com/3,S,82989

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