Wednesday, November 27, 2013

IC... The Basics.....

 I have had some people ask me to explain and give information and facts that people can share to help raise awareness for IC. 

So here it is, the facts about Interstitial Cystitis! Some maybe scary or windy, But they are cold hard facts. 

IC or Painful Bladder Syndrome(PBS)  is a chronic condition and diagnosis of exclusion of unknown cause characterized by bladder pain. It may be associated with urinary urgencyurinary frequency, waking at night to urinate. Those with interstitial cystitis may have symptoms that overlap with other urinary bladder disorders such as: urinary tract infection (UTI), overactive bladderurethritisurethral syndrome, and prostatitis. IC/PBS in a quality of life comparable to that of a patient with rheumatoid arthritis, chronic cancer pain, or a patient on kidney dialysis. (thanks Wikipedia) 



The cause of IC/PBS is unknown. 

Most IC/PBS patients have damaged lining to their bladder, Which makes it difficult to urinate, more prone to infections, problems with intercourse, and sever pain.  On average, a healthy adult urinates no more than seven times a day and seldom needs to get up at night to use the bathroom. Someone with a severe case of IC, on the other hand, may urinate as frequently as 60 times in 24 hours, including multiple nighttime trips to the bathroom.


Types of IC/PBS, Currently there are two recognized subtypes of IC: non-ulcerative and ulcerative. 
    • Non-ulcerative: 90% of IC patients have the non-ulcerative form of IC. Non-ulcerative IC presents with pinpoint hemorrhages, also known as glomerulations, in the bladder wall. However, these are not specific for IC and any inflammation of the bladder can give that appearance.
    • Ulcerative: 5 to 10% of IC patients have the ulcerative form of IC. These patients usually have Hunner's ulcers or patches, which are red, bleeding areas on the bladder wall. 
Because there is no cure for interstitial cystitis, the goal of treatment is to relieve symptoms. Not everyone with IC responds the same way to the same treatment. What works for one person may not work for another. In addition, IC treatments generally take several weeks to several months to provide relief. When you discuss your treatment options with your doctor, your doctor will help you decide which one might work best for you. 


The AUA Treatment Guidelines include a treatment protocol ranging from conservative treatments to more invasive interventions with lower numbers representing less invasive methods:
1. First-line treatments - Patient education, self care (diet modification), stress management
2. Second-line treatments - Physical therapy, oral medications (amitryptiline, cimetidine or hydroxyzine, pentosan polysulfate), bladder instillations (DMSO, heparin or lidocaine)
3. Third-line treatments - Treatment of Hunner's ulcers (laser, fulguration or triamcinolone injection), hydrodistention (low pressure, short duration)
4. Fourth-line treatments - Neuromodulation (sacral or pudendal nerve)
5. Fifth-line treatments - Cyclosporine ABotulinum Toxin (BTX-A)
6. Sixth-line treatments - Surgical intervention (urinary diversion, augmentation, cystectomy)
I hope this helps Please let me know if you have questions.....