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Interstitial cystitis (in-ter-stish-uhl
si-sti'tis), or as we call it, IC, is a condition that
consists of recurring pelvic pain, pressure, or
discomfort in the bladder and pelvic region, often
associated with urinary frequency (needing to go often)
and urgency (feeling a strong need to go). It can also
be referred to as
- painful bladder syndrome (PBS)
- bladder pain syndrome (BPS)
- hypersensitive bladder syndrome
(HBS)
IC can affect anyone. Women, men,
and children of any age or race can develop IC, but it
is most commonly found in women. Three to 8 million
women in the United States may have IC. That is about 3
to 6% of all women in the US. Approximately 1 to
4 million men have IC as well, however, this number is
likely lower than the true rate because IC in men may
often be mistaken for another disorder, such as chronic
prostatitis/chronic pelvic pain syndrome.
Types of IC
Most IC experts agree that IC is
actually several diseases rather than only one disease,
and can present as different subtypes. Currently there
are 2 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. There is also no relationship between
the number of glomerulations you have and how bad
your symptoms are.
- Ulcerative: 5-10% 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.
Patients with Hunner's ulcers may benefit from
treatment with laser surgery.
Causes of IC
The exact cause of IC remains a
mystery, but researchers have identified a number of
different factors that may contribute to the development
of the disease. Many researchers believe a trigger
(caused by one more events) may initially damage the
bladder or bladder lining, and ultimately lead to the
development of IC. Some of these triggers are:
-
Bladder trauma (such as from
pelvic surgery)
-
Bladder overdistention
(anecdotal cases suggest onset after long periods
without access to bathroom facilities)
-
Pelvic floor muscle dysfunction
-
Autoimmune disorder
-
Bacterial infection (cystitis)
-
Primary neurogenic inflammation
(hypersensitivity or inflammation of pelvic nerves)
-
Spinal cord trauma
It is thought that this damage to
the bladder wall then allows particles in the urine,
such as potassium, to leak into the bladder lining. Once
these particles get into the bladder lining, they can
lead to a variety of body responses that may further
damage the bladder and cause chronic nerve pain.
Researchers speculate that one
reason for this continued damage to the bladder is that
normal repair of the lining of the bladder does not
occur in patients who develop IC. Research indicates
that this might be due to a protein called
antiproliferative factor (APF). Studies have shown that
APF is produced by the cells of patients with IC, but
not by the cells of healthy people. APF prevents the
growth of bladder cells and the bladder may be unable to
repair itself when APF is present.
In recent years the relationship
between IC and abuse (sexual, physical, and childhood
sexual) has become a hotly debated topic. The results of
IC and abuse studies have varied greatly, indicating no
connection, a slight connection, and a fairly high rate
of incidence among those with IC. Many studies have also
indicated that the rate of abuse for people with IC is
the same as the rate in the general population. Finding
a definitive answer to the abuse question may lie in
using longitudinal studies which would follow a large
group IC patients and controls over several years.
However, several researchers and clinicians believe that
since there has been only modest data supporting the
abuse theory, clinicians and researchers may be losing
sight of their main goal -- providing real help to those
with IC -- by focusing on this issue.
* The above is for information
purposes only, and should not be construed as advice,
medical or otherwise. Please consult a licensed
physician before relying upon any of the information
above.
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is waiting to
help you! Call us at 1-800-503-7604
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