Interstitial Cystitis: Symptoms and Signs

by: Tina Samuels



Interstitial cystitis (IC) is a chronic and debilitating disease of the urinary tract and bladder that affects approximately one million people. There is an inflamed and irritated bladder wall that leads to many bladder symptoms. The bladder wall of an IC patient will have stiffening and scarring of the bladder, less bladder capacity as a result of the scarring, small pinpoint bleeding on the bladder (glomerulations) and ulcers in the bladder lining (Hunner’s ulcers).

So much isn’t known about the illness, even though it has been around for a while now. This article deals with the signs and the symptoms of interstitial cystitis. A general guideline for interstitial cystitis is from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), and although it has come under fire and scrutiny as it doesn’t incorporate all of the prevailing symptoms and has some things included as an exclusion that some people with IC do indeed have, it is meant as a oversee of the illness and not a conclusive.

NIDDK Research Definition of Interstitial Cystitis

Inclusion Criteria
1. Cystoscopy — glomerulations and/or classic Hunner’s ulcer.
2. Symptoms — bladder pain and/or bladder urgency.

Exclusion Criteria
1. Bladder capacity greater than 350cc on awake cystometry.
2. Absence of an intense urge to void with the bladder filled to 100cc during cystometry using a fill rate of 30-100cc/min.
3. Demonstration of phasic involuntary bladder contractions on cystometry using the fill rate described in number 2.
4. Duration of symptoms less than 9 months.
5. Absence of nocturia.
6. Symptoms relieved by antimicrobials, urinary antiseptics, anticholinergics, or antispasmodics.
7. Frequency of urination while awake of less than eight times a day.
8. Diagnosis of bacterial cystitis or prostatitis within a 3-month period.
9. Bladder or ureteral calculi.
10. Active genital herpes.
11. Uterine, cervical, , or urethral cancer.
12. Urethral diverticulum.
13. Cyclophosphamide or any type of chemical cystitis.
14. Tuberculous cystitis.
15. Radiation cystitis.
16. Benign or malignant bladder tumors.
17. Vaginitis.
18. Age less than 18 years.

This is a research definition only (for inclusion of patients in clinical trials) and is not necessarily applicable to diagnoses made in clinical practice. The major difference in the less stringent Interstitial Cystitis Database (ICDB) inclusion criteria for the diagnosis of IC is that cystoscopy (and its related diagnostic criteria) is an optional criterion for entry into the ICDB study. The rigid urodynamic exclusion criteria in the NIDDK definition do not exclude patients from an ICDB IC diagnosis.

The symptoms and signs of interstitial cystitis are varied and not every IC patient will have all of them. It is a difficult illness to pinpoint and this is meant only as a guideline to some of the symptoms that the interstitial cystitis patient may have.

1. Pelvic and perineal pain and pressure.
2. Urinary frequency: over 8 times/day; average is 16 times/day; can be up to 60 times/day.
3. Nocturia (excess urination at night).
4. Urinary urgency: urge not relieved by voiding.
5. Over 9 months of symptoms.
6. Dyspareunia (painful ).
7. Hematuria (blood in urine).
8. Symptoms worsen during menstruation.
9. Diminished bladder capacity.
10. and scrotum pain and pressure.
11. Dysuria (pain on urination).
12. UTI (Urinary tract infection) symptoms that do not improve upon antibiotic treatment.

50% of IC patients will have pain while riding in a car or with any prolonged sitting function; 63% are unable to work full time. Perhaps the most staggering statistic of IC is that interstitial cystitis patients are 3-4 times more likely to commit suicide than those who do not have the illness and that they rank below kidney dialysis patients in quality of life. So please, if you have any of the above mentioned signs or symptoms, get to an urologist. This diagnosis takes approximately 7 years to receive, usually through trial and many errors. Get checked, get tested, and get back on tract with your life.

Cystitis: Symptoms, Causes, Treatment and Prevention

Cystitis is an infection of the bladder, but the term is often used indiscriminately and covers a range of infections and irritations in the lower urinary system.

Symptoms of cystitis include:

* Burning sensations or pain during urination.
* Frequent urination.
* Cloudy and foul-smelling urine.
* Pain directly above the pubic bone.
* Blood in the urine, a common feature and need not cause undue alarm.
* Children under five years of age often have less concrete symptoms, such as weakness, irritability, reduced appetite and vomiting.
* Older women may also have no symptoms other than weakness, falls, confusion or fever.

Causes:

Infection from intestinal bacteria is by far the most frequent cause of cystitis, especially among women, who have a very short urethra (the tube through which the urine passes from the bladder to the outside). Normally, urine is sterile (there are no micro-organisms such as bacteria present). Between 20 to 40 per cent of women will get cystitis in their lifetime.

Treatment:

* The best first aid treatment is to drink, drink, drink.
* To some extent alkalizing the urine helps to eradicate the germs and also soothe the bladder. You can try using bicarbonate of soda, 5ml (1 tea spoon) in half a glass of water, two or three times a day, or one of the over the counter cystitis remedies.
* For similar reasons the folklore remedy is barley water or, these days, cranberry juice.
* If the symptoms are any more than transient, you should contact your doctor, when next able to, regarding the possibility of antibiotics.
* There have been herbal remedies for centuries in Europe. Read what Tina Samuels has to say:

THREE HERBS FOR CYSTITIS

Herbalists know that not everyone with cystitis needs antibiotics or other prescription medication. There have been herbal remedies for centuries in Europe, a culture far more accepting of nontraditional medicinal methods than the US. Below are three herbs designed for cystitis relief.

Corn Silk (Zae mays)

Corn silk is also known as corn, Indian corn, maize jagnog, Turkish corn, and yu mi xu. It has been used to treat urinary tract syndromes because of its diuretic and anti-inflammatory properties for centuries. The supplement is produced from the female flower stamen (picked before full bloom) and fine soft silks about 4-8 inches long. It is a good aid to treating the pain of any inflamed/irritated mucous surfaces.

Combining corn silk with couchgrass, bearberry or even yarrow is good for treating cystitis. You may need to experiment to see what works for you. Corn silk is used as a remedy for cystitis, stones, bladder irritation, edema, and gonorrhea. Its herbal medicinal qualities are diuretic, demulcent, anti-inflammatory, tonic, anodyne, alterative, and lithotriptic. It is really a “soother”.

To make an infusion, pour a cup of boiling water on 2 teaspoonfuls of dried corn silk. Leave this mixture to steep for 10-15 minutes. The tea, when used as a medicinal, should be taken three times a day. As a tincture, take 3-6 ml of it three times a day.

Marshmallow Root (Althea officinalis)

A hardy perennial that grows up to 4 feet tall, althea officinalis has white or pink flowers that bloom in late summer. It is generally found in damp salty places. Known simply as “mallow”, it is used as an expectorant, anti-inflammatory, diuretic, mucilaginous, emollient and one of the most effective demulcents. Mallow flowers, leaves, syrup and roots are used in herbal pharmacology and most supplements use the dried root and leaves. The roots of the marshmallow have been used medicinally for the digestive tract for the relief of local irritation, bladder infections, and an immune system stimulant. The leaves are used for the urinary tract, lungs, cystitis relief, urethritis, respiratory infections, and coughs. The roots are very rich in mucilage and can get gummy when they are wet, making it good to protect and coat the gastrointestinal tract.

Mallow can be bought as a tea, powder, extract, capsules or tablets. The normal dosage is 1-4ml of tincture three times a day.

Pipsissewa (Chimaphila Umbellata)

An evergreen shrub native to woody areas, pipsissewa has been traditionally used by Native Americans to treat fevers and to induce sweating. Primarily it is the leaves, twigs and flowers that make up the herbal remedies. It makes a good disinfectant for the urinary tract and herbalists use this plant specifically for that. The plant contains hydroquinones which is why the plant makes a good disinfectant and antimicrobial, but not good for any long term treatment usage. This herb may interfere with birth control pills due to the phytoestrogenic properties, so talk to your doctor before taking this or any herb remedy. This can be found in tincture, extract, tablet, and tea form.


Prevention:

As a prevention, the website Netdoctor.co.uk recommends drinking cranberry juice every day or taking capsules. “There is no doubt that this simple and natural treatment brings relief to many women with cystitis. It is thought that the cranberry juice works by preventing common bacteria from ‘sticking’ to the walls of the bladder and so preventing infection taking hold.”