Interstitial cystitis is a painful bladder condition, called IC or BPS (bladder pain syndrome), and can consist of a variety of symptoms. Many patients facing IC have recurring pelvic pain, urinary frequency and urgency (needing to go often, with a strong need to go), and pressure. Along with the tags IC and BPS, this condition could also be called PBS (painful bladder syndrome) or chronic pelvic pain.
IC can directly block intimacy and sexual acts for patients who are struggling. This is because the pain caused by the bladder condition can make intimate touch, insertion, or otherwise entirely too painful to handle. Not to mention, when we are not feeling our best, we typically do not have a desire to be intimate or feel sexually attractive. By confronting IC head on and beginning your treatment plan, you can embrace intimacy and sexual acts comfortably without issue.
There are also several comorbid conditions, or conditions that occur at the same time as IC. Having these issues does not mean you do or do not have IC. If you suspect you may be dealing with IC, do not hesitate to contact your medical care team to begin treatment. Some of these comorbidities are:
- Allergies
- Irritable Bowel Syndrome
- Sensitive Skin
- Endometriosis
- Migraine headaches
- Vulvodynia (various painful vagina conditions)
- Fibromyalgia
- Chronic fatigue syndrome
- Lupus
- Pelvic Floor Dysfunction
- Panic Attacks & Mental strain
Types of Interstitial Cystitis
Interstitial cystitis is continually researched, and treatment plans are expanded to help patients better control their symptoms and get back to living. There are two recognized types of IC, although many specialists believe there are many more. These are:
- Ulcerative. Five to ten percent of patients will end up with the ulcerative type of IC. These patients may have patches or Hunner’s ulcers (red, bleeding areas) all over the bladder wall.
- Non-ulcerative. Over 90% of patients will have the non-ulcerative IC. They may present with pinpoint hemorrhages in the bladder well.
In some cases of IC, roughly five percent of all patients will have persistent symptoms for more than two years, with very hard bladders, low capacity, and terrible pain. These patients are said to have “end stage IC” with many ulcers.
Treatment for Interstitial Cystitis
As IC is still being researched and treatment plans constantly evolved and updated, this is a list of some of the more common treatment options for patients with IC.
- Physical Therapy. In recent years, physical therapy has become the top treatment for patients with IC. Physical therapy helps the patient get to know their body, helps their body begin to work, flow, and function as it should, and working directly with abdominal muscles and the pelvic floor can help to bring back some levelness to the bladder. Seek out a physical therapist who has had training specifically on Interstitial Cystitis treatment.
- Bladder installations. These installations are often a mixture of medications put directly into the bladder via a noninvasive procedure. The medications put inside of your specific installation would depend on your doctors’ orders.
- Diet. In many cases, changing your diet to avoid allergens, triggers, inflammatory foods, and processed foods can help to calm the entire body and bladder. This may mean avoiding dairy, gluten, alcohol, or completely shifting gears to an alkaline diet, anti-yeast diet, or avoiding all inflammatory foods. A nutritionist can help you with these changes.
- Immunosuppressants. By suppressing the immune system in some patients, this helps the body to have an extended period of calm, allowing the bladder to settle.
- Antidepressants. Antidepressants are used to help calm the brain and can also have an overall calming body effect.
- Antihistamines. While the antihistamine hydroxyzine is most used, things like Benadryl, Claritin, and Singulair have also been used for calming effects for IC.
- Pain Medications. Pain medications are available in a variety of forms, potency levels, and make-up. Your doctor will advise you on the best option for your situation.
- Over the Counter. OTC pain meds could be aspirin, acetaminophen, non-steroidal anti-inflammatory, ibuprofen, ketoprofen, or naproxen sodium.
- Non-narcotic pain medications. Options are Urelle oral, Uribel, or Utira.
- Topical medications. Lidocaine patch, vaginal or rectal suppositories to relieve pain, or topical amitriptyline (which offers less side effects than its counterparts for many).
- Narcotic pain medications. The lists of optional narcotic pain medications are much longer than the others. Some of the more common options are codeine, hydrocodone, oxycodone, oxymorphone. For severe pain: morphine, hydromorphone, oxycontin, or fentanyl.
Never, ever begin a new medication without first discussing all options, potential side effects, and your specific situation first. Many of these listed medications come with their own side effects which can cause other problems if their use is not monitored.
Diagnosing Interstitial Cystitis
Your medical care team will begin the evaluation at your appointment. This will begin with a patient history, physical examination, abdominal palpations, possible pelvic examination, and a discussion. They may also do blood work, labs, and other testing that they deem fit. These tests are most often not at all invasive and often get the patient on the path to comfort quickly.
For many patients, interstitial cystitis is a condition that they can live with once they have gained the tools from medical professionals on how to maintain their bladder health. If you are dealing with IC, do not wait to get your appointment made to get treatment started!
Check out our Empowerment Video Series with Dr. Maureen O’Keefe from Purple Mountain Physical Therapy covering Interstitial Cystitis! She is also one of the doctors who has worked on revamping the treatment plans for IC and has an amazing understanding of this condition.
Citations:
Purple Mountain Physical Therapy
National Institutes of Health and Human Services
Interstitial Cystitis Association