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Interstitial Cystitis Symptoms & Diagnosis

 

Inflammation of the urinary bladder Cystitis, interior lining closeup illustration

 

In last week’s blog, we talked about what interstitial cystitis is, what causes it, and how the urinary system works. This week we are continuing the conversation about interstitial cystitis and we will be discussing the symptoms of this condition.

Symptoms of Interstitial Cystitis

IC patients who also have chronic pelvic/abdominal pain from other causes, such as endometriosis or irritable bowel syndrome, may experience IC flare-ups when their other symptoms are at their worst. Some patients have reported that their symptoms worse during their period. Additionally, some patients can experience pain lasting several days triggered by sexual intercourse. 

Some patients find that their symptoms are worse after consuming certain foods or drinks, including chocolate, spices, caffeine, alcohol, acidic beverages, and specific types of fruit. However, some patients reported complete relief from their symptoms during the second and third trimesters of pregnancy.

Pain

IC onset is usually gradual, with symptoms developing over a period of months. Symptoms vary for each patient, sometimes symptoms can even vary dramatically in the same patient, however, the most common symptom is pain (typically with pressure). Symptoms can be so inconsistent they can change daily or weekly, or they can remain constant for years, then go away and return months later. 

IC patients typically have bladder pain that worsens as the bladder fills and empties. On the other hand, some IC patients have a constant urge to urinate, because urinating can help some patients relieve pain. Pain can vary from dully/achy to acute/stabbing and discomfort while urinating ranges from mild stinging to burning. 

Furthermore, some patients report additional pain in areas besides the bladder, such as the urethra, lower back, lower abdomen, or the pelvic/perineal area.

Frequency

Some IC patients have reported that their symptoms began with urinary frequency. Urinary frequency is when a patient feels the need to pass urine more often than the average person who doesn’t urinate more than seven times in a day. The average person doesn’t have to get up at night, especially more than once, to use the restroom. However, an IC patient typically has to urinate frequently regardless if it’s day or night. Additionally, it’s important to note that as the frequency becomes more severe, it can turn into urgency.

Urgency

The urgency to urinate is a common IC symptom. Some patients always feel the urge to pee, even right after urinating. Many patients don’t see this as a problem because they are so used to urinary urgency being a part of their daily life. On the other hand, for some patients, the onset is very noticeable, with severe symptoms seemingly coming out of nowhere.

Many IC patients report certain things that they’ve noticed can make their symptoms worse. These triggers can vary from certain foods or drinks, physical or mental stress, menstruation, or pain with sex.

It’s unusual for IC patients to experience urinary leakage and this symptom may be a sign of a separate problem.

Who Gets Interstitial Cystitis?

Since there is no standard technique to diagnose IC, it’s hard to estimate the number of people who have IC. What we do know is that the data shows that the risk of IC increases with age and is two to three times more common in women compared to men. It’s estimated that one to four million men and three to eight million women have symptoms of IC. 

However, the difference between men and women has the potential to not be as high as researchers have estimated. This is because some male patients who have IC could be misdiagnosed with “prostatitis” or a similar condition. 

Currently, there isn’t any evidence that IC can be caused by physical or mental stress. On the other hand, it’s well documented that stress can worsen symptoms for IC patients. 

How Interstitial Cystitis Can Affect Your Life

Severe IC symptoms can cause patients a great deal of distress by interrupting their social life, exercise, and sleep. Without treatment, it can be hard for patients to get through their day, maintain relationships, or be able to hold a job because of their symptoms.

Diagnosis of Interstitial Cystitis

Unfortunately, IC isn’t like a urinary tract infection that can be diagnosed by a simple urine test. Instead, it’s a diagnosis of exclusion, which means that it’s only diagnosed after numerous other conditions have been ruled out. The healthcare practitioner will look through the patient’s medical history, conduct a physical exam, and perform a number of tests to rule out other conditions. 

Additionally, the American Urological Association’s guidelines recommend an early assessment of pain, urinary frequency, and urine volume, to help evaluate the effectiveness of later treatments. If there are symptoms that suggest other conditions or a diagnosis is still uncertain, typically the next step is a cystoscopy. This medical imaging procedure allows the doctor to examine the bladder lining and urethra with a fiber-optic tube. During the cystoscopy, the doctor may take a tissue sample to rule out bladder cancer. The cystoscopy can also detect Hunner’s ulcers, red patches, or lesions that can stiffen tissue and reduce bladder capacity, which occur in 10-15% of IC patients. The detection of these Hunner’s ulcers can help diagnose IC patients but they aren’t required to make a diagnosis.

Come back next week for part three of this series where we are discussing the treatment options and process for interstitial cystitis.

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