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What is Interstitial Cystitis?

interstitial cystitis infographic

Interstitial cystitis (IC) is a chronic bladder health condition that causes recurring bouts of pain and pressure in the bladder and pelvic area, often accompanied by an urgent and frequent need to urinate. Considering symptoms vary from patient to patient, experts today describe interstitial cystitis as a member of a group of disorders collectively referred to as interstitial cystitis/painful bladder syndrome. Throughout this article, we’ll refer to it as interstitial cystitis or IC.

It was determined by a National Household Sample, that discomfort associated with interstitial cystitis can be so excruciating that 11% of the 42% of women unemployed with IC reported that they were kept from working by bladder problems or pelvic pain and 6% of the 18% of women with IC who worked part-time said their pain or symptoms kept them from working full -time. 

According to the Interstitial Cystitis Association, IC is common and affects as many as 3-8 million women and 1-4 million men in the United States. Most patients are diagnosed in their early 40’s. There are several other health issues associated with IC, such as irritable bowel syndrome, chronic fatigue syndrome, fibromyalgia, allergies, migraine, and vulvodynia.

Currently, there isn’t a cure for IC but there are many treatment options available to provide patients with relief. Unfortunately, figuring out what works best for each patient is a process because there isn’t a way to predict which patients will respond best to particular treatments. 

For some patients, symptoms can come and go, as well as range from mild to severe. For other patients, symptoms can be consistent. Although IC is not an infection, many patients have reported that it feels similar to a bladder infection and some patients report pain during sex. Typically, the more severe cases that are left untreated begin to significantly impact the patient’s life and their loved ones. 

How the Urinary System Works 

The bladder and kidneys are part of the urinary system which is the organs in our bodies that make, store, and pass urine. The system has 2 kidneys that make urine, a bladder to store the urine and lower abdomen muscles to hold the bladder in place.

The bladder is relaxed when it’s not full of urine. If the bladder is functioning properly, it can hold up two cups of urine for 9-10 hours and still be considered, “in the safe zone,” without the possibility of damaging organs. 

Once the body is ready to pass urine, the nerve signals in the brain send a signal to the bladder. After that, the bladder muscles contract and force urine out of the urethra. The urethra has muscles called sphincters that help keep urine from leaking and these muscles relax when the bladder contracts. 

Causes of Interstitial Cystitis

The exact cause of IC is unknown, however, it’s theorized that there is more than one cause. Bladder wall biopsies of IC patients indicate various abnormalities, but it’s unclear if these abnormalities are a cause or result of the condition. 

Some research has focused on the antiproliferative factor (APF), which is a substance that’s found only in the urine of IC patients. These substances appear to block normal bladder cell growth and may hinder the bladder tissue healing process. Researchers trying to develop a diagnostic test for IC are considering APF as a potential biomarker.

Another line of research focuses on defects in the glycosaminoglycan (GAG) layer which is a part of the layer of mucus that lines and protects the bladder. Defects in the GAG layer might allow toxins in the urine to leak through, damage underlying tissues, and trigger symptoms like pain or hypersensitivity.

There are several other theories proposed by experts about the cause of IC, such as: 

●     IC could be an autoimmune disorder caused by a bladder infection.

●     IC could be caused by an unknown infection or virus (it could also potentially be an infection or virus.)

●     IC could happen when mast cells incorrectly trigger an allergic response and release histamines into the bladder.

●     Considering women are more likely than men to develop IC, many experts theorize that hormones might play a role. 

●     IC could be caused by erratic sensory nerves in the bladder and spur the release of substances that cause these symptoms.

There are no specific behaviors that are known to increase a patient’s risk of developing IC. However, there is the potential that having a family member with IC could increase your risk of developing IC. Additionally, patients with IC may have a substance in the urine that inhibits the growth of their bladder tissue cells and this may mean that people are more likely to develop IC after an injury to the bladder.

Come back next week for part two where we will be discussing the symptoms and diagnostic process of interstitial cystitis.  

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