To accomplish this goal patients filled out a questionnaire and were interviewed on when their symptoms began, what they were and are now as well as the various diagnoses that they received before they were determined to have IC. They were serially selected from patients presenting for either a new patient visit of a return visit.
One hundred female subjects were recruited and signed an informed consent. Their responses were reviewed with the principal investigator. They were asked if at the onset of their symptoms if they were either intermittent or continuous. The patients were asked what their current symptoms are including frequency, urgency, bladder or pelvic pain, and urinary incontinence.
The patients were asked what their initial diagnoses were and if they received any associated gynecologic diagnoses. If they had a diagnosis of recurrent urinary tract infections UTI , they were asked if they had been told that they had negative cultures during a flare of their bladder symptoms. They reported the effect of sexual activity on their pain and whether or not they had post intercourse flares of their bladder symptoms.
For those that had a menstrual cycle the effect of it on their symptoms was recorded as to when during their cycle the symptoms flared. Each subject was queried about childhood bladder symptoms, at what age they presented, whether or not they had seen a doctor for these problems and if they knew the diagnosis they were given if any.
Patients were asked if any male or female relatives had bladder symptoms similar to their own symptoms. They reported on mothers, sisters, daughters, father, brothers or sons who had problems.
A total of females with IC were evaluated. At the time of this survey the median age of the females was 40 Table 1. The age that IC symptoms began are shown it Table 2 and Table 3 lists the first symptoms that were experienced. Other diagnoses included urethral problem, anxiety, small bladder or no diagnosis was given.
Sexual and menstrual cycle effects on symptoms are reported in Table 4. Diagnoses the patients received before an IC diagnosis are in Table 5. First degree relatives with similar bladder symptoms are listed in Table 6. The main reason that these data were obtained was to explore the issue of how does IC begin. I have evaluated more than 9, people with IC over the past 35 plus years and during that time have done extensive basic laboratory and clinical research on IC. From this research I have come to believe that there is one primary disease process that causes bladder symptoms in females at all ages and in males less than 55 years of age 3.
That process is a dysfunction of the mucus barrier GAG layer at the bladder epithelial surface. The severe phase of this disease process is the traditional IC patient. But IC has to have a beginning and in the early phase of IC symptoms are milder, intermittent, develop slowly and numerous incorrect diagnoses are given as shown by these data.
Patient histories I have taken have many common threads and one does develop an impression for how the disease begins. It is my observation that the first symptom is usually a slow insidiously progressive frequency.
The patient does not present for help from a physician until it bothers them such as voiding every hour, multiple episodes of nocturia or has post void urgency. But after time many will note the onset of pain cycles that appear suddenly are intense and drive the patient to seek medical care. These cycles typically occur after sexual activity and last for days and then resolve. Most are diagnosed with a urinary infection and will receive antibiotics regardless of the results of a urine culture often negative.
Others will receive no actual diagnosis or treatment. When the flares are multiple in a short time period or last for weeks and months then they are referred to urology. This diagnosis is separated from IC only by an arbitrary definition and not on scientific evidence. The current study was conducted to obtain data to determine whether or not these impressions were valid.
And the data reported here are consistent with this overall concept. This problem did not appear in most of the patients until after age These patients see the gynecologist because they do not perceive the bladder as the cause of the pain or else they would be seeing an urologist.
These traditional concepts have to be changed incorporating all of the new data so that patients can be correctly diagnosed and treated. Others were told they had a urethral problem, anxiety, small bladder or the physician did not know what caused the symptoms. An important point is most of these patients after having a number of flares of symptoms go into a remission until they become sexually active.
Your bladder, kidneys, ureters and urethra make up your urinary system. When you have interstitial cystitis, the walls of your bladder become irritated and inflamed shown right , compared with those of a normal bladder shown top. The pain ranges from mild discomfort to severe pain.
The condition is a part of a spectrum of diseases known as painful bladder syndrome. Your bladder is a hollow, muscular organ that stores urine. The bladder expands until it's full and then signals your brain that it's time to urinate, communicating through the pelvic nerves. This creates the urge to urinate for most people. With interstitial cystitis, these signals get mixed up — you feel the need to urinate more often and with smaller volumes of urine than most people.
Interstitial cystitis most often affects women and can have a long-lasting impact on quality of life. Although there's no cure, medications and other therapies may offer relief.
The signs and symptoms of interstitial cystitis vary from person to person. If you have interstitial cystitis, your symptoms may also vary over time, periodically flaring in response to common triggers, such as menstruation, sitting for a long time, stress, exercise and sexual activity.
Diagnosis and treatment can be difficult, as the exact cause is unknown. No specific test exists to diagnose interstitial cystitis; it is often diagnosed after other conditions have been ruled out. Genetic and immune disorders, recurrent bacterial infections, and pelvic floor dysfunction are possible factors that can lead to this condition.
Excessive frequency of urination, urinary urgency, and urethra, bladder or pelvic pain are common symptoms. Treatment is divided into five phases, ranging from lifestyle changes to injections to surgery.
Interstitial cystitis IC is an inflamed or irritated bladder wall. It can lead to scarring and stiffening of the bladder. It is a chronic disorder. IC may also be known as:. The cause of interstitial cystitis IC is unknown. Researchers are looking at many theories to understand the causes of IC and find the best treatments. Feelings of pressure, pain, and tenderness around the bladder, pelvis, and the area between the anus and vagina or anus and scrotum perineum.
The symptoms of IC may look like other conditions or medical problems. Always talk with a healthcare provider for a diagnosis.
No single test can diagnose IC. And symptoms of IC are a lot like those of other urinary disorders. For these reasons, a variety of tests may be needed to rule out other problems.
Your healthcare provider will start by reviewing your medical history and doing a physical exam. Other tests may include:. With IC, you may feel pain or burning along with an urgent need to urinate before your bladder has had time to fill. Frequency is urinating more often than you think you should need to, given the amount of liquid you are drinking. Most people urinate between four and seven times a day.
Drinking large amounts of liquid can cause more frequent urinating. Taking blood pressure medicines called diuretics, or water pills, can also cause more frequent urinating. Some people with IC feel a strong, painful urge to urinate many times a day. As your bladder starts to fill, you may feel pain—rather than just discomfort—that gets worse until you urinate. The pain usually improves for a while once you empty your bladder.
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