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News Archive - 24th of March 2011

Interstitial cystitis - What are the symptoms of interstitial cystitis?

Interstitial cystitis is a name that is given, amongst others to describe the frequency, urgency, pressure and/or bladder pain that some people experience on an ongoing basis for many years. It can be ulcerative and non-ulcerative, depending on the presence or absence of ulcerations in the bladder lining. Ulcerations in the bladder wall are known as Hunner's ulcers.

“Interstitial cystitis (IC), also known as bladder pain syndrome (BPS), painful bladder syndrome (PBS) or hypersensitive bladder syndrome (HBS), is a condition that results in "an unpleasant sensation (pain, pressure, discomfort) perceived to be related to the urinary bladder, associated with lower urinary tract symptoms of more than 6 weeks duration, in the absence of infection or other identifiable causes." (2009 new American IC/BPS Guidelines).

What are the symptoms of interstitial cystitis?

The symptoms of interstitial cystitis vary greatly from one person to another but whether ulcerative or non ulcerative they have some similarities to the symptoms of a urinary tract infection. They include:

• Decreased bladder capacity
• An urgent need to urinate frequently day and night
• Feelings of pressure, pain, and tenderness around the bladder, pelvis, and perineum (the area between the anus and vagina or anus and scrotum
• Painful sexual intercourse (dyspareunia)
• Discomfort or pain in the penis and scrotum.

Theories about the cause of interstitial cystitis are many and varied and even include a form of autoimmune disorder, or that an unidentified organism may be producing the damage to the bladder and thus creating the accompanying symptoms.
When a person presents with chronic cystitis and the bladder is examined, little wounds will be observed; these are called Petechial hemorrhages and it is then that the ulcerative or non-ulcerative condition is diagnosed.

Symptoms vary greatly from person to person, but all include an urgent need to urinate (urgency), a frequent need to urinate (frequency) and, for some, pressure and/or pelvic pain. People with severe cases of IC/PBS as opposed to cystitis may urinate as many as 60 times a day, including frequent nighttime urination (nocturia).

The University of Maryland (led by Susan Keay) isolated a substance found almost exclusively in the urine of people with interstitial cystitis. They have named the substance the antiproliferative factor (APF), because it appears to block the normal growth of the cells that line the inside wall of the bladder. This explains why it may take longer for an IC sufferer to heal as opposed to a regular cystitis sufferer.

Interstitial Cystitis and labelling

A huge number of bladder problems, ranging from painless but frequent urination through to severely crippling and debilitating bladder pain that gets worse as the bladder gets full, are labelled under the general heading of 'interstitial cystitis'.

"It's a non malignant, non infective condition which may be associated with changes that are apparent when you look at the bladder, but sometimes the bladder may appear absolutely normal, [although] the patient may be crippled with discomfort."  Dr Helen O'Connell, consultant urologist - Royal Melbourne Hospital.

Other possible causes of the symptoms found in Interstitial Cystitis include physical abnormalities such as prolapse of the bladder, vaginal infections, urinary tract infections or disorders, endometriosis, bladder cancer, sexually transmitted diseases, and kidney stones. Tests may be necessary to rule out these causes.

When blockages, physical abnormalities, and symptom-causing diseases are ruled out, the absence of infection, when combined with pain or frequent urination, is the over-riding factor that can lead to a diagnosis of interstitial cystitis.

Triggers for Interstitial Cystitis (IC)

Some people believe that certain foods such as tomatoes, spices, alcohol, chocolate, caffeinated and citrus beverages and high-acid foods may add to bladder irritation and inflammation. Others notice that their symptoms get worse after eating or drinking products containing artificial sweeteners. If you believe that your interstitial cystitis is related to your diet, try keeping a diary of food and symptoms. Or try cutting out all of the above, and gradually introducing them to see what the trigger is.

Unfortunately, the triggers are not always detectable. Interstitial cystitis can affect otherwise healthy individuals for no apparent reason. However, it is likely that diet and lifestyle plays a part, and it has recently been accepted that previous antibiotic use for one or more bladder infection may kill E. Coli but leave fragments of the bacteria bio-molecularly attached to lining of bladder and urinary tract. This can cause long-term irritation of the bladder, making it painful to fill the bladder completely, leading to frequent urination, gradual shrinking of the bladder, and the beginning of a cycle that can be very difficult to break.

The U.S. microbiologist Dr. Paul Fugazzotto, believes that interstitial cystitis is caused by gram-positive bacteria, usually enterococcus, but others believe that gram negative bacteria can also be involved. Our own experience is only with Interstitial Cystitis related to E.coli and Salmonella.

Possibilities

• Waterfall D-Mannose can help to detach bacterial fragments if they are present.
  
  Go to www.waterfall-d-mannose.com for more information on using the product to help.
  
  
• Dietary changes may help. For example, alkalising urine  through food choices.
  
  
• Antibiotics seem to bring some relief to some sufferers.
  
  
• Bladder training to stretch the bladder. Try holding it in as long as you can.
  
  
• Stress reduction, and low-impact exercise are said to reduce symptoms.

Over the last eight years, Waterfall D Mannose has given relief to literally thousands of IC sufferers and with daily use over a few months they have reported that their symptoms no longer trouble them.

For further information please visit E-coli related bladder infections in the info section.