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    Painful Bladder--Could It Be Interstitial Cystitis?

    Amanda Phelps-Jones, WHNP-BC Pelvic Health & Wellness Center at The Women’s Hospital 11/11/2017
    Interstitial cystitis (I.C.) is a problem with the lining of the bladder and is often called painful bladder syndrome or irritable bladder – and for good reasons, it's painful! I.C. occurs mostly in women, is underdiagnosed and often mistaken for a urinary tract infection.

    Most of the I.C. patients I see at the Pelvic Health & Wellness Center talk about
    • frequency of urination
    • urgency of urination--gotta go RIGHT NOW
    • painful urination (which is key to this diagnosis)
    • bladder becomes more irritable with certain foods/beverages (more on that in a bit)
    • painful sexual intercourse due to constant irritation of the bladder 
    • generalized chronic pelvic pain

    Diagnosing I.C.
    There isn’t a specific test for interstitial cystitis so we try to exclude other problems or conditions before assigning a diagnosis of I.C.   

    At the Pelvic Health & Wellness Center, we have a three-step diagnosis process that includes:
    1.  The PUF questionnaire - Pain, Urgency and Frequency
    2.  A physical exam
    3.  A medical history discussion

    Sometimes we learn that a patient has overactive bladder and not I.C. or we may discover a different pelvic health issue. That's why a complete exam with several components is so important for a correct diagnosis.

    I.C. Treatment
    Once I.C. has been diagnosed, there are several components to treating and managing the condition. Like other medical conditions, treatments are based on the patient’s specific conditions, needs, severity, etc.

    Treatment options can include:
    • Dietary modifications
    • Oral medications to help repair the bladder lining
    • Oral medications that help with pain (non-narcotic)
    • Oral medications for overactive bladder
    • Antihistamines that help calm the bladder lining
    • Medications that are administered directly into the bladder via a catheter 
    • Pelvic floor physical therapy
    • In severe cases, there are advanced treatments that are more invasive, such as bladder hydrodistention. These procedures are done by specialist physicians, including uro-gynecologists and urologists.

    Diet and I.C.
    Many patients will experience a worsening of symptoms from eating or drinking certain things.  Here is a list of the most common problem foods/drinks for someone with I.C.:
    • Citrus foods and drinks
    • Tomato-based products, due to the acid in them
    • Spicy foods
    • Caffeinated and carbonated drinks--coffee, tea, soda, etc.  Even decaf can be a problem.
    • Artificial sweeteners
    • Alcoholic beverages
    Different patients will have different responses to these foods and drinks, but in general, eliminating or limiting these irritants can have a beneficial effect for many patients.

    I want to recommend a couple of websites for additional information about I.C.
    Both of these sites offer helpful tips, support and guidance in managing I.C.

    Learn more about the Pelvic Health & Wellness Center, including  details about conditions we treat and our expert team of providers.
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