What you should know about this underdiagnosed chronic bladder disease

  • Interstitial cystitis may mimic a urinary tract infection, but antibiotics will not treat the symptoms
  • People with the condition can experience urinary incontinence and severe pain
  • Unfortunately, experts don’t know what causes the condition

Your bladder is a hollow organ that is capable of holding almost half a litre of urine during the day and up to 800ml while you sleep. Your bladder is also vital for kidney health and for preventing urinary incontinence and infections of the urinary tract.

Despite its important job in the body, we tend to overlook bladder health and take our bladders for granted. But interstitial cystitis can result in a constant feeling of pressure on the bladder that can causes severe pain and discomfort.

The condition is mostly found in women and is still poorly understood and rarely diagnosed.

What causes interstitial cystitis?

The condition occurs when there is a defect in the layer of mucus that protect the cells in the lining of the bladder. This may then cause toxic substances from urine to enter the surrounding tissues and inflame the tissues and blood vessels, which can then lead to small patches of bleeding, known glomerulations.

There are many factors and mechanisms that can contribute to IC, but experts are still unsure about the exact cause. According to Harvard Medical School, biopsies from the bladder walls of those who have IC indicate abnormalities in the mucus layer, as well as the presence of a substance called antiproliferative factor (APF) in the urine of people with CF. This substance potentially disables the growth of normal cells, which then interferes with the bladder’s process of repairing itself.

Other theories suggest that IC may be an autoimmune disorder triggered by a bladder infection, or that the sensory nerves in the bladder don’t completely match up with the brain, causing a “disconnect”, wrongly signalling that you want to urinate.

What are the signs and symptoms?

Symptoms differ from person to person and can vary in severity. They can either start gradually and remain constant for months, or go away and return later.

Although the symptoms and severity of pain vary greatly, the most common signs are:

  • Discomfort in urinating, that can range from mild stinging to burning
  • A dull pain or constant pressure on the bladder
  • Frequent urination in small amounts
  • Chronic pelvic pain

Not only are the symptoms uncomfortable and debilitating, but can also interfere with self-confidence and your sex life, which can have a negative effect on your quality of life.

Many of these symptoms mimic a urinary tract infection, so you need to rule this out by consulting a urologist, states Dr Preena Sivanskar from The Urology Hospital in Pretoria

How is this diagnosed and treated?

Unfortunately, there is no specific treatment and the condition is often misdiagnosed or not recognised, as it is not an infection and can’t be identified by a simple urine analysis.

Doctors tend to diagnose the condition by exclusion of other possible underlying diseases. A doctor or urologist may also suggest a biopsy or cystoscopy to rule out bladder cancer if there is any blood in the urine.

A urodynamic study will also help rule out any other conditions.

How can you manage IC?

A normal course of treatment for bladder infection, such as antibiotics, will not work as there is no infection. In fact, misdiagnosis of IC can result in the unnecessary use of antibiotics, which can lead to antibiotic resistance, while your symptoms remain persistent, says Dr Sivanskar.

A urologist will work with you on a specified treatment plan. This may also involve the following lifestyle changes and simple tips:

Control how much you drink, without becoming dehydrated, as this may irritate the bladder even more.

  • Reduce stress and anxiety, as this can be linked to more frequent urination patterns.
  • Relieve pain and pressure with over-the-counter medication and heat, such as a warm bath or a heating pad.
  • Keep a “diary” of your urination to determine when exactly your bladder becomes too full.
  • Limit caffeine, alcohol and sugary drinks as these can further irritate the bladder lining.

READ | What your bladder is trying to tell you about your health 

READ| It may be embarrassing for you, but it won't be for your doctor: Tips on how to get the "uncomfortable conversation" out of the way

READ | 5 reasons why you should never leave incontinence untreated 

Image credit: Polina Zimmerman from Pexels

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