Interstitial cystitis, also known as bladder pain syndrome, is a chronic condition characterized by pelvic pain, often felt in the lower abdomen, along with frequent and urgent urination.
While its exact causes remain unclear, potential contributing factors include autoimmune disorders, a defective bladder lining, and allergies.
Stages of Interstitial Cystitis is classified into mild, moderate, and severe stages, reflecting the spectrum of symptom severity, from manageable discomfort to debilitating pain that significantly impacts quality of life.
Understanding the Progression of Interstitial Cystitis
Interstitial cystitis (IC) is a chronic disease that begins with mild symptoms, where the patient suffers from a frequent need to urinate with a feeling of discomfort in the lower abdomen that comes and goes from time to time.
Over time, the symptoms develop and the need to urinate increases many times with severe pain in the lower abdomen that prevents the patient from practicing his daily life.
The disease is classified into mild, moderate and severe according to the severity of the symptoms.
Symptoms at Different Stages of the Condition
Stages of interstitial cystitis can be described as follows:
Early stage:
- Mild discomfort or pressure in the bladder.
- Increased frequency of urination, with control.
- Symptoms come and go, and may be mistaken for a urinary tract infection.
Intermediate stage:
- Increased frequency of urination and an urgent need to urinate.
- Noticeable pain in the pelvic area, usually triggered by certain activities or foods.
- Symptoms begin to interfere with daily life.
Severe stage:
- Chronic, severe bladder pain.
- Frequent urination, sometimes hourly.
- Painful intercourse.
- Difficulty with work and social activities due to severe symptoms. (National Institute of Diabetes and Digestive and Kidney Diseases, n.d.)
Factors that can affect progression:
- Not everyone has the same progression, with some individuals experiencing milder symptoms throughout their lives while others progress quickly to severe stages.
- Certain foods, stress, hormonal changes, and physical activity can worsen symptoms and potentially speed up progression.
- Early diagnosis and continued treatment with lifestyle modifications, medications, or other therapeutic approaches can help manage symptoms and slow the progression of the disease. (Parsons, 2015)
Treatment Options for Each Stage
Treatment of the disease depends on the stages of interstitial cystitis.
In the early stages, it is possible to depend on changing the lifestyle, such as abstaining from certain foods.
In the advanced stages, some other treatment options can be used, such as giving Elmiron medication, bladder implantation, nerve stimulation, or performing a surgical procedure.
This is as follows:
Early stage:
- Bladder training.
- Fluid management.
- Avoiding bladder irritants such as caffeine, alcohol, and acidic foods.
- Stress management.
- Pelvic floor exercises.
- Stopping smoking.
- Keeping a bladder diary.
- Over-the-counter medications: such as pain relievers such as acetaminophen or ibuprofen and antihistamines.
Intermediate stage:
- Oral medications such as pentosan polysulfate sodium (Elmiron).
- Low dose antidepressants (such as amitriptyline).
- Anticonvulsants.
- Intravesical injections of medications such as lidocaine or heparin directly into the bladder to numb pain.
- Pelvic floor muscle therapy to improve bladder control.
Severe stage:
- Higher doses of medications such as Elmiron.
- Cyclosporine (an immunosuppressant, used with caution due to side effects).
- Sacral nerve stimulation implant to help manage bladder function.
- Cystoscopy with bladder dilation.
- Cauterization of Hunner’s ulcers (bladder lesions).
- Botulinum toxin injections into the bladder muscle to relax it.
- Surgical bladder augmentation.
- Cystectomy.
Important considerations:
- A treatment plan for interstitial cystitis is tailored to each patient’s specific symptoms and severity.
- Most treatments for IC involve a combination of lifestyle changes, medications, and physical therapy.
- Frequent monitoring by a healthcare professional is critical to assess the effectiveness of treatment and modify it as needed.
Read Also: Best Antibiotic for UTI in Females
References
- National Institute of Diabetes and Digestive and Kidney Diseases. (n.d.). Retrieved from Treatment of Interstitial Cystitis
- Parsons, C. L. (2015). PubMed. Retrieved from How does interstitial cystitis begin?
