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Cystitis

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Interstitial cystitis is a recurrent, chronic, bladder problem that often causes pain and urinary discomfort, as well as renders the patient into a state of chronic urinary need. Often mistaken for urinary tract infections or painful bladder syndromes by patients, cystitis is one of the more common chronic urinary problems faced by Americans. It can often lead to embarrassing moments of incontinence, interrupted sleep patterns, and painful bladder cramping.

A few children and men have experienced the chronic discomfort of cystitis, but over 90% of case belong to women. The long lasting adverse effects on the quality of a patient’s life often send patients to their physician in hopes that another round of antibiotics may help. Because it is not a bacterial infection, antibiotics are useless. Many patients will experience periods of remission. However, there is no cure for interstitial cystitis. Programs, therapies, and medications are all aimed at improving bladder control and improving the quality of a patient’s life.

CYSTITIS SYMPTOMS

There are a wide variety of symptoms, in random combinations, that may or may not affect individual patients. Sometimes one patient has all the symptoms while others have only one or two. Other patients may experience different symptoms at different times, depending on the state of their cystitis aggravation.

Symptoms may include a chronic need to urinate, frequent urination that yields only small amounts of urine but leaves the patient feeling as though they still have to urinate, pelvic pain or pain between the vagina and the anus known as suprapubic pain, pelvic pain during sexual intercourse, painful ejaculations in males, and chronic pain. The symptoms associated with interstitial cystitis are very similar to those with a chronic urinary tract infection. Urine cultures, however, will come back negative time and again.

CYSTITIS CAUSES

The cause of interstitial cystitis is relatively simple and somewhat mysterious. The bladder is a hollow balloon like organ that fills with fluid as a waste material. As the bladder fills, it sends a message to the brain that tells the human it is time to urinate. Patients afflicted with cystitis receive mixed signals to the brain. The bladder sends the message indicating the need for urination almost constantly, which results in small amounts of urine production. Why these signals get confused is a mystery. Sometimes even during the act of urination the bladder still sends the signal that urination is required. Some patients will find themselves trying to urinate right after they have finished urinating, leading to a frustrating cycle that prevents them from being able to satisfy their urge or to confidently walk away from the toilet.
cystitis
Image: Cystitis


There has been evidence to suggest that patients with interstitial cystitis also may have a small tear or defect in the lining of the bladder’s epithelium. This may create a situation for chronic irritation and even infection to develop as toxic substances leak through the lining. In cases like these, diagnosis is even more difficult because antibiotics clear up any infection, which takes care of about ½ of the symptoms.

There are theories regarding additional possible sources of interstitial cystitis such as autoimmune deficiencies, hereditary issues, infections, and allergic reactions. However, these causes are still theoretical and none of it has been proven.

CYSTITIS RISK FACTOR

Risk factors for interstitial cystitis include gender (females are most often affected while males are rarely affected,) age, and additional chronic disorders. Most patients receive their diagnosis between the ages of 30 and 40. Patients with irritable bowel syndrome and fibromyalgia are also more likely to suffer from interstitial cystitis.

CYSTITIS DIAGNOSIS

Diagnosis of interstitial cystitis is usually complicated and a rather long process. Like many diseases, it reflects the symptoms of other disorders that can easily be confused. There are some tests that can help determine whether interstitial cystitis is the cause of the physical discomfort including urine tests to rule out infections, potassium sensitivity tests, cystoscopy to rule out other possible causes of pain, and even the occasional biopsy.

CYSTITIS TREATMENT

Cystitis often affects personal relationships, intimacy, and leads to depression. The general quality of life suffers from a chronic need to urinate and the chronic pain suffered by the victims.

Nerve stimulation using a TENS unit has helped some patients regain control over their bladder and reduce pain. Oral medications aimed at relieving the chronic need to urinate and reduce pain have also helped some patients reclaim their life. A surgical procedure called a bladder distention can offer temporary relief from symptoms. In rare cases, surgical options such as partial or total removal of the bladder may help, but not always. Physicians rarely take this route and it is not recommended unless all other forms of therapy have failed to change even a small portion of the problem.
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