Bladder Pain, Cystitis and Interstitial Cystitis (IC)
The Bladder is a hollow organ located in the lower part of the abdomen which stores urine – the waste produced by the kidneys which passes into the bladder through a small tube – the urethra.
- Bladder Pain and Interstitial Cystitis
- Bacterial Cystitis
- Testing for Cystitis
- Treatment for Cystitis
Cystitis is a bacterial infection of the bladder. It is very common, with an estimated 50 to 70 per cent of women developing this infection at least once during their lifetime.
Interstitial Cystitis (IC) is also referred to as Painful Bladder Syndrome is a chronic inflammatory condition of the bladder, also known as hypersensitive bladder. Unlike bacterial cystitis, it is not caused by common bacteria, and does not respond to traditional antibiotic treatment. IC is not stress-related. Pain can be also felt not only around the bladder, but also in the lower back, abdomen, anus, genitals and above the pubic bone area.
- Burning sensation or pain when passing urine
- Strong odour from urine
- Cloudy urine
- Frequent urination
- Pain directly above the public bone
Other symptoms can include:
- Blood in urine
- Mild fever and chills
- Pain during sexual intercourse
- Penile pain
- Dull pain in the lower back or abdomen
- Fatigue and generally feeling unwell
However, it is possible to have cystitis without developing any symptoms.
It is also important to note that although in most cases, mild cystitis can be successfully treated with a course of antibiotics, recurrent cystitis left untreated can lead to serious complications.
The severity of the condition varies – it can be fairly mild thorough to severe, when the patient experiences chronic pelvic pain. Symptoms can vary significantly amongst sufferers, with no two people experiencing the same combination or severity of the symptoms detailed below:
- Frequency – The need to urinate very regularly, day and/or night. In extreme cases it has been known to need to urinate up to 60 times in a day. In early or very mild cases, frequency is sometimes the only symptom, with urinating in excess of 8 times a day and twice in the night. Frequency to urinate can be linked to stress/ anxiety, travel and sexual intercourse.
- Urgency – The sudden urge to urinate can cause excruciating pain. The need to urinate immediately may also be accompanied by abdominal pain, pressure or spasms.
- Pain – Pain can be so extreme that it can wake the sufferer up in the night and can be in the abdominal, urethral or vaginal area. Pain can be aggravated by stress/ anxiety, travel and sexual intercourse.
IC most commonly affects women, however it can also be found in men regardless of age or race. Risk factors can include having another member of the family being diagnosed with IC, and undergoing pelvic/ abdominal surgery prior to having any bladder pain related symptoms.
In 1999, The Cystitis and Overactive Bladder (COB) Foundation, a UK charity and patients support group, conducted a survey of its members where 64% of its members took part in the survey. The survey confirmed what the charity had suspected since it was established in 1994, that IC affects not just post-menopausal women only, which had always been believed, but also younger women and men, impacting significantly on their everyday lives and sexual relationships. The survey also showed that on average it took 6 years for the average person to be suffering with symptoms before receiving a diagnosis.
The survey also highlighted that sufferers of IC also had other medical conditions, with Back Pain, Arthritis, Irritable Bowel Syndrome, Bacterial Cystitis, Thrush and Sinusitis being cited by survery participants.
How does IC affect a sufferer’s life?
Bladder Pain Syndrome/ IC affects people in very different ways. Unfortunately there are no standard common symptoms for IC, but the way the condition can affect an individual’s day to day life cannot be underestimated enough, with sufferers having difficulty in performing daily tasks which we all take for granted, such as shopping, leisure activities, housework and shopping The condition is often debilitating and may cause the sufferer to experience feelings of depression, anxiety, difficulty in concentrating, insomnia and extreme fatigue (Source- The Cystitis and Overactive Bladder Foundation).
The majority of sufferers find that their life revolves around constantly having to find out where the nearest toilet facilities are. Therefore, any trip away from home requires careful consideration and planning and as a consequence some sufferers of IC can find themselves almost housebound. Obviously this can lead to other problems such as social isolation and depression. Severe tiredness can also occur if the sufferer has to get up repeatedly during the night to go to the toilet. Sufferers may also be in constant pain which can have a detrimental effect on their relationships and working lives. Pain is often only relieved when actually emptying the bladder and is therefore only momentary.
A large number of sufferers find that certain foods, drink and even clothing can aggravate their condition and their diet can become very restricted.
The most common cause of cystitis is infection from bacteria. Women are affected more often than men because in women the urethra – the tube which passes urine out from the bladder – is shorter than in men and more easily contaminated by bacteria from the bowel. Cystitis can also occur in men and children. This is usually due to problems with the urinary function or abnormalities in anatomy.
Cystitis can also be introduced into the urinary system for other reasons, for example:
- Prostate – In men, an enlarged prostate prevents the bladder from emptying completely.
- Kidney/bladder stones – These prevent the bladder from emptying completely.
- Sexual activity – Sexual intercourse can introduce bacteria to the urethra and bladder, or cause bruising.
- Sexually transmitted diseases – Infections such as chlamydia and gonorrhoea can cause symptoms similar to cystitis, particularly when they are present in young, sexually active men.
- Catheters – During catheterisation, urethra or bladder can become damaged, which can increase the risk of infection.
- Postmenopausal changes – Decreasing hormone levels in postmenopausal women result in changes within the body which can result in increasing episodes of cystitis.
- Diabetes – The urine of diabetics can contain increased levels of sugar which can encourage bacteria to grow. The bladder may also be affected by diabetes, preventing it from contracting and therefore not emptying completely which can encourage bacteria to grow.
- Irritants – Everyday household and hygiene products, for example deodorants, shower gels can cause irritation to the urethra and bladder.
Testing for cystitis
In most cases, a simple urine test can be undertaken to detect whether bacteria causing cystitis is present. If the condition is recurrent and/or accompanied by serious complications such as fever, it is important that an ultrasound scan of the kidneys is undertaken. This is to check for any abnormalities and ensure the bladder is being correctly emptied. For patients with recurrent cystitis you my need a telescopic examination of the bladder called a cystoscopy, which is a procedure in which a doctor inserts a lighted instrument, called a cystoscope, into the urethra in order to examine the inside of the urethra and the bladder.
The cystoscope is as thin as a pencil and has lenses like a telescope or microscope. These lenses let the doctor focus on the inner surfaces of the urinary tract. The images are transferred to a camera and a monitor system with option for you to watch the procedure if you wish.
The cause of IC is not fully understood. It may be triggered by a rare organism, or may be related to abnormalities in the nerve endings or the lining of the bladder. Sufferers of IC often spend a long period being treated with conventional antibiotics for cystitis without success, before being diagnosed with IC.
The condition is diagnosed by a number of different tests – it is necessary to rule out other causes of bladder problems before establishing IC as the cause of problems. Therefore patients will need to undergo a urodynamics test and cystoscopy.
However, effective treatments for IC are available. The symptoms of IC can be controlled with what is known as Bladder Installation Therapy when a combination of medication in a liquid solution is flushed into th bladder. To find out about a patient’s experience of IC visit our testimonials.