An overview of chronic cystitis
Symptoms of chronic cystitis
Who does chronic cystitis impact?
Etiology of chronic cystitis
The long-term effects of chronic cystitis
Treatment of chronic cystitis
References
An overview of chronic cystitis
Chronic cystitis (interstitial cystitis, bladder pain syndrome, painful bladder syndrome ) is a condition that is generally poorly understood and results in pelvic pain and problems urinating. The condition is often characterized by the frequent and urgent need to urinate, as well as pain while urinating.
While a urinary tract infection (UTI) can usually be treated and resolved with antibiotics, chronic cystitis differs in that it is more challenging to diagnose and treat. The condition seriously impacts the quality of life, with research showing that living with chronic cystitis is comparable to living with kidney dialysis or suffering from chronic cancer pain. The illness, which causes chronic inflammation of the bladder, can cause a person to urinate more than 50 times a day, which can be painful and drastically alter a person’s day-to-day activities.
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Symptoms of chronic cystitis
The patterns of symptoms of chronic cystitis are often unique to the individual; however, symptoms may include pain in the pelvis or between the vagina and anus in women, pain between the scrotum and anus (perineum) in men, feeling of pressure on the bladder, needing to urinate frequently, urgently needing to urinate often, burning pain in the urethra, pain during intercourse, slight fever, bloody or cloudy urine,
Over time, symptoms can fluctuate, and it is not uncommon for symptoms to be more severe for a number of weeks, go through a period of improvement, and then flare again. Women may also find pain more intense during their period, and certain food and drinks can also impact pain levels.
The nature of chronic cystitis symptoms means that everyday life can be significantly impacted for sufferers. All aspects of life, such as work, relationships, and mental health, can be affected by chronic cystitis.
Who does chronic cystitis impact?
More women than men are affected by chronic cystitis. Figures estimate that around 3-6% of women in the US have the condition, equating to around 3 to 8 million women. It is believed that men account for just 10% of all chronic cystitis cases, although the prevalence of this condition in men is likely to be underestimated due to the tendency to mistake chronic cystitis with chronic prostatitis and chronic pelvic pain syndrome. However, it is still most common in women, particularly those over 30 years old.
Etiology of chronic cystitis
Currently, the exact etiology of chronic cystitis is unclear, which means there is no single effective treatment. Research has elucidated several possible theories regarding the underlying causes of chronic cystitis. For example, some scientists theorize that damage to the bladder lining is the root cause, while others believe that issues with pelvic floor muscles are more heavily implicated. Some studies have also shown that the immune system may play a role in chronic cystitis.
The long-term effects of chronic cystitis
Chronic cystitis can affect a person for many years, and it can have a significant impact on their life. Fortunately, it is not life-threatening and does not lead to bladder cancer.
Without diagnosis and access to treatment, people with chronic cystitis may find themselves in unnecessary pain, and the condition may be detrimental to their work lives, relationships, and sexual activity. Sometimes, normal social functioning can become challenging.
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Treatment of chronic cystitis
Currently, there is no cure for chronic cystitis. Several treatment options are available to treat the symptoms, but it is not a one-size-fits-all approach. A person may take one or a combination of the following treatments to find relief: oral medications such as Elmiron, antidepressants (e.g., tricyclics such as Elavil), anti-inflammatory drugs, antispasmodics, antihistamines, and muscle relaxants. Bladder instillations are another treatment option, and they involve filling the bladder with water while under general anesthetic to stretch it.
Adjustments to diet can also help control symptoms of chronic cystitis. Studies have shown that as many as 90% of people with chronic cystitis have sensitivities to a wide range of food and drink. Often, doctors recommend reducing or eliminating certain consumables that may exacerbate symptoms. Generally, it is advised that acidic foods (e.g., citrus fruits, tomatoes), spicy foods, coffee, tea, alcohol, carbonated drinks, artificial sweeteners, and vitamin C should be avoided or consumed immediately after taking calcium glycerophosphate and/or sodium bicarbonate, which has been shown to reduce the negative effects of consuming trigger foods.
Finally, self-help techniques are also popular in treating chronic cystitis. Stress reduction methods, visualization, biofeedback, bladder retraining, and exercise can improve quality of life and reduce the frequency and severity of symptom flare-ups.
As more research is conducted into chronic cystitis, we will likely gain more knowledge on the etiology of the illness. Hopefully, this should lead to effective disease-modifying therapies or a cure.
References:
- Bassaly, R., Downes, K. and Hart, S., 2011. Dietary Consumption Triggers in Interstitial Cystitis/Bladder Pain Syndrome Patients. Female Pelvic Medicine & Reconstructive Surgery, 17(1), pp.36-39. https://journals.lww.com/fpmrs/Abstract/2011/01000/Dietary_Consumption_Triggers_in_Interstitial.7.aspx
- Birder, L., 2019. Pathophysiology of interstitial cystitis. International Journal of Urology, 26(S1), pp.12-15. https://onlinelibrary.wiley.com/doi/full/10.1111/iju.13985
- Friedlander, J., Shorter, B. and Moldwin, R., 2012. Diet and its role in interstitial cystitis/bladder pain syndrome (IC/BPS) and comorbid conditions. BJU International, 109(11), pp.1584-1591. https://bjui-journals.onlinelibrary.wiley.com/doi/abs/10.1111/j.1464-410X.2011.10860.x
- Homma, Y., Akiyama, Y., Tomoe, H., Furuta, A., Ueda, T., Maeda, D., Lin, A., Kuo, H., Lee, M., Oh, S., Kim, J. and Lee, K., 2020. Clinical guidelines for interstitial cystitis/bladder pain syndrome. International Journal of Urology, 27(7), pp.578-589. https://onlinelibrary.wiley.com/doi/full/10.1111/iju.14234
Further Reading