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Aug 26, 2006
Most common causes of inflamed bladder
by SirGan
 Inflamed bladder could be very serious problem and the condition is medically called the interstitial cystitis, or painful bladder syndrome (PBS). Everyone should know that interstitial cystitis is a condition that results in recurring discomfort or pain in the bladder and the surrounding pelvic region. Problem is that the symptoms vary from case to case and even in the same individual with time. People may experience mild discomfort, pressure, tenderness, or intense pain in the bladder and pelvic area. Most of the female patients reported that theirs symptoms often get worse during menstruation. They may sometimes experience pain with vaginal intercourse. Several experts now believe that it is not one, but several diseases because the disease varies so much in symptoms and severity. People with severe cases of inflamed bladder may even urinate as many as 60 times a day, including frequent nighttime urination (nocturia). Although there's no treatment that completely eliminates the signs and symptoms of interstitial cystitis, a number of medications and therapies offer pretty good relief.Incidence of the conditionSeveral researches found that interstitial cystitis affects between 700,000 and 1 million Americans. Problem is that this disorder can have a long-lasting adverse impact on quality of life. Several researches done in the past have shown that interstitial cystitis is far more common in women than in men. Of the estimated 1 million Americans with these bladder problems, up to 90 percent are women.
Possible causes of these bladder problemsThe fact is that no experts really knows what causes this condition, although there are many theories. Some of the most common theories are that, for example- interstitial cystitis is an autoimmune, hereditary, infectious or allergic condition, but none has been proved. Although the fact is that some of the symptoms of this disease are similar to those of bacterial infection- medical tests reveal no organisms in the urine of patients.
Diet
There is no scientific evidence linking diet to interstitial cystitis, but many doctors and patients find that alcohol, tomatoes, spices, chocolate, caffeinated and citrus beverages, and high-acid foods may contribute to bladder irritation and inflammation.
Smoking
Many patients feel that smoking makes their symptoms worse.
Possible symptoms of the conditionAlthough symptoms vary significantly among patients- people with interstitial cystitis may have some of the common following symptoms:
In many women, the symptoms get worse before their menstrual period.
Risk factorsThere are several risk factors which are associated with a higher risk of interstitial cystitis. Some of the most common are:
Diagnosis of the conditionEveryone should know that it can be difficult to detect interstitial cystitis because signs and symptoms resemble those of many other disorders.
First step in diagnosis of interstitial cystitis should be taking medical history and ask a patient to describe symptoms.
Well, the fact is that examining urine under a microscope and culturing the urine can detect and identify the primary organisms that are known to infect the urinary tract and that may cause symptoms. It is done very easily! The patient washes the genital area before collecting urine middle stream in a sterile bottle. What are the results? Well, white and red blood cells and bacteria in the urine may indicate an infection of the urinary tract, which can be treated with an antibiotic.
Everyone should know that a test sometimes used to rule out other causes of bladder pain is cystoscopy which involves an examination of bladder through a thin tube with a tiny camera – an instrument called the cystoscope. Patients should know that this procedure is generally performed with general or regional anesthetics to reduce discomfort. During cystoscopy under anesthesia, a sample of tissue may be removed from the bladder and the urethra for examination under a microscope. This is to check for bladder cancer and other rare causes of bladder pain.
A biopsy is a tissue sample that can be examined under a microscope.
Possible complicationsEvery patient should know that interstitial cystitis can result in a number of complications, including:
TreatmentUnfortunately- there is no simple treatment to eliminate the signs and symptoms of interstitial cystitis, and no one treatment works for everyone.
MedicationsMost commonly doctors are prescribing an oral medication called pentosan (Elmiron). Elmiron is the only oral drug approved by the FDA specifically for interstitial cystitis. Funny thing is that no one really knows how it works. Some experts are saying that it may be working by restoring the inner surface of the bladder, which protects the bladder wall from substances in urine that could irritate it. It may take two to four months before a patient begin to feel pain relief and up to six months to experience a decrease in urinary frequency. There are also several possible side effects such as minor gastrointestinal disturbances and possible hair loss. Not for use by pregnant women, Elmiron may cause bleeding and loss of pregnancy.
Other oral medications that may improve the signs and symptoms of interstitial cystitis include ibuprofen (Advil, Motrin, others) and other nonsteroidal pain medications. Tricyclic antidepressants, such as amitriptyline or imipramine (Tofranil), may help relax bladder and block pain.
Nerve root modulationNot too many people know that the sacral nerves, which run from lower spinal cord to bladder, pelvic floor and lower bowel, are important nerves for bladder and bowel control. A method of nerve stimulation called sacral nerve root modulation can be very helpful for people with interstitial cystitis. It is easily done- a small wire is placed next to the sacral nerves to determine if bladder symptoms will respond to neuromodulation. If the results are positive- a small operated device with battery in it- is surgically implanted in patient’s upper buttocks.
Bladder distentionIt is proven that some patients notice a temporary improvement in symptoms after undergoing cystoscopy with bladder distention- stretching of the bladder with water or gas.
Medications instilled into the bladderAlthough this is very old method if treatment – it is still considered very helpful! The prescription medication dimethyl sulfoxide, or DMSO, is placed into bladder through a thin, flexible tube. The solution sometimes is mixed with other medications, such as a local anesthetic or bicarbonate, to change the pH levels of the DMSO. After remaining in the bladder for 15 minutes, the solution is expelled through urination. Big problem is that DMSO can affect patient’s liver.
SurgeryIt is important to point out that doctors rarely use surgery to treat interstitial cystitis because removal of part or the entire bladder doesn't relieve pain. Beside that-it can lead several other complications. Surgical options include:
Everyone should know that in this procedure, surgeons remove the damaged portion of bladder and replace it with a piece of colon, but the pain still remains and most women need to empty their bladders with a catheter multiple times a day.
This is one minimally invasive method which involves insertion of instruments through the urethra to burn off ulcers that may be present with interstitial cystitis.
Another minimally invasive method also involves insertion of instruments through the urethra to cut around any ulcers.
Useful diet habitsThe foundation of therapy is a modification of diet to help patients avoid those foods which can will further irritate the damaged bladder wall. Common bad diet habits include coffees, teas, herbal teas, green teas, all sodas, concentrated fruit juices, multivitamins, monosodium glutamate, chocolate, and potassium-rich foods such as bananas. So, when the patient cuts out all foods except the basics and then introduces new foods one at a time- it is the best way to find out your triggers!
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