What Is The Difference Between Cystitis & Interstitial Cystitis?

  • Interstitial cystitis involves pain in the upper bladder, pelvis, and lower abdomen, frequent urination and its urgency, and sometimes urinary incontinence.(1)
  • A biopsy of the bladder should be done by observing the inside of the bladder.(2)
  • Interstitial cystitis is different from normal cystitis resulting from a bacterial infection in your bladder
  • Often normal cystitis and IC are misdiagnosed since both have similar symptoms(3)
  • There is no cure for IC, but improving your diet and urinary habits, pain-relieving medications, and pentosan compounds can help(4)

Difference Between Cystitis And Interstitial Cystitis?

The cause of common cystitis is a bacterial infection. Symptoms appear when bacteria that invade the urethra multiply in the bladder and cause inflammation. It is caused by a bacterial infection, so it can be treated by taking antibiotics. In most cases, common cystitis is caused by Escherichia coli infection.

On the other hand, the cause of interstitial cystitis has not yet been clarified. Symptoms appear when the stroma between the bladder epithelium and muscles becomes chronically inflamed, but the cause is unknown. 90% of patients with interstitial cystitis are women. Interstitial cystitis is a painful illness that has severe symptoms and interferes with daily life. It is also a disease that will worsen if left untreated.

The diagnosis of these two diseases is often mistaken. Interstitial cystitis is often taken as common cystitis due to similar symptoms and a lack of proper diagnostic guidelines for IC. While the cause of bladder inflammation is an infection in the case of common cystitis, the bladder inflammation in IC is due to unknown causes. It often affects middle-aged women, but it also affects men and children.(4)

The interstitial cystitis is a chronic inflammation of the bladder, whose causes remain unknown. It manifests as urinary disorders associated with pain in the lower abdomen.

Its diagnosis is complex and is mainly based on the elimination of other causes of urinary disorders. Similarly, medical management is difficult and consists essentially of relieving the symptoms.(1)

It is assumed that the cause is the dysfunction of the mucous membrane of the bladder and abnormal immune reaction, but it has not been clarified yet.

The main symptoms of interstitial cystitis include frequent urination, increased urgency (strong desire to urinate), urgent need to urinate, bladder discomfort, and bladder pain. Bladder discomfort and pain tend to worsen when urine accumulates in the bladder and is characterized by insufficient retention of urine. In addition to increasing the number of toilet visits, pain in the bladder will greatly affect daily life.(2)

Diagnosis Of Interstitial Cystitis

In diagnosing interstitial cystitis, interviews are used to confirm symptoms and cystoscopy (endoscopy to observe inside the bladder) to see if other similar diseases can be ruled out.

The reddish mucous membrane is common in interstitial cystitis. Patients with interstitial cystitis have difficulty retaining enough urine and keep their bladder from expanding. Therefore, if you fill the bladder with water, dilate it, and drain it, you will see punctate bleeding from the bladder mucosa.(3)

Treatment For Interstitial Cystitis

There is no specific treatment provision. Symptomatic treatment options are the main options. However, you may try reducing the IC flare by changing your meals, by stress reduction and exercise of pelvic floor muscles. Another good option is undergoing bladder training. There are some pain medicines, antiallergic drugs, and anti-inflammatory medications showing good outcomes in relieving the pain and discomfort of interstitial cystitis. Occasionally surgery is performed if other treatments do not help.

Treatment of interstitial cystitis is effective in up to 90% of patients, but complete elimination of symptoms is rare. Doctors encourage patients to be aware of the factors that trigger the symptoms of interstitial cystitis.

Occasionally, the area near the spinal cord (nerve root) that controls the bladder is stimulated to try to reduce pain and urgency. Another possible option is to expand the bladder with a liquid or gas. This is a treatment called bladder dilatation, which may reduce symptoms.

Combination therapy is often given to promote relief. If the combination does not help, surgery may be tried.

The first step in treatment is a dietary change. Avoid spiced foods and foods high in potassium that can further irritate the bladder. You should also refrain from smoking and drinking.

Reducing stress and have pelvic floor muscle exercises that may help reduce symptoms.(5)(6)

References:

  1. Giusto LL, Zahner PM, Shoskes DA. An evaluation of the pharmacotherapy for interstitial cystitis. Expert opinion on pharmacotherapy. 2018;19(10):1097-1108.
  2. Birder LA. Pathophysiology of interstitial cystitis. International Journal of Urology. 2019;26:12-15.
  3. Patnaik SS, Laganà AS, Vitale SG, et al. Etiology, pathophysiology and biomarkers of interstitial cystitis/painful bladder syndrome. Archives of gynecology and obstetrics. 2017;295(6):1341-1359.
  4. Homma Y. Interstitial cystitis, bladder pain syndrome, hypersensitive bladder, and interstitial cystitis/bladder pain syndrome–clarification of definitions and relationships. International Journal of Urology. 2019;26:20-24.
  5. Hsieh C-H, Chang S-T, Hsieh C-J, et al. Treatment of interstitial cystitis with hydrodistention and bladder training. International Urogynecology Journal. 2008;19(10):1379-1384.
  6. Garzon S, Laganà AS, Casarin J, et al. An update on treatment options for interstitial cystitis. Menopausal Review/Przeglad Menopauzalny. 2020;19(1).

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