Interstitial cystitis or IC is a condition of your bladder leading to pelvic pain(1)
There are no connections established between autoimmune disease and interstitial cystitis(2)
But autoimmune conditions related to the bladder can be secondary comorbidity of IC(3)
IC is not caused by stress, it may aggravate the symptoms(4)
Both mental and physical stress may flare up your IC symptoms(4)
Is Interstitial Cystitis An Autoimmune Disease?
Interstitial cystitis is a chronic condition affecting your bladder, the cause of which is still not known. Autoantibodies, for instance, antibodies against bladder and nuclear epithelial antigens, were located in IC patients, but it is more likely to be secondary to this condition. So, to date, there is no evidence of IC being an autoimmune disease.(2) (3)
Can Stress/Anxiety Cause Interstitial Cystitis?
It is often noticed that interstitial cystitis (and other forms of pelvic pain) and anxiety are interrelated. So, if you are feeling depressed due to pain caused by interstitial cystitis, it is important to reduce the stress as far as feasible. IC is not caused by stress, but it can aggravate your condition. Both mental and physical stress may increase IC symptoms. Stop worrying about the discomforts as they will get better and worrying will only make the discomforts to last longer.(4)
At one time, interstitial cystitis was considered a relatively rare disease. However, it is now believed that this illness is more prevalent than it once was, and maybe causing other issues such as long-term pelvic pain. Adult men & children can also develop interstitial cystitis, but about 90% occur in adult females.
The cause of interstitial cystitis is not known, but it is suspected that the cells lining the bladder are damaged, resulting in substances in the urine stimulating the bladder. Mast Cells that are normally involved in allergy might be involved in bladder changes, but their specific role has not been clarified.(1)
Symptoms Of Interstitial Cystitis
Even with interstitial cystitis, there may be no symptoms at first. The signs usually appear gradually & get worse as the bladder wall is damaged over the years. Pain and pressure can be felt in the bladder, pelvis, and lower abdomen. Patients also often feel an urgent need to urinate, often occurring many times an hour. Signs get worse when the bladder is full and less after urinating. In very severe cases, you may sit in the toilet for hours and continue to urinate little by little.
Symptoms may be exacerbated by ovulation and menstruation, seasonal allergies, physical or mental stress, and sexual intercourse. High potassium foods like citrus, chocolate, caffeine drinks, tomatoes, etc. tobacco, spicy foods, & alcohol can also aggravate the symptoms.(1)
Diagnosis Of Interstitial Cystitis
Physical evaluation by a doctor
Cystoscopy with or without biopsy
Interstitial cystitis is suspected from the symptoms. The doctor will have a comprehensive consultation, which often includes a pelvic examination (for women) and a digital rectal exam. Testing should be done to make sure the symptoms are not due to other causes. For example, a urine test and a urine culture test to check for urinary tract infections.
The bladder is examined using an endoscope and the mucosa of the bladder is observed. Sometimes, a bladder biopsy is done at the same time to rule out the possibility of cancer.
Occasionally, a liquid containing potassium is infused directly into the bladder to see how the bladder mucosa responds to potassium and other potential irritants.
Treatment For Interstitial Cystitis
Symptomatic treatment for interstitial cystitis is important. Relief of mental stress, dietary instruction (avoiding acidic drinks, coffee, spices, alcohol, citrus, etc.), regular urination (timed urine before bladder filling), and bladder training (collecting urine in the bladder) is effective in alleviating symptoms.
Regarding water intake, if urine is concentrated due to water suppression, the symptoms may worsen, so it is rather important to ensure the generation of a certain amount of urine by ingesting an appropriate amount of water.
As an internal medicine, analgesics, antidepressants, anti-allergic agents, immune-suppressants, etc. are used. Bladder dilatation is widely used as an endoscopic treatment, and dilation of the bladder may reduce symptoms.
Radical cystectomy and urinary diversion are rarely performed in patients who are refractory to any treatment and have severe symptoms.(5)
- 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.
- Duh K, Funaro MG, DeGouveia W, et al. Crosstalk between the immune system and neural pathways in interstitial cystitis/bladder pain syndrome. Discovery medicine. 2018;25(139):243-250.
- Wen JY, Lo TS, Chuang YC, et al. Risks of interstitial cystitis among patients with systemic lupus erythematosus: A population‐based cohort study. International Journal of Urology. 2019;26(9):897-902.
- Birder LA. Pathophysiology of interstitial cystitis. International Journal of Urology. 2019;26:12-15.
- 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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