Interstitial cystitis is a condition affecting about one million people in the United States. Although it affects both men and women, it is more common in women. The symptoms of interstitial cystitis are so varied between patients, and even within a patient, that diagnosis is difficult. The cause of interstitial cystitis is not exactly known, but there are several theories linking the condition to some skin conditions, and further research in these areas may help to shed light on not only the cause but also on treatment options.
Types
Since the symptoms are so varied and generalized, many doctors believe that interstitial cystitis could actually be several disorders instead of one disease. There are two types of interstitial cystitis, ulcerative and non-ulcerative. About 10 percent of the patients have star-shaped ulcers on the bladder wall. All those who suffer from interstitial cystitis are likely to sustain damage to the bladder wall due to the chronic inflammation. This is one factor supporting evidence that interstitial cystitis is related to an allergic skin condition.
Symptoms
The symptoms of interstitial cystitis are very similar to a bladder or urinary tract infection. In fact, it is usually diagnosed when the symptoms are present, but there is no evidence of a bacterial infection. These symptoms include urinating frequently, a feeling a urinary urgency, pressure or pain or tenderness in the pelvic region and painful sexual intercourse.
The symptoms may subside at times and become worse or flare up at other times. As for many conditions, stress may be a trigger for a flare-up, and for women the symptoms may become worse during menstruation.
Related Conditions
The three most common diseases in patients with interstitial cystitis are sensitive skin, allergies and irritable bowel syndrome. In fact, many patients complain of having dry, itchy skin.
Patients with interstitial cystitis are more likely than the general population to have one or more of the following conditions: endometriosis, chronic fatigue syndrome, rheumatoid arthritis, fibromyalgia, inflammatory bowel disease and systemic lupus erythematous. There is no evidence that interstitial cystitis is caused by any of these conditions.
Theories
The pain and discomfort felt by patients with interstitial cystitis is due to inflammation in the bladder wall. Cells known as mast cells, which are part of the body's response to inflammation, release a chemical called histamine. Histamine is also released in an allergic response, causing itching, swelling and redness. It is theorized that interstitial cystitis is a type of allergic reaction, but instead of on the skin, it is on the bladder wall. Some patients report that their interstitial cystitis symptoms are relieved when they take antihistamines for their allergies, which supports this theory.
Some doctors theorize that interstitial cystitis is caused by too much progesterone. Progesterone is a steroid hormone that is found in higher levels in women than in men (which may be why interstitial cystitis affects more women than men). There is a dermatological syndrome known as autoimmune progesterone dermatitis, which causes a skin rash, and it is thought that interstitial cystitis may be similar, only the rash is on the bladder wall.
Treatment
Oral medications may be prescribed to help control the symptoms, including ibuprofen for pain and antihistamines for related allergy reactions. There are also a variety of procedures that may help, including electrical nerve stimulation, bladder distention and bladder instillation. As with many conditions, diet and lifestyle have a profound effect on symptoms and the incidence of flare-ups.
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