Interstitial Cystitis: Symptoms, Diagnosis, and Management

Q: Interstitial Cystitis: Symptoms, Diagnosis, and Management

Hello： Are you taking any other medications? If not, I recommend that you increase your fluid intake, engage in moderate exercise, temporarily avoid alcoholic and spicy beverages, ensure you get enough sleep, and eat fruits. <br>If there is still no improvement, you can keep a re

Interstitial cystitis

Hello: I experience sharp pain in the right lower perineum about 1 to 2 times a day (I'm not sure if it's from the urethra or the vagina; I've seen a gynecologist who said everything is fine, and it might be nerve-related pain).
During the pain, I feel the urge to stay on the toilet and not get up, and the symptoms usually resolve on their own after about 1 to 2 hours.
Could this possibly be interstitial cystitis or overactive bladder? What can be done to improve this condition? Do I need to undergo further examinations? This symptom has been bothering me for six months, and I hope to find effective relief.

Amay, 40~49 year old female. Ask Date: 2017/06/08

Dr. Du Shixi reply Urology

Hello: Are you taking any other medications? If not, I recommend that you increase your fluid intake, engage in moderate exercise, temporarily avoid alcoholic and spicy beverages, ensure you get enough sleep, and eat fruits.
If there is still no improvement, you can keep a record for a week noting the times when you experience these symptoms and your urine output, which can be shared with a urologist for reference.
As for interstitial cystitis or overactive bladder syndrome, they do not seem very likely.
At the very least, a urinalysis is necessary.
Wishing you good health.

Reply Date: 2017/06/08

More Info

Interstitial cystitis (IC), also known as painful bladder syndrome, is a chronic condition characterized by bladder pressure, bladder pain, and sometimes pelvic pain. The symptoms can vary widely among individuals, making diagnosis and management challenging. Your description of experiencing intermittent pain in the right lower pelvic area, which lasts for about 1-2 hours and is associated with a strong urge to remain on the toilet, raises the possibility of IC or overactive bladder (OAB).

Symptoms of Interstitial Cystitis
The symptoms of IC can include:
- Chronic pelvic pain
- Pressure or discomfort in the bladder area
- Frequent urination (more than normal)
- Urgency to urinate
- Pain during sexual intercourse
- Painful urination
In some cases, symptoms may worsen during certain times, such as after consuming specific foods or beverages, or during menstrual cycles. The pain you describe, particularly if it is relieved after a period of time, aligns with the symptomatology of IC.

Diagnosis
Diagnosing IC typically involves a comprehensive approach, including:
1. Medical History: A detailed account of your symptoms, their duration, and any potential triggers.

2. Physical Examination: A pelvic exam may be performed to rule out other conditions.

3. Urinalysis: To check for infections or other abnormalities.

4. Cystoscopy: A procedure where a thin tube with a camera is inserted into the bladder to look for inflammation or other issues.

5. Bladder Diary: Keeping track of your urination patterns, fluid intake, and symptoms can help in diagnosis.

Given that you have already consulted with a physician and undergone examinations that ruled out other conditions, it may be beneficial to consider further diagnostic tests, such as cystoscopy, if your symptoms persist or worsen.

Management
Management of IC can be multifaceted and may include:
1. Dietary Changes: Identifying and avoiding foods or beverages that trigger symptoms (e.g., caffeine, alcohol, spicy foods).

2. Medications:
- Antihistamines: To reduce bladder inflammation.

- Pain relievers: To manage discomfort.

- Bladder instillations: Medications placed directly into the bladder to relieve symptoms.

3. Physical Therapy: Pelvic floor therapy can help alleviate pain and improve bladder function.

4. Behavioral Techniques: Bladder training and relaxation techniques can help manage urgency and frequency.

5. Alternative Therapies: Some patients find relief through acupuncture or herbal supplements, although these should be discussed with a healthcare provider.

Conclusion
Your symptoms, particularly the intermittent pain and urgency, could indeed be indicative of interstitial cystitis or overactive bladder. Given that this has been a persistent issue for six months, it would be advisable to follow up with a urologist who specializes in IC for a thorough evaluation and to discuss potential treatment options tailored to your specific situation. Early intervention can often lead to better management of symptoms and improved quality of life.
If you experience any new symptoms, such as significant changes in urination patterns, blood in urine, or worsening pain, it is crucial to seek medical attention promptly.

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