Interstitial Cystitis: Symptoms, Treatments, and Insights

Urethral cystitis

Hello doctor, a few years ago I underwent a colonoscopy and since then I have been unable to have normal bowel movements without using enemas.
After a while, I started experiencing severe bladder pain.
Initially, I didn't know what the problem was, and I was seeing a family physician for irritable bowel syndrome for some time.
It wasn't until I noticed significant bleeding during bowel movements that I realized I had urethral cystitis.
Since then, I have been continuously monitored and have taken antibiotics, but I still experience inflammation every month.
It improves this month, but after my menstrual period, it flares up again [sometimes with bleeding].
I take antibiotics, but sometimes the medications prescribed by my doctor still cause pain, and I occasionally feel pain in my lower back [I don't know why; I have mentioned this to my doctor].
My urine protein levels are very high, and my doctor suggested I take cranberry supplements, but I feel they are ineffective.
I wonder if my frequent use of enemas contributed to the ongoing inflammation, as I had no such issues before the colonoscopy.
I still have this problem, and I previously read a report about a woman who took a long time to be diagnosed with interstitial cystitis.
I would like to ask the doctor if I might have this condition.
I also saw a talk show where a doctor mentioned that eating watermelon and lotus root could help.
Another doctor told me that if I can't manage my symptoms with medication, I should undergo another endoscopy, which terrified me.
I'm very afraid to hear that.
I'm worried that even after the procedure, the situation will remain the same.

Tang Tang, 30~39 year old female. Ask Date: 2012/05/30

Dr. Jiang Yini reply Urology

It is recommended to consult with a gynecologist and a urologist.
Please rely on the physician's professional judgment and assessment, and discuss your upcoming examinations and treatments with them.
Thank you!

Reply Date: 2012/05/30

More Info

Interstitial cystitis (IC), also known as painful bladder syndrome, is a chronic condition characterized by bladder pain, urgency, and frequency of urination. The symptoms can significantly impact a person's quality of life, and the exact cause of IC is still not fully understood. It is essential to differentiate IC from urinary tract infections (UTIs) and other bladder conditions, as the treatment approaches can vary significantly.

From your description, it seems you have been experiencing a range of gastrointestinal and urinary symptoms following a colonoscopy. The onset of your bladder pain and the need for enemas could suggest a complex interplay between your gastrointestinal and urinary systems. It's not uncommon for individuals with gastrointestinal issues, such as irritable bowel syndrome (IBS), to also experience bladder symptoms, as the two systems are closely linked through the pelvic floor and nervous system.

The symptoms of interstitial cystitis can include:
1. Pelvic Pain: This is often the most debilitating symptom, and it can vary in intensity. Pain may be felt in the bladder, lower abdomen, or pelvic area.

2. Increased Urgency: A frequent and urgent need to urinate, often with little urine output.

3. Frequent Urination: Many individuals with IC may urinate more than 10 times a day and may wake up several times at night to urinate.

4. Pain During Intercourse: Some women report discomfort during sexual activity.

5. Flare-ups: Symptoms can worsen during certain times, such as during menstruation or after certain foods.

Given your history of recurrent urinary tract infections and the presence of blood in your urine, it is crucial to consult with a urologist who specializes in interstitial cystitis. They may perform a series of tests, including urine cultures, cystoscopy, and bladder biopsies, to rule out other conditions and confirm a diagnosis of IC.

Treatment for interstitial cystitis can be multifaceted and may include:
1. Dietary Modifications: Some patients find relief by avoiding certain foods and beverages that can irritate the bladder, such as caffeine, alcohol, spicy foods, and acidic fruits.

2. Medications: While antibiotics are used for UTIs, they may not be effective for IC. Medications such as pentosan polysulfate sodium (Elmiron) can help protect the bladder lining. Antihistamines and pain relievers may also be prescribed to manage symptoms.

3. Bladder Instillations: This involves placing medication directly into the bladder to reduce inflammation and pain.

4. Physical Therapy: Pelvic floor physical therapy can help address muscle tension and pain in the pelvic area.

5. Lifestyle Changes: Stress management techniques, such as mindfulness and relaxation exercises, can also be beneficial.

Regarding your concerns about undergoing another cystoscopy, it is understandable to feel anxious. However, this procedure is often necessary to obtain a definitive diagnosis and to rule out other potential issues, such as bladder cancer or severe infections. Discuss your fears with your healthcare provider; they can provide reassurance and explain the benefits of the procedure.

In conclusion, interstitial cystitis is a challenging condition that requires a comprehensive approach to management. It is essential to work closely with your healthcare team to develop a personalized treatment plan that addresses both your urinary and gastrointestinal symptoms. If you suspect you may have IC, seeking a specialist's opinion is a crucial step toward finding relief and improving your quality of life.

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