During my many years of pediatric practice, I saw and treated my many patients - especially young girls - with urinary tract infections. Often these infections would respond to a short course of an antibacterial drug. Yet, when children continued to be troubled by recurrent infections, I would refer them to a urologist for examination and further therapy.
After becoming interested in adults with complex health problems, I began to receive letters and phone calls from women who were troubled by repeated bladder problems.
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The occasional bout of cystitis or a bacterial bladder infection can usually be cleared up with a course of antibiotics with few long-term consequences.
Interstitial cystitis is a quite different condition: It's a painful, chronic inflammation of the bladder. Its origin is unknown, but we do know that it's not caused by bacteria. We also know it is not caused by stress, and it is not a psychosomatic disorder.
Patients with severe IC may experience a need to urinate as many as 60 times a day. That frequency may be the only symptom, or others may develop:
- Urgency - The need to urinate immediately, sometimes accompanied by pain, pressure or spasms.
- Pain - This may be lower abdominal pain or discomfort in the urethral or vaginal areas. There is often pain with intercourse.
- Women's symptoms often worsen during menstruation.
Interestingly, a recent study published in the Journal of Urology says that 10% of women with IC also have vulvodynia.
Of even more interest: In 1997, researchers at Temple University in Philadelphia found that people with interstitial cystititis often had other chronic conditions:
- more than 40% had allergies
- 25% had irritable bowel syndrome
- 22% had sensitive skin
- a significant percentage had the following chronic conditions:
- fibromyalgia
- migraine
- endometriosis
- chronic fatigue and immune deficiency syndrome
- asthma
- 100 times more likely than the general population to have inflammatory bowel disease
- 30 times more likely to have systemic lupus erythematosus (an autoimmune disease)
This suggests to me that IC may be part of the universe of symptoms of chronic yeast overgrowth. I spoke with Phillip Mosbaugh, M.D., an Indianapolis urologist who has for years used an anti-yeast regimen to treat some of his patients who have not responded to conventional IC therapy.
He said, "I think there's a subset of patients that have the diagnosis of IC along with fibromyalgia, irritable bowel syndrome, chronic fatigue syndrome, migraines, chemical allergies, etc., and candida is part of that. Not everybody gets better, but some did, and some did very well."
The Interstitial Cystitis Foundation's (ICF) newsletter underscores the severity of the problem for its victims: Epidemiological studies reveal that:
- It takes on average 5-7 years to get diagnosed, and sometimes even longer.
- The quality of life of IC patients has been shown to be worse than that of patients undergoing dialysis for end-stage renal disease.
- Economic impact is estimated to be $1.7 billion per year when combining medical expenses and lost wages due to inability to work.
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DIAGNOSIS
The National Institute of Diabetes, Digestive and Kidney Diseases (NIDDK) of the National Institutes of Health says since there is no test to definitively diagnose IC, it is usually diagnosed by ruling out other urological problems. These can include urinary tract or vaginal infections, bladder cancer, bladder inflammation or infection caused by radiation to the pelvic area, other types of cystitis, kidney stones, endometriosis, neurological disorders, sexually transmitted diseases, low-count bacteria in the urine and, in men, prostatitis.
These other conditions can sometimes be identified by a variety of laboratory tests. Frequently, cystoscopy (the insertion of an instrument to look inside the bladder) under anesthesia is necessary. This test can give an idea of bladder capacity and bladder wall inflammation or other abnormalities of the bladder wall that may help with a diagnosis. To find out more, you can check out How Do I Get Yeast Infections.