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Interstitial Cystitis

What is Interstitial Cystitis (IC)?

  • Characterized by chronic urgency (feeling need to urinate) and frequency (frequent urinating) with or without pelvic pain
  • Cystitis refers to inflammation of the bladder
  • Bacterial cystitis refers to an infection in the bladder whereas in interstitial cystitis there are no infectious organisms identified
  • 90% of patients with IC are women
  • Average onset is age 40
  • Over time may cause damage to bladder wall causing scarring and stiffing of bladder wall leading to decreased bladder capacity

Causes

  • Exact cause is unknown
  • Some think that one of the layers of the bladder that helps protect the bladder from toxic substances in the urine, leaks allowing these substances to pass through and irritate the bladder wall itself

Signs and Symptoms

  • Signs and symptoms vary  greatly from person to person
  • May include urinary urgency, frequency, frequent urination at night, pain with bladder filling that is relieved with urination, feelings of pressure and pain around the bladder, painful intercourse or pelvic pain

Diagnosis

  • The symptoms of IC are similar to other disorders so testing may include a urinalysis, urine culture, potassium sensitivity test, cystoscopy, and biopsy of bladder wall
  • Potassium Sensitivity Test
  • The bladder is filled with a saline/potassium solution
  • The severity of the discomfort determines a positive or negative result
  • 78% of women with IC have a positive result
  • 2% of women without IC have a positive result

Treatment

  • The main oral medication helps repair the lining of the bladder
  • It takes a long time for this repair to occur
  • About 1/3 to 2/3 of patients will see an improvement in about 3 to 4 months
  • Most doctors will wait a year before determining if the medication is effective or not

Foods that may cause worsening of symptoms:

  • Fruits
  • Citrus fruits (oranges, grapefruits, lemons)
  • Apples
  • Apricots
  • Avocados
  • Bananas
  • Cantaloupes
  • Cranberries
  • Grapes
  • Nectarines
  • Peaches
  • Plums
  • Rhubarb
  • Strawberries
  • Caffeinated beverages
  • Chocolate
  • Alcoholic beverages (especially red wine)
  • Tomatoes and tomato sauces
  • Spicy foods
  • Carbonated beverages

Other foods and additives that may worsen symptoms:

  • Aspartame (NutraSweet)
  • Saccharine
  • Foods with artificial colors
  • Monosodium glutamate (MSG)
  • Citric acid
  • Cheeses (except American, cottage, cream, ricotta)
  • Sour cream
  • Yogurt
  • Chicken livers
  • Corned beef and other smoked meats
  • Pickled herring
  • Vinegar
  • Salad dressing mayonnaise
  • Lentils, lima beans, fava beans, soy beans
  • Nuts (almonds, pine nuts, and peanuts are ok)
  • Onions
  • Raisins, cranberries, prunes
  • Rye and sourdough bread
  • Soy sauce tea (some herbal teas are ok)

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