Do you also have frequent bladder pain? (Interstitial Cystitis/Bladder Pain Syndrome) - Let's talk about this!

Do you often feel pain or discomfort in your lower abdomen, where the bladder is located? Do you have a short, but frequent need to urinate ? If so, this is something that may be important to you. We call this condition "Interstitial Cystitis" or "Bladder Pain Syndrome" (BPS) . Simply put, this is chronic pain or discomfort in the bladder.

What is Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS)?

Simply put, interstitial cystitis is a condition where the "interstitial" in it means something that affects the spaces between our tissues or organs. "Cystitis" means inflammation. So, what happens is that there is pain that comes with some kind of inflammation in the walls of your bladder.

If you have IC/BPS, you may need to urinate more often (frequency) than normal. You may also feel a sudden need to urinate (urgency) . This is also called:

• Painful bladder syndrome
• Frequency-urgency-dysuria syndrome
• Chronic pelvic pain

There are two main types of IC/BPS.

Doctors divide this into two main types:

1. Ulcerative IC/BPS: In this, painful ulcers called "Hunner's ulcers" develop on the bladder wall. However, this is a bit rarer, affecting between 5% and 10% of people with IC/BPS.

2. Non-ulcerative IC/BPS: This is the most common type. About 90% of people with IC/BPS have this type. In this type, very small hemorrhages, similar to small bruises (glomerulations) , are seen in the bladder wall.

Think of it like your bladder is like a small balloon. It gets bigger as it fills with urine , and it gets smaller again when you urinate . Now, with IC/BPS, it's as if the lining inside that balloon is damaged and it becomes sensitive.

What is this "Stage 4" IC/BPS?

You may have heard of "Stage 4" IC/BPS. This is for people who have had ongoing symptoms of IC/BPS for more than two years. At this point, the bladder tissue becomes very stiff, so it can no longer hold as much urine as before. This condition is often seen in people with the aforementioned "Hunner's ulcers."

How common is this condition?

IC/BPS is actually a more common condition than you might think. For example, in the United States alone:

• Between 1 and 4 million men
• It is estimated that this condition affects between 3 and 8 million women.

This shows that this is something that is seen more often among women, but it can also develop in men.

What are the symptoms of IC/BPS?

The symptoms can vary from person to person. Some people may experience only mild discomfort , while others may experience severe pain . Also, these symptoms may be present all the time, or they may come and go from time to time.

These are the symptoms that are commonly seen:

• Bladder inflammation (cystitis)
• Pain in your lower abdomen, that is, in the area where your bladder is.
• Pressure or discomfort when the bladder fills with urine .
• Frequent urination and the sudden feeling of needing to urinate .
• Very little urine is released when urinating .

These symptoms may worsen during your monthly period, especially if you are a woman.

How does this feel?

This really feels different for everyone. Some people may just feel a slight heaviness or discomfort in their lower abdomen. Others may feel a sharp pain, like someone is squeezing them from the inside, or stabbing them with a knife. Along with this, the constant need to urinate , and the need to urinate again even after passing a small amount, is very annoying.

What are the causes of IC/BPS?

To be honest, doctors and medical researchers still haven't figured out the exact cause of IC/BPS. However, they suspect that it may be linked to some of the following medical conditions:

• Autoimmune diseases: That is, diseases in which our body's own immune system attacks our own cells.
• Allergies: Some people have allergies to various things.
• There are some defects in the lining of your bladder.
• Vascular disease / vasculopathy .
• Abnormalities in "mast cells", a type of cell that causes allergic symptoms.
• Having abnormal substances in your urine . For example, persistently high levels of protein in the urine (proteinuria) .
• Unidentified infections.

One or more of these factors may be contributing to this situation.

Who is affected the most by this situation?

Anyone can develop IC/BPS. However, you may be at higher risk of developing this condition if you:

• If a woman .
• Age 30 or olderIf someone.
• If you suffer from another medical condition that causes long-term pain (e.g. Irritable Bowel Syndrome, Fibromyalgia).

How to accurately diagnose IC/BPS? (Diagnosis)

There is no specific test that can tell you for sure if you have IC/BPS. However, a doctor will order several tests to make sure you don't have other infections or medical conditions. These tests may include:

• Medical history: Your doctor will ask you about your symptoms. You may be asked to keep a diary, including your symptoms, what you drink, how much you drink, and how much you urinate . This will help your doctor get a better idea of ​​your condition.
• Urinalysis / urine test: When you provide a urine sample, it is examined under a microscope to check for blood in the urine (hematuria) and signs of infection (bacteria, pus, white blood cells). If there is an infection, the doctor will prescribe antibiotics . If your urine does not contain an infection after treatment, but your symptoms persist, your doctor may suspect IC/BPS.
• Biopsy: This involves putting you under anesthesia (meaning you are asleep) and using a fine needle to take a small sample of tissue from the bladder wall and urethra. This is done to make sure there are no other serious conditions, such as bladder cancer.
• Cystoscopy: In this procedure, a doctor looks inside your urethra and bladder. This is done using a thin, flexible tube with a camera and light on one end (cystoscope) . This is inserted through your urethra and into your bladder. You usually don't need anesthesia for this procedure. However, if your doctor decides that a biopsy is needed along with the cystoscopy, you may be given anesthesia.
• Cystoscopy under anesthesia with hydrodistension: Sometimes doctors also do this test. During the cystoscopy, the bladder is filled with water and distended to its maximum size. This procedure can check for any injuries or tears in the bladder. It is painful, so it is done under anesthesia. However, many people find temporary relief from their IC/BPS symptoms after this.

How is IC/BPS treated?

The important thing is that IC/BPS cannot be completely cured . However, there are many treatments available. The main goal of treatment is to control your symptoms and provide you with relief.A doctor will talk to you and decide which treatment is best for you. Sometimes a combination of treatments may be used.

Doctors cannot predict how you will respond to any treatment. So, you may have to try different treatments and see how your body responds. Your symptoms may go away completely, or they may get worse. Even if your symptoms go away, they may come back later.

IC/BPS treatments may include:

Changes in your diet

Some people with IC/BPS say that certain foods and drinks trigger their symptoms. Therefore, it is important to keep a food diary of what you eat and drink throughout the day, and how much you eat and drink. By recording what you ate and drank before your symptoms started, or before a flare-up, you can identify and avoid foods that trigger your symptoms.

If you find that acidic foods and drinks (such as citrus fruits like lemons and oranges, chili peppers, carbonated drinks, tomatoes) make your symptoms worse, your doctor may recommend that you take an antacid with your meals. Antacids work by reducing the amount of acid in your urine .

What foods and drinks can be harmful if you have IC/BPS?

These are the foods and drinks that can generally worsen IC/BPS symptoms:

• Alcohol
• Artificial sweeteners
• Caffeine (found in tea and coffee)
• Carbonated beverages (like soda)
• Chocolate
• Tomatoes
• Fruit juices (especially those with high acidity)

A doctor may also refer you to a dietitian who can help you develop the best diet to reduce your IC/BPS symptoms.

Physical activity

Exercise and physical activity can help relieve symptoms of IC/BPS. These include:

• Walking
• Bicycling
• Gentle stretching or yoga

Reducing stress

Stress can cause flare-ups of IC/BPS symptoms. Therefore, learning to recognize and manage stress can help reduce your symptoms. Talking to a mental health counselor (psychotherapy) can help reduce stress.

Physical therapy

Your pelvic floor muscles are what hold your bladder in place and help you control your urination . Strengthening these muscles (Kegel exercises), stretching, and especially relaxing can help relieve symptoms of interstitial cystitis/bladder pain syndrome. A doctor can help make sure you are doing these exercises correctly. Many people work with a pelvic floor physical therapist to learn how to properly relax these muscles.

Bladder retraining

When you have bladder pain, it's easy to get into the habit of going to the bathroom as soon as you feel the pain or the urgent need to urinate, even if your bladder is not completely full. This will help your body get used to going to the bathroom more often. Bladder retraining involves training you to hold your urine for longer periods of time and breaking this habit.

To get used to this, keep a diary of how often you urinate and how often you feel the need to urinate . Using your diary, try to gradually increase the time between bathroom trips.

Oral medications

The following oral medications may help treat IC/BPS symptoms:

• Heartburn medications: Over-the-counter antacids (e.g., Tums®, Rolaids®) can help reduce the amount of acid in your body and reduce symptoms.
• Antidepressants: Low doses of a tricyclic antidepressant such as amitriptyline (Elavil®) can help reduce pain and frequent urination.
• Hydroxyzine: A chemical called histamine can cause symptoms of IC/BPS. Hydroxyzine is a type of antihistamine . It helps remove histamine from your bladder.

Bladder instillations

In this procedure, a doctor inserts a thin plastic tube (catheter) into your urethra and threads it up to your bladder. Then, through the tube, your bladder is filled with a mixture of several medications, including dimethyl sulfoxide (DMSO) , a steroid, and a numbing medication. DMSO is a liquid medication that helps relieve symptoms.

Hydrodistension - as a treatment

A doctor will fill your bladder with sterile water and stretch it. This will help the bladder hold more urine.The size increases. Also, hydrodistension can calm or destroy overactive nerve endings that tell your brain that you have bladder pain. You are given anesthesia during hydrodistension, so you are asleep, so you do not feel any pain during the procedure.

Nerve stimulation

Neuromodulation therapy regulates your bladder function, reducing the urge to urinate and frequent urination. It uses electrical stimulation to stimulate your nerves and cause a response. Sometimes it can also help reduce pain in your bladder and abdomen.

Botulinum toxin injections

A doctor injects Botulinum toxin (Botox®) into your bladder muscle through a cystoscope. A small amount of Botox paralyzes the muscle and relieves pain. However, you may need to get Botox injections every four to nine months.

Surgery

If you have very severe IC/BPS symptoms and you don't respond to other treatments, your doctor may recommend surgery. This involves removing part or all of your bladder (cystectomy) . But this is only done as a last resort.

Other considerations

In addition to treating your bladder and pelvic floor, a doctor will also consider other conditions that may be causing your pain. For example:

• Hormonal imbalances
• Endometriosis (growth of uterine tissue outside the uterus)
• Issues that affect your small or large bowel

Will interstitial cystitis/bladder pain syndrome ever be completely cured?

It's hard to say. Most people with interstitial cystitis/bladder pain syndrome will need to be treated for the rest of their lives. If they don't get treatment, their symptoms can come back. They can have flare-ups of symptoms even while they're still taking their IC/BPS treatment.

However, some people respond well to treatment. Their symptoms gradually decrease, and sometimes even disappear completely.

Is there a way to get rid of IC/BPS quickly?

The best thing to do is to see a doctor right away . He or she can tell you what treatments will provide the fastest relief from your IC/BPS symptoms. It's wise to seek medical advice rather than just doing what you feel like doing.

How soon will I feel better after treatment?

It may take several weeks or months for your symptoms to begin to improve after IC/BPS treatment. It is important to be patient with your treatment.

Can the development of IC/BPS be prevented?

Doctors and medical researchers still don't know exactly how to reduce the risk of developing interstitial cystitis/bladder pain syndrome or how to prevent symptoms from recurring. However, you can do the following to help prevent flare-ups:

• Keep a food diary, identify the foods that cause you problems, and avoid them.
• Continuing your treatment even if your symptoms disappear.
• Trying to reduce stress in your life.

What should I expect if I have IC/BPS?

For many people, interstitial cystitis/bladder pain syndrome is a long-term condition. Your symptoms may be mild or severe. They may occur only occasionally or be constant.

It is important to talk to a doctor to determine your condition and the best treatment options.

What is the life expectancy of someone with IC/BPS?

Interstitial cystitis/bladder pain syndrome is not a life-threatening condition. It does not cause bladder cancer or affect your lifespan. However, it can affect your quality of life.

How do I take care of myself if I have IC/BPS?

The following may help reduce the duration and severity of your interstitial cystitis/bladder pain syndrome flare-ups:

• As soon as you feel a sudden increase in symptoms (flare-up), take medication to help reduce your symptoms.
• Drink plenty of water to dilute your urine .
• Avoid foods and drinks that aggravate symptoms.
• Place an ice pack or heating pad on your abdomen or the area between your genitals and anus (perineum) .
• Sit in a bowl of lukewarm water (sitz bath) .
• Try some yoga poses to help relax your pelvic floor muscles. For example, you can squat down with your legs wide apart ("goddess squat"), or lie on your back with your knees drawn up to your chest, your feet turned up, and the backs of your feet clasped together ("happy baby").
• Try relaxation techniques, such as deep breathing exercises, meditation, or getting a massage.
• Avoid wearing tight clothing (e.g., tight pants, tights, girdles) that constrict your abdomen.
• If sexual intercourse increases symptoms, take analgesics before sex and use lubricants to reduce discomfort.

When should I see a doctor?

If you have symptoms of interstitial cystitis/bladder pain syndrome, make an appointment to see a doctor right away . A doctor will order tests to make sure you don't have an infection or other conditions that could be causing your IC/BPS symptoms. He or she may also prescribe medication and give you advice.

When should I go to the Emergency Treatment Unit (ETU) ?

If your symptoms are very severe, or if they do not improve after treatment, go to the nearest emergency room .

What questions should I ask a doctor?

It may be helpful to ask your doctor these questions:

• How do you tell if I have interstitial cystitis/bladder pain syndrome?
• If I don't have interstitial cystitis/bladder pain syndrome, what other condition could I have?
• What kind of tests would you do to confirm your conclusion?
• What treatment do you recommend?
• Are there any side effects to the treatment you recommend?
• Do you recommend a single treatment option or a combination of several treatments?
• What is the complete list of foods and drinks I should avoid?
• What lifestyle changes can help manage my symptoms?
• Should I see a nutritionist, a urologist, or another specialist?

What is the difference between interstitial cystitis/bladder pain syndrome and a urinary tract infection (UTI)?

Sometimes people confuse interstitial cystitis/bladder pain syndrome with a urinary tract infection (UTI) . But IC/BPS and UTI are not the same thing. UTIs are caused by germs (most often bacteria, especially E. coli ). Doctors still don't know exactly what causes IC/BPS. However, medical conditions that may be linked to IC/BPS include autoimmune diseases, allergies, and problems with your blood vessels.

Finally, things to remember (Take-Home Message)

Interstitial cystitis/bladder pain syndrome (IC/BPS) is a common, long-term condition that causes inflammation and discomfort in your bladder. It can also affect your urination habits – you may need to urinate several times a day, and when you do need to urinate , it can be an urgent need.

Pain, discomfort, and urinary problems can make you feel embarrassed and scared. However, if you have symptoms of IC/BPS , don't be shy about talking to a doctor. He or she can run tests to make sure you don't have other conditions. He or she can also work with you to develop the most effective treatment plan that can reduce the duration and severity of your flare-ups and improve your quality of life.You are not alone, there is help for this.

` Bladder pain, Interstitial Cystitis, Bladder Pain Syndrome, Frequent urination, Urinary tract infection, Bladder injuries, IC/BPS, Sinhala health