Interstitial cystitis (cystitis): symptoms, causes and treatment

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Definition

What is cystitis?

Interstitial cystitis or cystitis is a chronic disease that causes inflammation, pain, and pressure in the bladder. Although known as pain bladder syndrome, pain can radiate to the pelvis, kidneys, and surrounding areas.

Cystitis is a bladder disease that can interfere with the function of these organs in storing and removing urine (urine). You will feel the urge to urinate more often, but the volume of urine that comes out is only a small amount.

Symptoms

What are the symptoms interstitial cystitis ?

Common symptoms of cystitis include:

• Bladder pressure and pain that gets worse when you want to urinate.
• Pain in the lower abdomen, lower back, pelvis, or urethra (the passage through which urine passes from the body).
• Feeling like urinating frequently (more than 8 times a day).
• Suddenly want to pee (overactive bladder), even though you just urinated.

Women usually feel pain in the vagina, vaginal lips, and the area behind the vagina. Complaints of pain also often arise during sex.

Meanwhile, men usually experience pain in the testicular sac (testicles), testicles, penis, or the area behind the testicles. The pain also appears during orgasm or after sex.

Cause

Intersistial cystitis is a disease caused by two factors, namely:

1. Bacterial infection

Most cystitis is caused by a bacterial infection. Infection begins when bacteria E. coli from feces into the urethra. Bacteria E. coli actually useful for digestion, but in the urethra, these bacteria will multiply and cause inflammation.

Cystitis is more common in women. This may be because the vagina is closer to the anus and a woman's urethra is shorter. Bacteria can also enter during sex or if you clean your vagina incorrectly.

2. Other factors

Apart from bladder infections, inflammation can also be caused by the following factors:

• Take medicine. Medicines, especially chemotherapy drugs such as ifosfamide and cyclophosphamide, can trigger inflammation of the bladder once it breaks down.
• Radiation. Radiation treatment to the pelvic area can cause inflammation of the bladder area.
• Chemical material. Chemicals from vaginal cleaners, soaps, and sperm killers can trigger an allergic bladder reaction that mimics inflammation.
• Medical tools. The use of urinary catheters and contraceptives can trigger bacterial growth and irritation of the bladder.
• Certain diseases. Diabetes, kidney stones, BPH (prostate enlargement) disease, and spinal cord injuries can interfere with bladder function.

Triggers

Who is at risk interstitial cystitis ?

There are a number of factors that increase a person's risk of cystitis, for example:

• Sexually active. Sex can push bacteria into the urethra.
• Are female. Women get cystitis more often than men. This has to do with the difference in the shape of their urethra.
• Age. In most cases, cystitis is diagnosed in people 30 years of age or older.
• Using certain contraceptives. The risk is higher in women who use diaphragmatic birth control.
• Menopause. The drop in the hormone estrogen after menopause makes the bladder wall weaker, making it more susceptible to infection.
• Obstruction of urine flow. This condition is usually caused by bladder stones or prostatitis in men.
• Decreased immune system. This makes it easier for the bladder to become infected with bacteria.

Diagnosis

How to diagnose interstitial cystitis ?

Quoted from the Mayo Clinic, the method of diagnosis interstitial cystitis is as follows:

1. Pelvic examination

The doctor will examine the vagina, uterus, and abdomen to check the organs in the pelvic area. Your doctor may also examine your anus and rectum.

2. Urine test

Your urine sample will be checked for signs of urinary tract infection such as white blood cells, red blood cells, or bacteria. The doctor also tests a sample of your urine to check for cells and to make sure there is no cancer.

3. Hydrodistance

The doctor will insert a cystoscope (a long, small tube with a camera) into the urethra to view your bladder. After that, the doctor injects a special fluid to check the capacity of your bladder.

4. Potassium sensitivity test

Your doctor will insert water and potassium chloride into your bladder. If you feel pain when urinating (anyang-anyangan) when you are injected with potassium, this could be a sign of cystitis. The reason is, people with a normal bladder will not feel the difference between the two fluids.

Treatment

What is the right treatment for this disease?

The following methods are commonly used to treat cystitis.

1. Medicines

Medications that you can take to treat symptoms of interstitial cystitis are:

• Ibuprofen or naproxen sodium for pain relief.
• Amitriptyline or imipramine, to help relax the bladder and prevent pain.
• Loratadine to reduce urge to urinate.
• Pentosan polysulfate sodium to protect the bladder from substances that can cause irritation.

2. Transcutaneous electrical nerve stimulation (TENS)

TENS utilizes a light electric current to relieve pelvic pain. In some cases, this method can even reduce the urge to urinate. The trick, your back or pubic area will be fitted with an electric cable. This cable will conduct electricity.

3. Sacral nerve stimulation

The sacral nerves are the links between the spinal nerves and the bladder. This method is performed by placing a thin wire near the sacral nerve. The cable will conduct electricity to improve bladder function.

4. Bladder distension

Bladder distension is a procedure that stretches / dilates the bladder with water. If you notice lasting progress for a long time after this procedure, your doctor may repeat it as needed.

5. Medicine that is inserted into the bladder

The doctor inserts a dimethyl sulfoxide drug into the bladder through a catheter inserted into the urethra. You will then be asked to pee to get rid of it. This treatment usually lasts 6-8 weeks.

6. Operations

Surgery is usually performed when other treatments have been tried and have failed. Operation options that can be done include:

• Inserting a device through the urethra to burn the wound that has resulted from cystitis.
• Inserting a tool through the urethra to cut the wound.
• Enlarged bladder.

Lifestyle changes

How to prevent interstitial cystitis ?

Here are lifestyle improvements that can help you prevent cystitis.

• Avoid anything that irritates the bladder, such as sour and spicy foods and caffeinated drinks (coffee, soda, tea).
• Exercising the bladder by scheduling urination according to certain hours, not when you feel like urinating.
• Wear loose clothing so that the stomach and bladder are not compressed.
• Control stress. This is one of the best ways to keep your bladder healthy.
• Quit smoking, because smoking can worsen the condition of the bladder and increase the risk of cancer.
• Doing stretching exercises or pelvic muscle exercises.

Interstitial cystitis is a chronic condition of the bladder. That is, this condition has been going on for a long time so it should not be ignored. If you experience symptoms of cystitis, you should immediately consult a doctor to find a solution.