For the millions of men and women who suffer from interstitial cystitis, commonly called IC, pain can be a daily reminder of their damaged bladder lining. Although some people have compared the pain of IC to a urinary tract infection, the pain experienced by most patients is both specific and varied.
A Painful Bladder
Three pain symptoms appear to be consistent among interstitial cystitis patients. Over 90 percent of patients report that consuming certain foods, beverages and supplements aggravates their symptoms. In addition, 97 percent of patients who took part in the epidemiological study, "Events Preceding Interstitial Cystitis," or EPIC, reported their pain increased as their bladder filled and that emptying their bladder provided temporary relief. This specific description is in contrast to the pain caused by a bladder infection, where the act of urination can be extremely painful. Patients often describe their IC pain in dramatic terms, saying they feel like they have "razor blades" or "battery acid" in their bladder.
Atypical Pelvic Pain
Although most patients primarily experience pain in the bladder, many also experience pain that is not organ-specific. Patients may feel pain or pressure in the lower abdomen, shooting down the legs, in the lower back or in the external genitalia, including the urethra. Pain with intercourse is common with both men and women, but whereas men often complain of pain with ejaculation, women may report pain up to 24 hours later. Pain also tends to fluctuate with hormonal changes in women, particularly premenstrually and during perimenopause.
Diet Modification
Just as most patients report that certain foods and beverages can trigger symptoms, patients also find that eliminating certain trigger foods can help control their symptoms, including pain. Common IC trigger foods include cranberry juice; coffee, tea and other acidic, caffeinated products; citrus fruits and juices; tomatoes and tomato products; alcoholic beverages; carbonated beverages; artificial sweeteners; preservatives and flavor enhancers such as monosodium glutamate (MSG); spicy foods; soy-based products; and chocolate.
Behavior Modification Techniques
Other, nonmedical pain management techniques can be very helpful in controlling the pain of interstitial cystitis. These techniques include practicing stress management, particularly breathing exercises and guided imagery; engaging in gentle exercise such as yoga; applying heat or cold packs to the abdomen or perineal area - many patients like the convenience of the stick-on pads; and taking warm, not hot, baths with a half-cup of Epsom salts or baking soda.
Medical Pain Management
A variety of other medical treatments are available to help interstitial cystitis patients if diet and other behavior modification techniques do not provide adequate pain control.
Over-the-counter medications include acetaminophen, ibuprophen and phenazopyridine hydrochloride (a urinary tract anesthetic). The doctor may prescribe medications such as tri-cyclic antidepressants, nonsteroidal anti-inflammatory agents or narcotics.
A medical care provider or the patient may perform an intravesical installation; this procedure involves using a catheter to fill the bladder with topical medications, which may include lidocaine and heparin.
In acute pain situations, patients may need assistance from intravenous medications provided under the supervision of a physician.
Finally, if pain is not controlled using standard treatment options, patients may need a referral to a pain management clinic.
References
- “Journal of Urology”; Effect of Comestibles on Symptoms of Interstitial Cystitis; B. Shorter, M. Lesser, R.M. Moldwin, L. Kusher; July 2007
- "Urology"; Evidence-Based Criteria for Pain of Interstitial Cystitis/Painful Bladder Syndrome in Women; J.W. Warren, J. Brown, J.K. Tracy, P. Langenberg, U. Wesselmann, P. Greeberg; March 2008
- Interstitial Cystitis: A Guide for Nutrition Educators; J. Beyer; 2010
- "Understanding the IC/PBS Diet”; J. Beyer et al.; October 2009
