The RAND Interstitial Cystitis Epidemiology report estimates that 3 to 8 million women and 1 to 4 million men struggle with a painful bladder disorder called interstitial cystitis, or IC. In addition to bladder pain that is relieved upon urination, patients may also experience sudden urges to urinate and frequent urination. According to the Interstitial Cystitis Association, people with IC may void dozens of times each day and several times each night.
Damaged Bladder Lining
The primary characteristic of IC is that of a damaged bladder lining. This damage, which varies from tiny cracks to bleeding ulcerations, allows the urine to penetrate the protective glycosaminglycan, or GAG, layer of the bladder and reach the urothelial layer. The urothelial layer is rich in nerve endings and transmits pain messages to the brain. A number of events can cause this damage, including bladder trauma from surgery and repeat bladder infections, repeatedly holding the urine too long thus hyperdistending the bladder, pelvic floor dysfunction, autoimmune disease, spinal cord damage, extreme exposure to chemicals such as chlorine, and ketamine abuse.
Antiproliferative Factor
Although there is no question that an IC bladder is damaged in some way, the question remains as to why some bladders heal themselves after similar injury yet other bladders become chronically damaged, leading to the diagnosis of interstitial cystitis. The answer may be antiproliferative factor, or APF, a compound identified at the University of Maryland by Susan Keay and colleagues, which inhibits the proliferation, or cell growth and division of the bladder epithelial cells. This compound has been identified in the urine of IC patients and may explain the delayed or lack of healing that normally takes place in healthy bladders. Keay and colleagues theorize that the presence of this compound may signal a more systemic problem in IC patients.
Stress and Diet:
Many IC patients have reported that their first experience with an IC flare was preceded by some traumatic or stressful event. Some patients have tried to connect their symptoms to previous sexual or physical abuse. This is a connection well documented by researchers. However, it is unlikely that stress, including stress from abuse, is actually the cause of a patient's IC; rather, it is more likely that the stressful event triggered an underlying predisposition to IC. Similarly, although 90 percent of patients report that their symptoms are triggered by certain food or beverages, no research to date points to diet as a cause of the condition.
References
- International Continence Society: Prevalence of Interstitial Cystitis/Painful Bladder Syndrome in the United States
- Interstitial Cystitis Association: General Symptoms
- PubMed.gov: Ketamine-Associated Ulcerative Cystitis: A New Clinical Entity
- PubMed.gov: Bladder Epithelial Cells from Patients with Interstitial Cystitis Produce an Inhibitor of Heparin-Binding Epidermal Growth Factor-Like Growth Factor Production
- PubMed.gov: Stress and Symptoms in Patients with Interstitial Cystitis: A Life Stress Model
