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Interstitial cystitis is a disease of a non-infectious nature, characterized by damage and inflammation of the interstitial tissue of the bladder with further chronicization of the process. Located under the mucous layer of the bladder, the tissue is exposed to the destructive action of urine, which causes severe pain. The walls of the organ are gradually replaced by connective tissue and compacted, this significantly reduces the volume of the bladder and leads to a violation of its functionality.
Mostly women suffer from the disease, their volume of the total number of cases is 90%. Manifests the disease after 40 years. Hunner’s ulcer is often found in patients with interstitial cystitis. In this regard, the disease is divided into two forms – ulcerative, which is found in 20% of cases and non-ulcer, which is diagnosed in the remaining 80%.
Symptoms of interstitial cystitis
Symptoms of the disease include the following:
Pain, localized in the pelvic region, can be given to the vagina, anus, lower abdomen, scrotum, penis, sacrum. Women often suffer from pain that occurs during intercourse. Also, pain is disturbed when the organ is filled with urine and subsides somewhat after going to the toilet. There are such pains for a long time period, which can reach a year or more.
Imperative or imperative urge to empty the body. In this case, only a few drops of liquid can stand out.
The number of urination increases, and often causes a person to spend sleepless nights. This often leads to depression, increased levels of anxiety, and isolation.
In the excreted fluid, blood can be detected, which becomes clear from the changed color of the urine. Often this is observed after the patient has long held back the urge to void.
The disease gradually progresses, there are periods of remission and exacerbation.
In addition, there is an increase in suicide among people suffering from interstitial cystitis, which is caused by the social exclusion of such patients. Men experience impotence, and women deliberately avoid sexual activity due to severe pain during intercourse.
Causes of Interstitial Cystitis
As for the causes of the disease, doctors are of the opinion that the manifestation of pathology is based on the neuroendocrine theory.
That is, the development of this form of cystitis is due to the following facts:
The disease develops as a result of a violation of glycosaminoglycans, which cover the upper layer of the bladder from the inside. This leads to its thinning and increased contact of urine with interstitial cells.
An increase in histamine, produced by mast cells of the immune system in response to changes in nerve fibers located in the wall of the bladder. At the same time, increased histamine provokes inflammation, akin to allergies, which ultimately causes the disease.
In addition, doctors identified additional factors that provoke the disease:
Surgical intervention in the gynecological and urological field;
Bowel disease, such as spastic colitis and irritable bowel syndrome;
Autoimmune diseases, in particular rheumatoid arthritis;
allergic reactions;
Genetic predisposition to develop the disease;
Exposure to toxic agents;
Bronchial asthma;
Pathologies of the nervous system;
Urination disorders caused by both anatomical features and diseases of the genitourinary system.
Treatment of interstitial cystitis
Therapy of the disease is based on three principles: it is necessary to restore the integrity of the damaged wall of the organ, reduce neurogenic activity and eliminate the existing allergy.
For their implementation, the following drugs are used:
Antidepressant – pentosan polysulfate sodium. This drug has the ability to restore the damaged glycosaminoglycan layer of the organ.
An antidepressant that lowers the pain threshold and also helps to reduce the frequency of the urge to urinate. Amitriptyline is most often prescribed for the treatment of this form of the disease. It affects the central and peripheral activity of the nervous system.
Antiallergic drugs that are aimed at reducing the production of histamine. It is he who has a significant impact on the development of the disease, according to one of the most likely theories of its origin. Popular remedies are Cimetidine, Hydroxyzine.
Anti-inflammatory drugs such as paracetamol.
Sodium heparin deserves special attention, which is used for installations and is administered intravesically. This drug has a good effect, in combination with hydrocortisone, oxybutyl and tolterodine. Positive results in the treatment of these drugs reach 73%.
The use of hyaluronic acid, which contributes to the protection of the inner layer of the bladder. In addition, the drug acts as an immunomodulator.
The effect is dimethyl sulfoxide. The drug has a relaxing effect on the diseased organ, has anti-inflammatory and analgesic effects.
If conservative treatment does not have the desired effect, then surgical intervention may be prescribed. It is aimed either at removing part of the damaged wall of the organ, or at removing the bladder completely and creating a new organ from the patient’s intestine. However, doctors note a rather low positive effect from operations, so they tend to resort to them only in extreme cases. Also, invasive methods include cauterization of the organ with a laser and the introduction of botulinum toxin.
Treatment with drugs must necessarily be supplemented by behavioral therapy, which is carried out for at least 6 months. To do this, the patient needs to perform sets of exercises, including Kegel exercises, as well as train the bladder. Equally important is a special diet, which is aimed at eliminating foods containing acid and potassium, followed by their gradual return to the menu.