bladder surgery

Interstitial Cystitis and Pelvic Floor Pain

What is Interstitial Cystitis (IC) / Painful Bladder Syndrome?

Interstitial cystitis (IC) is a chronic condition involving a myriad of symptoms hallmarked by pain in the bladder and pelvic region. There are two different forms of IC: Ulcerative and non-ulcerative.

Non-ulcerative IC comprises 90 percent of people with IC and is classified by the presence of “pinpoint hemorrhages or glomerulations in the bladder wall. Ulcerative IC comprises the remaining 5-10 percent of people with IC and is classified by the presence of “Hunner’s lesions” or patches of red, bleeding areas on the bladder wall.

IC and painful bladder syndrome are often used synonymously to describe people with pain in the bladder and pelvic region. Painful bladder syndrome (PBS) is a term used in research on IC and in medical literature.

Symptoms of IC/PBS

Symptoms of IC and PBS commonly include pain include:

  • Pressure and pain in the bladder that increases as the bladder fills
  • Pain in the genital region
  • The urge or need to urinate frequently
  • Intense desire to urinate immediately
  • Pain in the pelvic girdle
  • Pain during sex for both men and women, pain following orgasm for men

Pelvic Pain and IC

People with IC/ PBS commonly experience spasms or trigger points in the pelvic floor muscles as a guarding response to the pain the experience in their bladder. These spasms can in turn become a driver of pain themselves, inflicting greater pain and disability on the person suffering.

Pelvic physical therapy is a beneficial treatment to addressing these spasms and pain. Different modalities are used in conjunction with manual therapy and exercise to train the muscles to relax and have better co-ordination.

Additionally, a pelvic wand may be used to perform pelvic floor muscle release to decrease pain.

Common Foods that Make Interstitial Cystitis Worse

There is no one size fits all diet or nutrition plan for IC, however there are common foods that are known bladder irritants and should be avoided to decrease the symptoms of IC. These include:

  • Citrus fruits (lemons, oranges, lime)
  • Alcohol
  • Caffeine (coffee, tea, soda, energy drinks)
  • Tomatoes
  • Spicy foods
  • Carbonated drinks (seltzer, sparkling water, soda, etc)
  • Chocolate
  • Artificial sweeteners (commonly found in diet drinks and foods)

An elimination diet may be helpful in determining which foods spark a flare up for you. Contact your doctor to discuss a safe elimination diet to better determine which foods are best for your IC.

Medical Treatment for IC/ PBS

At this time, no single treatment has been found effective for the majority of patients, and acceptable symptom control may require trials of multiple therapeutic options (including combination therapy) before it is achieved, according to the American Urological Association IC Guidelines (2014).

Popular medical treatment includes Elmiron, which is commonly prescribed by urologists to treat the pain of IC/PBS and is thought to help in rebuilding the damaged walls of the bladder.

It is currently the only FDA approved drug specifically intended to treat IC/ PBS; however other medications may be prescribed to meet the needs of the individual person suffering with symptoms. Other medication options include amitriptyline, cimetidine, hydroxyzine, and pentosane polysulfate.

Relevant Tags: Interstitial Cystitis, Bladder Surgery, Painful Bladder Syndrome, Pelvic Floor Muscles

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By Dr. Amanda Olson, DPT, PRPC