Interstitial cystitis is used to describe a bladder that has a damaged inner protective layer. This inner protective layer is called the GAG layer and it protects the underlying bladder wall from irritation by urine. Gaps in this layer may lead to symptoms similar to a bladder infection. Men or women can have interstitial cystitis, and may experience pain or burning with urination, frequent urination, urinary urgency, or abdominal pain. Women who have interstitial cystitis may also experience vaginal or vulvar pain or irritation, and pain with intercourse.
Because interstitial cystitis may contribute to pelvic pain, it is an important consideration in women experiencing low abdominal pain and pelvic pain. It is of further importance as it is thought to be a disease which worsens without treatment.
The evaluation for interstitial cystitis starts with a basic questionnaire. This is followed by a bladder test in women who respond positively to the questionnaire. This test involves the instillation of 3 different solutions to make a diagnosis of interstitial cystitis and to start treatment. Subsequent treatment involves a bladder therapy wherein heparin is instilled into the bladder 1-2 times a week as needed to quiet the symptoms of pain or urgency. Therapy with Elmiron is simultaneously started, but as it may take 3 months to provide adequate relief the heparin bladder treatments may still be necessary for timely results. Occasionally other medications are necessary for optimal relief of symptoms.
Again the possibility of interstitial cystitis contributing to pelvic pain is a very important consideration, and it’s effective treatment can lead to a significant improvement in the quality of life.