Interstitial cystitis
Content:
- Interstitial cystitis symptoms
- Interstitial cystitis causes
- Interstitial cystitis treatment
Interstitial cystitis is a disease of a non-infectious nature, characterized by damage and inflammation of the interstitial tissue of the bladder with further chronicity 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 thickened, 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%. Disease manifests after 40 years. Gunner'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-ulcerative, which is diagnosed in the remaining 80%.
Interstitial cystitis symptoms
Among the symptoms of the disease are the following:
- Pain, localized in the pelvic region, can be given to the vagina, anus, lower abdomen, scrotum, penis, sacrum. Women often suffer from painful sensations during intercourse. Also, the pains bother when filling the organ with urine and subside somewhat after going to the toilet. Such pains are present for a long time period, which can reach a year or more.
- Imperative or imperative urge to empty the organ. In this case, only a few drops of liquid may stand out.
- The amount of urination increases and often causes the person to spend sleepless nights. This often leads to depression, an increase in the level of anxiety, and isolation.
- In the secreted fluid, blood may be detected, which becomes clear from the changed color of the urine. This is often observed after the patient has been holding back the urge to empty himself for a long time.
- 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 social maladjustment of such patients. In men, impotence is observed, and women deliberately avoid sexual intercourse because of severe pain during the act.
Interstitial cystitis causes
As for the causes of the onset of the disease, doctors are of the opinion that the neuroendocrine theory underlies the manifestation of pathology.
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 the mast cells of the immune system in response to changes in the nerve fibers located in the bladder wall. At the same time, increased histamine provokes inflammation, akin to allergies, which ultimately causes illness.
In addition, doctors identified additional factors that provoke the disease:
- Surgery 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 the development of the disease;
- Exposure to toxic agents;
- Bronchial asthma;
- Nervous system pathologies;
- Violation of urination caused by both anatomical features and diseases of the genitourinary system.
Interstitial cystitis treatment
Disease therapy is based on three principles: it is necessary to restore the integrity of the damaged organ wall, reduce neurogenic activity and eliminate the existing allergy.
For their implementation, the following drugs are used:
- The antidepressant is sodium pentosan polysulfate. 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. For the treatment of this form of the disease, amitriptyline is most often prescribed. It affects the central and peripheral activity of the nervous system.
- Antiallergenic drugs, which 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 probable theories of its origin. Popular remedies are Cimetidine, Hydroxyzine.
- Anti-inflammatory drugs such as paracetamol.
- Heparin sodium deserves special attention, which is used for installations and is injected intravesically. This drug works well when combined with hydrocortisone, oxybutyl, and tolterodine. Positive results in the treatment of these agents reach 73%.
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Using hyaluronic acid to help protect the inner layer of the bladder. In addition, the drug acts as an immunomodulator.
- Dimethyl sulfoxide has an effect. 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 organ wall, or at completely removing the bladder and creating a new organ from the patient's intestine. However, doctors note a rather low positive effect of operations, so they tend to resort to them only in extreme cases. Also, the invasive techniques include burning the organ with a laser and the introduction of botulinum toxin.
Treatment with drugs must be complemented by behavioral therapy, which is carried out for at least 6 months. For this, the patient needs to perform sets of exercises, including Kegly exercises, as well as train the bladder. No less important is a special diet, which is aimed at eliminating foods containing acid and potassium, with their subsequent gradual return to the menu.
The author of the article: Lapikova Valentina Vladimirovna | Gynecologist, reproductologist
Education: Diploma in Obstetrics and Gynecology received at the Russian State Medical University of the Federal Agency for Healthcare and Social Development (2010). In 2013 completed postgraduate studies at N. N. N. I. Pirogova.
