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CystitisInflammation is a protective reaction of the body tissue to irritation, injury, or infection. Inflammation of the bladder is called cystitis. When the inflammation is caused by bacterial infection, it is referred to as bacterial cystitis or just cystitis. Interstitial cystitis (IC) is a condition that causes pain and inflammation in the bladder when no infection is found. (Other causes of non-infectious inflammation of the bladder are also possible.) Inflammation of the bladder causes urinary frequency (frequent need to urinate), urgency (urgent need to urinate), pelvic pain, painful urination, incontinence, and nocturia (frequent need to urinate at night). Long-term inflammation of the bladder in people with IC can lead to scarring and stiffening of the bladder wall, which causes a decrease in the bladder capacity. Pinpoint areas of bleeding, called glomerulations, may occur in the lining of the bladder wall. IC is believed to be a spectrum of disease initially presenting with mild symptoms and progressing to severe urgency and pelvic pain. According to the National Institutes of Health (NIH), IC affects about 700,000 people in the United States, and 90% of IC patients are women. It is believed that IC is a much more prevalent disease and that many patients have early forms of IC with a delayed diagnosis. The average age of onset of IC is 40 years. Causes of cystitis: Although many theories have been put forward, the cause of IC is unknown. The theories for the cause of IC include the following: Autoimmune: An autoimmune response is a physical response in which cells and antibodies of a person's body are directed against that person's own tissues. An autoimmune response to a bladder infection destroys the lining of the bladder wall. An unexplained association of IC has been found to exist with other autoimmune diseases such as inflammatory bowel disease, systemic lupus erythematosus, scleroderma, Sjögren syndrome, fibromyalgia, and atopic allergy. IC has a very high association with disorders of the bowel such as inflammatory bowel disease. Hereditary: Studies of mothers, daughters, and twins who have IC suggest a hereditary risk factor. However, no gene has yet been implicated as a cause of IC. Mast cell abnormalities: In some people with IC , special white blood cells called mast cells (associated with inflammation) are found in the bladder lining. Mast cells release histamine and other chemicals that cause inflammation of the bladder . Defect in bladder epithelium: The bladder has a specialized natural lining called the epithelium. The epithelium is protected from toxins in the urine by a layer of protein called glycoaminoglycan. In people with IC, this protective layer breaks down, allowing toxins to irritate the bladder wall and cause inflammation of the bladder . Neurogenic: The nerves that carry bladder sensations are inflamed, so pain is caused by events that are not normally painful (such as filling of the bladder ). Infectious: Although no causative infective agent has been found in the urine of people with IC, an unidentified infectious agent may be the cause. Probably, different processes occur in different groups of people with IC It is also likely that different processes may affect each other, for example, a defect in the bladder epithelium may start the inflammation and stimulate mast cells to release histamine. Symptoms of cystitis: The symptoms of IC are similar to those of a urinary tract infection. They vary from person to person. Most people have some of the following symptoms: Frequency: People with IC need to urinate more often than normal. A person with good health urinates a maximum of seven times a day and does not have to get up at night to urinate. A person with IC urinates frequently, both during the day and night. In early or very mild cases, frequency is sometimes the only symptom. Urgency: As frequency becomes more severe, it leads to urgency. Urgency may also be accompanied by pain, pressure, or spasms. Some people with IC feel a constant urge to urinate that never goes away, even right after urinating. Pain: People with IC have bladder pain that gets worse as the bladder fills. Some people feel the pain in other areas besides the bladder . The pain may be felt in the lower abdomen, lower back, urethra, or the pelvic or perineal area. Men may feel pain in the scrotum, testicles, or penis. Women may experience pain in the vulva or vagina. The pain may be continuous or intermittent. Sexual difficulties: Women may have pain during intercourse, and men may have painful orgasm. Urinary incontinence (leakage) Symptoms of some people with IC become worse after consumption of certain foods or drinks. They include tomatoes, spices, alcohol, chocolate, caffeinated and citrus beverages, and high-acid foods. Many people also find that symptoms become worse if they have stress (either physical or mental stress). In women, symptoms may vary with the menstrual cycle; symptoms often get worse during periods. Medical Treatment: There is no cure for IC . The goal of treatment of IC is to provide relief of symptoms. Because there are probably many different causes of IC, no single treatment is effective for all people with IC. Treatment is tailored to the individual, based on the symptoms. Usually, different treatments are tried until symptoms improve. People with IC may have flare-ups and remissions. A particular treatment may work for a time and then quit working. Sometimes, a change of diet or stress triggers the symptoms. Most people with IC are helped by one or more of the following treatments: Dietary and smoking restrictions: Elimination of food items that worsen symptoms Medications: Anticholinergics, antimuscarinics, sodium pentosan polysulfate, tricyclic antidepressants, antihistamines, nonsteroidal anti-inflammatory drugs Bladder instillations of drugs: Dimethyl sulfoxide, heparin, corticosteroids Procedures: such as hydrodistention with cystoscopy (stretching of bladder ) Surgery Other therapies: Transcutaneous electrical nerve stimulation, sacral nerve stimulation, biofeedback It is important to remember that no treatment works immediately. It may take weeks to months for symptoms to improve. Most people need to continue treatment for their whole lives because it is possible for IC symptoms to recur, even if the disease has been in remission for a long time. Self-Care at Home: Diet Certain food items may worsen the symptoms of IC; they include the following: Citrus fruits Tomatoes Chocolates Coffee (or any caffeine) Spicy foods Artificial sweeteners Carbonated beverages Alcoholic beverages All food items do not affect all people with IC in the same way. Therefore, each person should find out which food item makes one's symptoms worse. This can be done by trying an "elimination diet." On an elimination diet, one needs to stop eating all food items that can make symptoms worse. If symptoms improve on the elimination diet, the food item that was irritating the bladder needs to be identified. This can be done by introducing one food item at a time into the diet. If the addition of the food item does not worsen symptoms, it can be added to the regular diet. In this manner, one can identify the food item that makes symptoms worse and thus avoid it. Smoking Many people with IC have reported that smoking makes their symptoms worse. Quitting smoking will not only provide symptomatic relief to people with IC but will also decrease the risk of developing bladder cancer, because smoking is a known cause of bladder cancer. Smoking cessation will also decrease the incidence of heart disease, hypertension, stroke, peripheral vascular disease, and lung cancer. Exercise Many people with IC have reported that gentle stretching exercises help alleviate the symptoms of IC. Bladder Training People with IC may be able to reduce urinary frequency by using bladder -training techniques. They are advised to progressively increase the voiding (emptying the bladder ) interval over the course of weeks to months by using relaxation techniques and distractions. A diary can help track the progress. Drink Chamomile tea and take Garlic capsules. Also try drinking pure spring water and home made lemon barley water. Essential oils can play a useful part in helping the sufferer. As a first line of defence when cystitis appears is to use Bergamot and Tea Tree externally as a local wash and in the bath. Chamomile Roman essential oil can also be used in external washes to help ease the pain and stinging. Always dilute essential oils to 1% or less in boiled and cooled water. Massage the lower abdomen with Bergamot, Chamomile Roman and Lavender essential oils diluted in carrier oil. A warm compress with Chamomile Roman oil may help if the sufferer is in pain. Even if the sufferer is taking antibiotics then to continue using essential oils in these ways can benefit and help. Sandalwood essential oil can be used as an alternative to Bergamot or Tea Tree if repeated treatment is needed. |
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