Interstitial Cystitis – Oh No, I Have to Go Number 1, Again…

September 3rd, 2009

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All of us know the feeling of a full bladder and the urgency to find nearby facilities at which to relieve ourselves. Typically, this discomfort is self-induced after either drinking the extra large pop in the movie theater or driving too long before seeking out a restroom. For people who suffer with overactive bladders, however, this very uncomfortable state occurs far more frequently. This can result in a significant reduction in quality of life.

In particular, two similar conditions called overactive bladder and interstitial cystitis (IC) both cause sufferers to face frequent strong urges to urinate. While both chronic conditions are debilitating, interstitial cystitis also causes pain in any of the pelvic area, the lower back, the genital area and the lower stomach area. This pain is also accompanied by the urge to urinate as many as 60 times per day, so beyond daily activities, the ability to sleep is also seriously affected.

In the US, between 1.3 and 9.5 million people suffer from IC, depending upon sources. In the UK, the number is roughly 400,000. Of those who are diagnosed with the condition, the vast majority, 90%, are women. Much of the evidence suggests the condition is genetic in nature.

The condition has, until very recently, been poorly understood and frequently misdiagnosed. In some cases, doctors have diagnosed the symptoms as an infection of the urinary system (UTI), a sexually transmitted disease (STD) or even bladder cancer. Without a definitive test for the condition, doctors had to come to a diagnosis based on ruling out other possible causes. As a result many patients have suffered extended periods of discomfort without knowing about their condition.

Now at least, preliminary research results published in June by a scientist at Ohio State University may offer the hope of a blood test for direct diagnosis of the condition. The blood test involves molecular analysis of the blood and has been used in both cats and humans to accurately identify the presence of the disease. The benefit of such a test, when it is available to the public, will be that a patient can be diagnosed more quickly.

Unfortunately at this time, the treatments for the condition only address the symptoms and not the underlying disease. Several medications are prescribed that have varying levels of success in controlling symptoms, but these must be taken for life to avoid return of symptoms. However, researchers are trying to identify any potentially genetic causes for the condition to better understand its causes and to allow for development of potential treatments.

Interstitial cystitis was expected to be genetic in nature. This is based on observations that those having blood relatives with the condition are 17 times more likely than other people to develop the condition. Research at the University of Maryland School of Medicine is, at this moment, attempting to identify the genes related to the condition. Other research in Switzerland including work done at the University of Zurich has identified a number of genes that could be indicators of the condition. Further work is required to know for sure.

Other efforts at the University of Maryland have identified that the cells lining the bladder and connected tubes of the urinary system in those with IC are more sensitive in communicating information to the nervous system relating to a full bladder. As a result, the cells over stimulate in ways that can create the urgency to urinate as well as causing pain.

Related research from the same researcher at Ohio State University who developed the blood test also suggests that the disorder is a problem of the central nervous system. His findings suggests that stress experienced by pregnant mothers results in genetic changes to the offspring in the womb. The offspring become highly sensitive to different stressors and experience pain in response to some stresses.

Other research completed at the Department of Urology at the Los Angeles Center for Neurobiology of Stress also indicates a relationship between stress and interstitial cystitis. The researchers measured the response of patients to being startled with a sudden noise when expecting a mild shock both when they were expecting the impending shock and when they were not. According to the results of the study, patients with IC were much more startled by the noise even when warned and the authors concluded that these patients had nervous systems that were highly sensitive to the stress of possibly threatening situations.

While research into understanding Interstitial Cystisis is still relatively immature, the preliminary identification of genes involved in the disease is a good start. The understanding of the condition as having a relation to stress in both the mother and child is also helpful though it does little to offer relief for those who suffer from the disease. In the mean time, it is very important to support those living day to day with the condition and the debilitating effects that it has on their lives.

Related Links:

http://www.reuters.com/article/pressRelease/idUS169890+19-Jun-2009+PRN20090619

http://www.medicalnewstoday.com/articles/123332.php

http://www.bbc.co.uk/radio4/womanshour/2004_45_mon_04.shtml

http://www.mayoclinic.com/health/interstitial-cystitis/DS00497/DSECTION=symptoms

http://researchnews.osu.edu/archive/icbiomarker.htm

http://icresearch.umaryland.edu/magic.asp

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2686735

http://www.ncbi.nlm.nih.gov/pubmed/19286199

http://www.urotoday.com/49/browse_categories/icpbsbps/editorial__bladder_urothelial_cells_from_patients_with_interstitial_cystitis_have_an_increased_sensitivity_to_carbachol.html

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