Bladder Pain Syndrome, Risk Factors, Causes And Treatment

A persistent illness known as interstitial cystitis causes bladder pressure, bladder pain, and occasionally pelvic pain. Mild discomfort and severe agony are all possible levels of pain. The condition belongs to the class of disorders known as painful bladder syndrome.

Urine is stored in your bladder, a hollow, muscular organ. The bladder expands until it is full and then signals to the brain that it is time to pee through the pelvic nerves. For the majority of people, this induces the urge to urinate.

When you have interstitial cystitis, these signals become confused, causing you to urinate more frequently and less frequently than the majority of people.

Women are more frequently affected by interstitial cystitis, which can have a long-lasting effect on their quality of life. Even though there is no cure, medications and other treatments might provide comfort.

Causes

Although the exact cause of Bladder Pain Syndrome (Interstitial Cystitis) is unknown, there are many theories that contribute to what the case may be.

These consist of; perhaps, a defect or any kind of damage to the bladder lining (epithelium), which could cause irritation of the bladder and surrounding nerves when a person urinates. The bladder may get irritated by toxic substances in the urine due to an epithelial leak. 

Another theory is an issue with the pelvic floor muscles that regulate urination which triggers an inflammatory response within the immune system. 

In addition, some people with Bladder Pain Syndrome (interstitial cystitis) may also have long-term (chronic) urinary infections (UTIs) in the bladder that are now undetected by urine tests. 

A possible yet untested contributing factor to Bladder Pain Syndrome could be an allergic reaction, infection or autoimmune reaction. 

Risk Factors

The increased likelihood of getting Bladder Pain Syndrome is raised by the following factors: 

Sex: Bladder Pain Syndrome or interstitial cystitis is more frequently diagnosed in women than in men. Although the symptoms in men may seem to resemble interstitial cystitis, they are more frequently linked to prostate gland inflammation (prostatitis). 

Age is another factor which suggests a higher risk of getting Bladder Pain Syndrome (interstitial cystitis). As the majority of interstitial cystitis cases are discovered in patients aged 30 or older. 

Another risk factor is being diagnosed with a chronic disease. Chronic diseases like fibromyalgia, myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS) and irritable bowel syndrome (IBS) may also be linked to Bladder Pain Syndrome.

Symptoms

Symptoms for Bladder Pain Syndrome may vary and change over time and can recur in response to typical triggers including menstruation, prolonged sitting, stress, exercise and sexual activity. 

However, the following are certain signs and symptoms of Bladder Pain Syndrome (interstitial cystitis): 

• Significant pelvic discomfort and this is typically felt over the lower tummy
• A sudden strong desire to urinate
• Needing to urinate more frequently than usual 
• Experiencing pain in the lower stomach area and that is eased by urinating
• Waking up many times through the night to use the toilet

These are some of the main symptoms of Bladder Pain Syndrome. Additional signs can include difficulty in urinating, urinary incontinence and blood in the urine known as hematuria. The colour of the blood may be bright pink, red or dark brown. 

Prevention

Bladder Pain Syndrome cannot be entirely prevented. However, if someone is experiencing frequent urination, chronic bladder pain or any of the symptoms above, a person should contact their healthcare practitioner. 

At first instance, a doctor may ask you to take a urine test to rule out a UTI because Bladder Pain Syndrome can mimic the symptoms of persistent or frequent UTIs. 

However, it is possible that not all bladder infections are detected by the common urine tests used in doctor’s offices and hospitals. A person may be prescribed antibiotics at this stage to see if they are of any assistance. 

A doctor may also recommend easy remedies such as keeping a diet journal and refraining from anything that aggravates these symptoms such as smoking as the bladder can become irritated by tobacco’s toxins. 

Treatments

There are a number of treatments that could be useful for someone who has been diagnosed with Bladder Pain Syndrome (interstitial cystitis) by a professional. 

Taking oral medication: 

Bladder Pain Syndrome patients may be treated with tablets or capsules. These can be painkillers available over-the-counter such as paracetamol and other non-steroidal anti-inflammatory medicine, such as naproxen sodium (Aleve) ibuprofen. 

It may also be tricyclic antidepressants which are medicine used to ease nerve pain and help the bladder relax. Examples of this are amitriptyline, gabapentin and pregabalin.

To target the specific issue of lessening the need to urinate, antihistamines such as loratadine, tolterodine, or mirabegron can lessen the need to urine urgently and frequently. 

There is another prescription drug that works by preventing the bladder’s reaction to a chemical called histamine and that may prove useful. 

Bladder instillations/Injections of the Bladder:

Some medications can also be administered directly into the bladder using a tiny tube known as a catheter. The mixture, which occasionally includes other drugs like a local anaesthetic, stays in your bladder for around 15 minutes.  A person has to urinate in order to remove the solution.

Intravesical medications include, for example, heparin, steroids, sodium bicarbonate, and the local anaesthetic lignocaine are all utilized to numb the bladder during the procedure.

A hospital specialist can explain the many possibilities if you ask.

However, it is important to remember that there is no treatment that unanimously works for everyone and there is also no proof that these treatments conclusively do. 

Different therapies and treatments 

The following therapies and supporting treatments may be beneficial for certain persons as well:

Physical therapies:

Physiotherapy can help you relax your muscles and relieve pain. Experts in this field include physiotherapists for the pelvic floor.

Acupuncture may aid with pain relief, while counselling and talking therapies can help you deal with your symptoms and how they affect your life.

Nerve stimulation techniques:

Transcutaneous electrical nerve stimulation (TENS) is a pain-relieving technique that uses a small battery-operated device to deliver electrical impulses into your body. These mild electrical pulses from TENS lessen urine frequency and relieve pelvic pain. TENS might improve blood flow to the bladder. This could make the bladder-controlling muscles stronger or cause the release of painkillers.

Contemplating surgery 

Surgery is usually only an option for people with severe discomfort or bladders that can only hold extremely small volumes of pee when other treatments have failed and symptoms are affecting their quality of life.

However, the following surgical options are available: 

Bladder Distension: 

Among the procedures that could be used are bladder distension, which stretches the bladder with fluid to help with diagnosis and may temporarily relieve symptoms, and cauterization, which seals bladder ulcers using an electrical current or laser.

Another way is giving injections of the botulinum toxin (also known as Botox) which are given directly into the bladder wall to temporarily reduce the pain and frequency of urination.

Another type of surgery is bladder augmentation. In this treatment, a surgeon covers your bladder with an intestinal patch to expand its capacity. However, this only happens in a select few, extremely uncommon circumstances. Although the treatment reduces pain, some patients still need to use a catheter frequently throughout the day to empty their bladders.

Rarely, and only as a last option, may it be necessary to entirely remove the bladder (cystectomy).

If this is done, your surgeon might have to find another mechanism for your body to excrete urine.

Complications of Bladder Pain Syndrome 

Numerous issues, such as the following, can arise from interstitial cystitis:

An individual may have reduced bladder volume. The bladder wall may thicken as a result of interstitial cystitis, which reduces the amount of urine that the bladder can contain.

A person may also experience a lower standard of living.  Regular urination and pain might make it difficult to engage in social interactions, work, and other everyday activities.

In addition, your personal connections could be strained by frequent urination and pain, and your sexual closeness might diminish.

Also, emotional difficulties may arise as bladder pain syndrome or interstitial cystitis is accompanied by chronic pain, sleep disruption, and other symptoms that can be depressing.

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