The painful bladder syndrome (also known as interstitial cystitis) is defined as chronic inflammation, meaning long-term inflammation, of the bladder walls. This causes abdominal pain and lower abdominal pain, accompanied by a constant and urgent need to urinate. Symptoms of interstitial cystitis may include:
- Pain or discomfort in the lower abdomen. Pain may worsen when the bladder is full and may temporarily disappear when it empties.
- Urgent need to urinate (urgency) or to do so very often (frequency) or both simultaneously. Most people urinate between 4 and 7 times a day. People with severe painful bladder syndromes may urinate up to 40 times a day, even during the night.
- Pain, pressure, or tenderness in the bladder, urethra, or genitals.
- Pain in the pelvic floor muscles, lower abdomen, and lower back.
- Pain that may worsen during menstruation.
- Pain during sexual intercourse.
- Ulcer, irritation, and/or bleeding in the bladder.
Symptoms may vary depending on age and the time of diagnosis. Furthermore, these symptoms can "flare up," meaning they can suddenly worsen and then improve. Even with only slight discomfort or very severe symptoms, this condition can lead to a deterioration in the quality of life of affected individuals. Sleep interrupted by the need to urinate during the night can cause extreme fatigue or even depression, which affects both physical and mental health. The risk of developing painful bladder syndrome is higher if one has had a urinary infection previously, if there is a family history of this condition, or if other specific conditions are present (irritable bowel syndrome, fibromyalgia, chronic fatigue syndrome, or endometriosis, among others). In addition, urine with an acidic pH causes irritation in the nerve fibers located in the epithelium of the urinary bladder, turning this irritation into painful stimuli. In this regard, studies show that maintaining urine above a urinary pH of 6.2 for just 4 weeks would help reduce the clinical symptoms of this pathology. It should be noted that this syndrome is not caused by bacteria and does not respond to conventional antibiotic treatment. Treatment will depend on each individual's situation and may not be effective for all affected individuals. Among the different treatments recommended to alleviate symptoms, we can find:
- Dietary changes. The elimination of some foods or drinks can help decrease the severity of symptoms, especially pain.
- Lifestyle changes. Wearing loose clothing so it does not compress the lower abdomen area or quitting smoking, as the cough caused by long-term smoking can compress the abdominal area and worsen symptoms, and the toxic products from cigarettes eliminated in the urine can increase pain, affect sleep quality, and increase anxiety levels.
- Regular exercise. Physical activity can help strengthen the muscles around the bladder and improve blood flow to the abdominal area.
- Physical therapy. Specifically exercises to relax the pelvic floor muscle.
- Bladder hydrodistention. This technique involves filling the bladder with water to stretch it, as well as the muscles in the area. It is performed under general anesthesia.
- Bladder instillation or bladder wash. This method involves filling the bladder with a liquid or solution with the aim of washing the inside of the bladder for approximately 15 minutes. It can help prevent muscle spasms that cause pain and the constant need to urinate.
- Transcutaneous electrical nerve stimulation. This technique is based on sending mild electrical impulses to the nerves in the lower back and bladder. This can help relieve pain and reduce the need to urinate so often.
- Several types of drugs, such as analgesics to relieve pain.
- Surgery. If other treatments have not worked, partial or total removal of the bladder may be resorted to. When the bladder is removed, urine must be collected and deposited in a bag outside the body. This should be considered as a last option and always under the advice of a specialist.
