Interstitial cystitis – prevent frequent urination by training to fill your bladder.
February 3, 2011
Many people worry about frequent urination. Among the illnesses showing symptoms of frequent urination is interstitial cystitis, which is increasing in number of patients recently. Acute bacterial cystitis, generally known as cystitis, is caused by an inflammation in the mucous membrane infected by bacteria. By eliminating the bacteria with medication, frequent urination will subside.
In interstitial cystitis, the substance that protects the mucous membrane from urine and bacteria is separated from the wall of urinary bladder resulting in a leakage of urine to stroma , which is the submucosa and the muscle layer underneath. When urine is accumulated, pain, pressure or discomfort may be felt at the inflamed areas. The symptom subsides after relieving oneself; hence naturally, frequent trip is made to the bathroom. It is not known why the inflammation occurs or why the ulcers develop.
According to Vice Principal Ito of Tamura Clinic (Tokyo Prefecture, Tama City), interstitial cystitis is “a case of hyperesthesia of the bladder”. He was involved in compiling the medical guideline for Japan Interstitial Cystitis Research Group, which is made up of specialists. The guideline is recommended by Japan Urological Association.
Despite the bladder having room to fill, patients would feel uncomfortable with small amount of accumulated urine and want to go to the toilet all the time.
According to Prof. Tomoe from pelvic floor function reconstructive department at Tokyo Women’s Medical University Higashi Medical Centre, those with a daily urine amount of approximately 1500 ml and go to the lavatory more than 8 times a day for less than 200ml each time should be suspected for frequent urination. Some are said to go to the toilet more than 20 times a day but passing only 50ml of urine at a time.
The medical examination is conducted under anaesthetic. Saline is inserted to expand the bladder and the interior is seen by a camera. It doubles as a treatment as many patients see improvement in their symptoms by the expansion of their bladders. Since April last year, this procedure has been eligible for health insurance claim and if ulcers are found at the time in the bladder, they are burnt off with laser to eliminate sensitive areas.
The treatment is strictly symptomatic, therefore, if symptoms reappear, surgeries may need to be considered.
After the treatment, patients’ mental attitudes in daily lives become important. One is “bladder control”, where you do not urinate until the bladder is full. Even if you want to go to the toilet, wait for 5~10 minutes to increase the ability of your bladder to expand. Another is to pay attention to what you eat so the urine itself is not a stimulant. Avoid citrus, chilli, caffeine and alcohol but increase water intake to dilute the urine. “If you avoid taking fluids to avoid frequent urination, the urine is more concentrated, therefore, stimulates more and give adverse effect”, says Dr. Ito.
Overactive cystitis, with a sudden urge to go to the bathroom, also shows frequent urination as its main symptom. In order to tell apart, it is better to get an expert opinion from the Urologist. (by Miyajima)
Helpline
Interstitial cystitis has only been known among the specialists in the last decade or so. It has been known that many people who were diagnosed as bacterial cystitis, suffers from the lack of improvement to their symptoms despite taking repeated antibiotics. In the Japan Interstitial Cystitis Research Group website （http://sicj.umin.jp/）, which was set up by the doctors in 2002, contact details of doctors can be found for consultation along with contents of reports from their annual meetings.
