Suggest treatment for interstitial cystitis

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Posted on Mon, 12 Jun 2017 in Digestion and Bowels
Question: Hello. I am a 43 year old, very healthy and physically active female. I do a lot of athletic competitions and I have a lower body fat - 15% and I'm on a strict diet. My last period was May 1st and it was a normal period, although I did have some dark brownish spotting on days 10 -13 (this could have been exacerbated by a new sexual encounter without using protection but using the pull out method). Just last Sunday the 14th, I had a very sharp, persistent pain in my lower left pelvic area accompanied by 8 hours of ongoing diarrhea. Then the next day the pain was gone but it felt like I had a constant urge to urinate and the pain seemed to migrate to the center of my pelvis and now I have had an ongoing urge to urinate and it feels like as if someone is sticking their finger in my belly button as I have shooting nerve pain down to my vagina. I saw my Gyno immediately, 5/16, and she tested me for all STDs, yeast, and UTI/PID and the results came back negative yesterday. Now I am dumbfounded as to what this could be and I'm kind of miserable. I will say that the pain is worse after noon until bed. I don't experience is much in the morning as that is when I empty my bowels. Please help me-- I'm obsessing and miserable about this.
doctor
Answered by Dr. Sunil 1 hour later
Brief Answer:
Could be painful bladder syndrome or interstitial cystitis.

Detailed Answer:
Hello dear,
Thanks for choosing HealthcareMagic for your query.
Have gone through your details and i appreciate your concerns.
As you have already been investigated thoroughly for pelvic inflammatory disease,STD and UTI the only common possibility which matches the description given by you is that it can be interstitial cystitis.
World health organisation defines IC as -"A chronic bladder problem associated with a feeling of pain and pressure in and around the bladder area and pelvis. This pain characterstically mimics lower urinary tract symptoms and usually lasts for more than 6 weeks,with all investigations turning up to be normal.
XXXXXXX says-
"Intetrstitial cystitis involves chronic inflammation of the bladder muscle layers, which produces symptoms of severe pelvic and abdominal pain and pressure along with frequent urination with increased urgency to urinate."

Unfortunately there are no tests that can be used to make a definitive diagnosis of IC. Therefore, many cases of IC go undiagnosed. Because IC shares many of the same symptoms of other bladder disorders it is a diagnosis of exclusion.

The following conditions need to be excluded before diagnosing a patient as having interstitial cystitis.
1)urinary tract infections
2)bladder cancer
3)endometriosis

So initially i would recommend you few tests like-
CT scan of urinary bladder.
USG abdomen to rule out endometriosis.
Urine cytology is a test to look for abnormal cells in your urine.Blood clots in urine can be caused by a variety of medical concerns.Inflammation of the bladder or the urethra, kidney and bladder diseases are among the commonest causes ,Hence a CT should be done asap.

Unfortunately here is no cure or definitive treatment for IC. A combination therapy is usually given for symptomatic relief.
Howeverthere no need to panic right now.
Please discuss the possibilities in person with a General surgeon or Nephrologist.

Till the tests are done refrain yourself from taking spicy food,coffee,smoking etc.

Please attach the details of investigations done on you by your gynecologist.
For symptomatic relief from pain take OTC anti inflammatory for time being like ibuprofen.

Follow up with details.
A detailed in person physical examination should be done by at least a general surgeon also.
Wish you great luck dear.
Thanks.


Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Sunil 12 hours later
Dear Dr. XXXXXXX

Thank you very much. I had also thought about cystitis as well as I thought the symptoms matched what I was feeling. I also do note that one the days I drink coffee, the pain is far worse.

Is it possible cranberry or grapefruit (acidic juices) might help?

What type of doctor should I see? Should I go back to my gynecologist and ask to be referred to a urologist or should I start with my general physician?

Thank you,
Alicia
doctor
Answered by Dr. Sunil 25 minutes later
Brief Answer:
Follow up answer.

Detailed Answer:
Hi again XXXXXXX

Coffee is a stimulant and stimulates the nervius system which causes spasms inalready inflammed muscles.Si its better to avoid any stimulant.

See if it is cystitis then there is inflammtion of muscles in urinary bladder so i don't think cramberry would help any thing acidic would irritate the musosal layer and would increase pain and other symptoms
.Frankly speaking our first target right now should be to reach exact diagnosis.Once we get the diagnosis we can treat it.

You should see a nephrologist.There is no use of going back to gyne better way ids to go back to GP and ask him for a referrel to nephrologist.You can discuss the above mentioned details to convince him/her.

Hope i answered your query well.
Fell free to follow up and remain in touch.

I wish you a quick recovery.
Above answer was peer-reviewed by : Dr. Prasad
doctor
Answered by
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Dr. Sunil

Gastroenterologist

Practicing since :1982

Answered : 351 Questions

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