It’s bad enough to have an occasional urinary tract infection. Imagine what it would be like to have one of the chronic conditions such as chronic urinary tract infections and interstitial cystitis, another chronic bladder disorder. Both conditions may feel much the same but there are important differences you need to know about.
Chronic cystitis is when a person has a bacterial or yeast infection of the bladder that doesn’t get better despite multiple antibiotics or anti-yeast medications. It is most common in women who have some sort of immunological disorder or who have a deformity of the bladder and ureters such that the bacteria keep flushing up inside the ureter, only to come down into the bladder and cause bladder infection symptoms after treatment has been resolved. Bacteria can become resistant to antibiotics, especially when many different antibiotics have been used so that they don’t get killed off, even with the strongest oral antibiotics. Sometimes doctors need to use multiple IV antibiotics to kill off the bacteria found in the bladder so that the infection is killed off. Unfortunately, if there is a deformity of the ureters or a double ureter, infections tend to come back again unless surgery is done to correct the deformity.
Interstitial cystitis feels a lot like chronic cystitis but there are no actual bacteria in the urine and the urine is sterile when checked with a urine culture. People with this condition are mostly women (90 percent) who feel exactly like they have a bladder infection, with frequency of urination, burning on urination and chronic urethral pain. They do not tend to have any kidney symptoms nor do they have a fever. The urinalysis is usually normal. The diagnosis is made when the symptoms of bladder infection are there but there are no laboratory findings to support a bladder infection.
Doctors sometimes call interstitial cystitis “painful bladder syndrome” because there is often pelvic pain that feels like pain in the bladder. Painful bladder syndrome is diagnosed when there are bladder symptoms that do not meet the exact diagnostic criteria for interstitial cystitis. About a million people in the US suffer from interstitial cystitis and it is particularly annoying because there is no good treatment for it. The average age of onset of the disorder is aged 40 but it can occur at other ages as well. People with interstitial cystitis are more likely to suffer from lupus, inflammatory bowel disease, vulvodynia (pain in the female genital area), fibromyalgia and endometriosis. There is, however, no reason to believe that any of these conditions are causative of interstitial cystitis.
There are two types of interstitial cystitis. One is ulcerative interstitial cystitis and another is non-ulcerative interstitial cystitis. This distinction occurs during a cystoscopy, where ulcerations of the bladder are seen in ulcerative IC and no ulcerations are seen in non-ulcerative IC. Ulcerative IC is also termed “classical” IC even though it is not the most common form of the disease. The ulcerations are star-shaped and are also known as Hunner’s ulcers. Damage and scarring of the bladder wall can eventually occur with this disorder.