Diagnostic criteria that must be met
A. At least one of the following two is met as seen on cystoscopy.
1. submucosal renal filamentous hemorrhagic spots — The examination must be performed under good anesthesia so that the bladder can fill well and the perfusion pressure is controlled at about 80-100 cmH2O and the bladder can be filled twice before observation. The submucosal blebs are scattered and range over at least 3/4 of the bladder area, with at least ten blebs in every 1/4 of the bladder area. The artifact of bleeding spots caused by friction of the cystoscopic sheath must also be excluded. Zhang Yaoguang, Department of Urology, Beijing Hospital
2. Typical Hunner’s ulcers — In a small number of patients, typical Hunner’s ulcers may be seen in a scattered pattern as the bladder fills and dilates.
B. At least one of the following two clinical symptoms is met.
1. urinary frequency and urgency
2. pain in the bladder area
Diagnostic conditions that must be excluded
1. Cystoscopic examination of bladder volume greater than 350 ml in a conscious state of the patient.
2, When the bladder is perfused to 100ml of gas or 150ml of fluid, the patient still has no urge to urinate.
3.At the above perfusion rate, the patient’s bladder appears to have no inhibitory contractions.
4.The symptoms persist for less than 9 months.
5.No increase in nocturia.
6.The symptoms are relieved after treatment with antibacterial drugs, anticholinergic drugs or antispasmodic drugs.
7.The number of frequent urination during the day is less than 8 times.
8.Bacterial cystitis or prostatitis has been diagnosed within 3 months.
9.Stone in the lower end of the bladder or ureter.
10.Active genital herpes.
11, Malignant tumors of the uterus, cervix, vagina, and urethra.
12.Urethral diverticulum.
13, Chemical cystitis (such as cyclophosphamide, etc.).
14, tuberculous cystitis.
15.Radiation cystitis.
16, Benign and malignant bladder tumors.
17, Inflammation of the vagina.
18, Patient’s age is less than 18 years.
Treatment.
Treatment regarding interstitial cystitis is chastening, the multitude of methods itself means that there is no effective treatment, the diversity of causes of interstitial cystitis may also be a cause. Stimulating diet is closely related to the disease and improvement of diet is one of the basic treatments; biofeedback and pelvic floor muscle training have limited efficacy; pain medication can relieve the patient’s pain to some extent but does not cure the disease; antihistamines may be effective in interstitial cystitis with mucosal mast cell infiltration; bladder perfusion therapy drugs include dimethyl sulfoxide, capsaicin, RTX, heparin and Sodium hyaluronate, etc., have anti-inflammatory, analgesic and mucosal protective effects; severe interstitial cystitis may present with reduced bladder volume, but the possibility of postoperative pain unrelieved by bladder enlargement or even cystectomy for urinary diversion still exists and should be chosen with caution. A more encouraging development in recent years is the results of a bulk clinical study of sodium pentose polysulfate (ELMIRON) showing that in mild to moderate interstitial cystitis; sacral nerve electrical stimulation neuromodulation therapy (bladder pacemaker) is effective not only in relieving bladder pain but also in treating pelvic floor pain, and recent studies have also found that neuromodulation therapy reduces urinary APF and restores HB-EGF levels, contributing to restoration of the blood-urine barrier in the bladder mucosa.
Dietary considerations.
Many people with interstitial cystitis (IC) find that dietary changes can help control the condition and prevent recurrence, but data collected by physicians and the Interstitial Cystitis Association (ICA) show that what foods trigger increased symptoms is a function of individual body composition.
While there are clear guidelines that most people with IC can accept, finding out which particular foods cause a change in symptoms takes patience. Many IC patients report that “food restriction” is an effective treatment modality and believe that patience is worth the effort. A recent survey of IC patients showed that 50% reported that acidic, alcoholic, carbonic beverages and coffee and tea aggravated their pain.
If you want to explore the role of diet in your symptoms, the best way is to start with foods that most people with IC find tolerable and then slowly add other foods, trying small meals rather than overeating, and keeping a dietary log of each food you eat. If the symptoms do not return, you can continue to eat them. If the symptoms worsen, you can remove them from your diet.
Suggestions.
1. Add a small amount of salt to carbonated drinks.
2. try less acidic orange juice.
3. Cook all condiments containing alcohol.
What should I do if I eat something I should not eat?
If you eat food that can cause a reaction, take a glass of water with a tablespoon of sodium bicarbonate. This will alkalize the urine and prevent the acid from irritating the bladder in the urine, some people take this method as a preventive measure, but if you have heart or high blood pressure problems, you should discuss this with your doctor because sodium bicarbonate contains high concentrations of sodium and salt, which can cause water retention in the body. In addition, if symptoms recur, drink plenty of water to dilute the urine.
Changing your diet to control IC is a challenge. After a period of trial and error, if you still cannot find your ideal recipe, do not be discouraged, the process takes time and patience, but the end result is worth the wait and you will have a wonderful resolution of your symptoms.