.

Interstitial cystitis, or IC, is a chronic condition characterized by recurring discomfort or pain in the bladder and/or pelvic region along with irritative voiding symptoms (urgency, frequency).1,2 IC has no single presentation but may be best viewed along a spectrum of symptom severity.2

Etiology of IC

 

The etiology of IC is not completely understood, but several theories have been proposed.3 These theories include

  • Bladder urothelium/glycosaminoglycan (GAG) layer permeability dysfunction3
    • Results in solute (potassium, urea, and other positively charged particles) leak into the interstitium
  • Mast cell activation3
    • When activated, mast cells release histamine and other mediators, stimulating sensory nerve fibers and causing local tissue damage and vascular constriction
  • Neurogenic inflammation3
    • Causes additional cell damage and further activation of mast cells. Over time, the ongoing effects of activation of mast cells and C-fibers damage local tissue and cause fibrotic changes within the bladder

Epidemiology of IC

IC is becoming increasingly understood and recognized among healthcare professionals, and studies have revealed the condition to be far more prevalent than previously thought.4, 5 IC occurs in both men and women. Although it is most commonly diagnosed in women, IC is being recognized increasingly more in men.4

Symptoms of IC

Patient presentation of IC is variable—symptoms may range from mild discomfort, pressure, or tenderness to intense pain in the bladder and/or pelvic region. Symptoms may also include urgency, frequency, nocturia, and painful intercourse.6 Symptoms of IC tend to develop gradually; they may episodically flare up or go into remission.2 Often, these symptoms mimic those of other conditions such as unresolved overactive bladder (OAB), recurrent urinary tract infection (rUTI), unresolved endometriosis, unresolved chronic pelvic pain, vulvodynia, or chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).1, 5 Due in part to these “mimicking conditions,” patients with IC can be symptomatic for years before a correct diagnosis is made.7

Diagnosing IC

Simple steps exist to evaluate patients for IC. For more information on identifying and diagnosing patients for IC, click here.

Treating IC—A multimodal approach

Therapeutic agents exist for the treatment of IC. Along with pharmacologic agents, diet, and lifestyle modifications, patients should receive counseling on expectations for treatment and ways to help manage their condition.8

For more about the foundation of IC therapy, click here.





Important Safety Information

  • Contraindications: ELMIRON® is contraindicated in patients with known hypersensitivity to the drug, structurally related compounds, or excipients
  • Anticoagulant Activity: ELMIRON® is a weak anticoagulant (blood thinner) which may increase bleeding. Patients undergoing invasive surgery or having signs/symptoms of underlying coagulopathy or other increased risk of bleeding (due to anticoagulant therapy or high doses of anti-inflammatory drugs) should be evaluated for the risk of hemorrhage
  • Alopecia: In clinical trials of ELMIRON®, alopecia began within the first 4 weeks of treatment. Ninety-seven percent (97%) of the cases of alopecia reported were alopecia areata, limited to a single area on the scalp
  • Use in Pregnancy: ELMIRON® is a Pregnancy Category B drug
  • Most Common Adverse Reactions (frequency 1% to 4%): Alopecia (4%), diarrhea (4%), nausea (4%), headache (3%), rash (3%), dyspepsia (2%), abdominal pain (2%), liver function abnormalities (1%), dizziness (1%)


    References:
  1. Hanno PM. Interstitial cystitis and related disorders. In: Walsh PC, ed-in-chief; Retik AB, Vaughan ED Jr, Wein AJ, eds; Kavoussi LR, Novick AC, Partin AW, Peters CA, associate eds. Campbell’s Urology. Vol. 1. 8th ed. Philadelphia, PA: Saunders; 2002:631-670.
  2. Parsons CL. Interstitial cystitis: epidemiology and clinical presentation. Clin Obstet Gynecol. 2002;45:242-249.
  3. Evans RJ. Treatment approaches for interstitial cystitis: multimodality therapy. Rev Urol. 2002;4(suppl 1):S16-S20.
  4. Clemens JQ, Meenan RT, O’Keeffe Rosetti MC, Gao SY, Calhoun EA. Prevalence and incidence of interstitial cystitis in a managed care population. J Urol. 2005;173:98-102.
  5. Rosenberg MT, Hazzard M. Prevalence of interstitial cystitis symptoms in women: a population based study in the primary care office. J Urol. 2005;174:2231-2234.
  6. National Kidney and Urologic Diseases Information Clearinghouse. Interstitial cystitis/painful bladder syndrome. http://kidney.niddk.nih.gov/kudiseases/pubs/interstitialcystitis. Published May 2005. Accessed September 21, 2007.
  7. Driscoll A, Teichman JMH. How do patients with interstitial cystitis present? J Urol. 2001;166:2118-2120.
  8. Kahn BS, Stanford EJ, Mishell DR Jr, Rosenberg MT, Wysocki S. Management of patients with interstitial cystitis or chronic pelvic pain of bladder origin: a consensus report. Curr Med Res Opin.  2005;21:509-516.