Chronic Pain Today

Crohn’s Disease, a part of Inflammatory Bowel Disease, will have inflammation through the entire bowel wall thickness. Crohn’s disease of the small intestine is called regional enteritis, while Crohn’s disease of the colon is called granulomatous colitis. People with Crohn’s disease will typically show abdominal tenderness to the touch especially in the lower right quadrant. Weight loss and general feeling of malaise will be felt in symptoms. There can be a loss of appetite and increase in flatulence. With those with Crohn’s disease there can be the same nutritional defects. Being on an elimination diet or a high fiber diet can show promise.

Interstitial cystitis (IC) is a chronic and debilitating disease of the urinary tract and bladder that affects approximately one million people. There is an inflamed and irritated bladder wall that leads to many bladder symptoms. The bladder wall of an IC patient will have stiffening and scarring of the bladder, less bladder capacity as a result of the scarring, small pinpoint bleeding on the bladder (glomerulations) and ulcers in the bladder lining (Hunner’s ulcers).

So much isn’t known about the illness, even though it has been around for a while now. This article deals with the signs and the symptoms of interstitial cystitis. A general guideline for interstitial cystitis is from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), and although it has come under fire and scrutiny as it doesn’t incorporate all of the prevailing symptoms and has some things included as an exclusion that some people with IC do indeed have, it is meant as a oversee of the illness and not a conclusive.

NIDDK Research Definition of Interstitial Cystitis

Inclusion Criteria
1. Cystoscopy - glomerulations and/or classic Hunner’s ulcer.
2. Symptoms - bladder pain and/or bladder urgency.

Exclusion Criteria
1. Bladder capacity greater than 350cc on awake cystometry.
2. Absence of an intense urge to void with the bladder filled to 100cc during cystometry using a fill rate of 30-100cc/min.
3. Demonstration of phasic involuntary bladder contractions on cystometry using the fill rate described in number 2.
4. Duration of symptoms less than 9 months.
5. Absence of nocturia.
6. Symptoms relieved by antimicrobials, urinary antiseptics, anticholinergics, or antispasmodics.
7. Frequency of urination while awake of less than eight times a day.
8. Diagnosis of bacterial cystitis or prostatitis within a 3-month period.
9. Bladder or ureteral calculi.
10. Active genital herpes.
11. Uterine, cervical, or urethral cancer.
12. Urethral diverticulum.
13. Cyclophosphamide or any type of chemical cystitis.
14. Tuberculous cystitis.
15. Radiation cystitis.
16. Benign or malignant bladder tumors.
17. Vaginitis.
18. Age less than 18 years.

This is a research definition only (for inclusion of patients in clinical trials) and is not necessarily applicable to diagnoses made in clinical practice. The major difference in the less stringent Interstitial Cystitis Database (ICDB) inclusion criteria for the diagnosis of IC is that cystoscopy (and its related diagnostic criteria) is an optional criterion for entry into the ICDB study. The rigid urodynamic exclusion criteria in the NIDDK definition do not exclude patients from an ICDB IC diagnosis.

The symptoms and signs of interstitial cystitis are varied and not every IC patient will have all of them. It is a difficult illness to pinpoint and this is meant only as a guideline to some of the symptoms that the interstitial cystitis patient may have.

1. Pelvic and perineal pain and pressure.
2. Urinary frequency: over 8 times/day; average is 16 times/day; can be up to 60 times/day.
3. Nocturia (excess urination at night).
4. Urinary urgency: urge not relieved by voiding.
5. Over 9 months of symptoms.
6. Dyspareunia (painful ).
7. Hematuria (blood in urine).
8. Symptoms worsen during menstruation.
9. Diminished bladder capacity.
10. and scrotum pain and pressure.
11. Dysuria (pain on urination).
12. UTI (Urinary tract infection) symptoms that do not improve upon antibiotic treatment.

50% of IC patients will have pain while riding in a car or with any prolonged sitting function; 63% are unable to work full time. Perhaps the most staggering statistic of IC is that interstitial cystitis patients are 3-4 times more likely to commit suicide than those who do not have the illness and that they rank below kidney dialysis patients in quality of life. So please, if you have any of the above mentioned signs or symptoms, get to an urologist. This diagnosis takes approximately 7 years to receive, usually through trial and many errors. Get checked, get tested, and get back on tract with your life.

Interstitial cystitis has a relatively long and complicated history. The first case of IC could be as far reaching as the mid 1800’s. Even after 150 years, there is still very little known about the illness. Interstitial cystitis is a chronic and debilitating disease of the urinary tract and bladder that affects approximately one million people. It may not be just one singular illness but one incorporating many different illnesses. There is an inflamed and irritated bladder wall that leads to many bladder symptoms. The bladder wall of an IC patient will have stiffening and scarring of the bladder, less bladder capacity as a result of the scarring, small pinpoint bleeding on the bladder (glomerulations) and ulcers in the bladder lining (Hunner’s ulcers). 5-10% of IC sufferers will have Hunner’s ulcers, the rest have a non-Hunner’s type. So much isn’t known about the illness, even though it has been around for a while now. A general timeline to some of the highlights of the interstitial cystitis illness knowledge progression is as follows:

1836- Mercier documented interstitial cystitis
1887- The term interstitial cystitis was first used by Skene in the book; Diseases of the Bladder and Urethra in Women
beginning 1900’s- Fenwich described ulcers on trigonal tissues
1914- Hunner documented non-trigonal ulcers; documented bladder epithelial damage
1938- Fister compared IC to Lupus
1940’s- first use of caustic instills with aniline dyes and silver nitrate.
1944- IC is now accepted as a disease that affects men as well
1950’s to 1980’s- Both research and information slows to a crawl. IC begins to be viewed as a “women’s hysterical disease”.
1953- IC documented in children.
End of 1970’s- Walsh first used the term “glomerulations”. Messing and Stamey recognizes glomerulations as an indicator.
1987 to 1988- The NIH and ICA offer workshops to establish research criteria. NIH launched a database ICDB (Interstitial cystitis database) studies in 1991.
1997- Christmas wrote comprehensive analysis of history of IC
1993- IC now accepted as most challenging condition in urology.

Following up from yesterday’s Acid and IC link article I am going to list the acidic foods that one should decrease in their diet if they have interstitial cystitis.
” All meat and fish
” Rice
” Oats, Rye, Wheat, Wheat germ, Bran, Cornmeal
” Popcorn
” Pastas
” Breads and other grain products, crackers, pastries
” Pinto, Navy, Garbanzo, red, white, black beans
” Cheese
” Sunflower and Pumpkin seeds
” Walnuts, pecans, cashews, dried coconut, pistachios, filberts, brazil nuts, peanuts, macadamia nuts
” Colas, other carbonated beverages
” Alcoholic drinks
” Coffee and other caffeinated beverages
” Sweetened yogurt
” Sweeteners
” Table salt
” Soy sauce
” Mustard, Ketchup, Mayonnaise, White vinegar
” Nutmeg

However there are some alkalizing foods that will bring down the acidic pH in your system. These are some of the more alkalizing foods that you can eat:
 

” Vegetables except peppers and beets
” Fruits except for blueberries, plums, prunes, and cranberries
” String, soy, lima, green, and snap beans
” Peas
” Potatoes
” Arrowroot Flour
” Flax, millet, quinoa, and amaranth
” Almonds, pignoli, fresh coconut, chestnuts
” Alfalfa sprouts, radish sprouts, chia sprouts
” Unsprouted sesame
” Unsalted butter
” Milk, cream, goat’s milk
” Eggs
” Whey
” Plain yogurt
” Raw unpasterized honey, dried sugar cane juice, brown rice syrup
” Fruit juices, vegetable juices
” Most herbal teas
” Garlic, cayenne, gelatin, most herbs, most spices, vanilla extract
” Miso
” Most vegetable and unprocessed sea salt
” Brewer’s yeast
” Unprocessed cold-pressed oils