IC and Painful Bladder Syndrome, one in the same?
With the recent news that researchers will be testing a new FDA approved antidepressant drug, amitriptyline at Queen’s University in Ontario, Canada (as well as locations in America) on both Interstitial Cystitis (IC) and “Painful bladder symptom” (PBS…not to be confused with the TV station of the same initials), I feel it might be good to have some info available on ICadvice regarding PBS.
The term Painful bladder symptom is basically what physicians use to describe IC-like symptoms such as urgency, frequency, pelvic/bladder pain related to bladder filling, and nocturia (night time voiding) when no other evidence of disease (of the bladder/urinary tact/etc) can be clearly found. Like IC it is a diagnosis of exclusion.
Typically these patients have chronic symptoms with flares, and like those with IC they sometimes reach a point where their bladder capacities have diminished (shrunken). However, while incontinence is not typically a sign of IC (however a person can have IC and incontinence as two separate, but overlapping conditions) when classifying PBS, both stress and urge incontinence may be taken in to consideration while diagnostically evaluating the patient’s symptoms.
There are no tests or quick ways to determine if a person has BPS, and typically a patient is diagnosed by cystometry (often with hydrodistention). No reliable pathology or etiology has been calculated or collected on the number of people who have been given this diagnosis.
There are some who feel that PBS is just IC, and others who believe that as no IC evidence (such as Hunner’s ulcers or severe pin point bleeding/inflammation) is seen that PBS must be separate from IC. As many as quick to point out, it is becoming more widely accepted that one does not have to have telltale visual evidence to have IC. Thusly doctors often treat PBS patients with IC like drugs and treatment methods, including Elavil and advising the patient to try the IC diet.
Some doctors use the term PBS as a first step diagnosis, until they are able to properly test and subsequently diagnosis a patient with IC (or other condition). In determining what is causing a patients bladder symptoms numerous other illnesses/diseases must be ruled out they include; UTIs, STDs, prostatitis, neurological disorders, kidney stones, bladder stones, vaginal infections or conditions, cystitis as a result of radiation or dug treatment, eosinophilic cystitis, schistosomiasis, and tuberculosis.
According to the IICPN (International Interstitial Cystitis Patient Network Foundation) PBS, IC and Chronic Pelvic Pain Syndrome are all being used to describe the same general set of symptoms. I personally think this is misleading, especially since there can be a great deal of reasons why a patient (especially a woman) can experience chronic pelvic pain such as endometriosis, uterine fibroids, cysts, various cancers, and other serious conditions.
It will most likely be the finding of an IC cause that will be able to say once and for all if IC and PSB are in fact the same condition. If this new study of amitriptyline proves beneficial to both ICers and PBS suffers, I feel it adds weight to the belief that these two conditions are really one in the same. But until then all the medical community can do is try to give those of us with bladder pain/symptoms of any kind as much help, care, understanding, and treatment as possible.
For further reading on this new study please check out these stories:
Antidepressant Drug Tested In Treatment Of Bladder Disease
Antidepressant drug tested in treatment of bladder disease (Article from Queen’s University, Ontario)