Bladder Pain Syndrome (or…the Syndrome formerly known as Interstitial Cystitis)
What is Bladder Pain Syndrome?
BPS/IC is usually described as a disorder with symptoms of mild to severe bladder pain and an urgent and/or frequent need to urinate. In a paper by Nickel et al (2010), BPS/IC was defined as ‘…a pelvic pain condition that has been reported to be associated with other regional and systemic pain syndromes, particularly irritable bowel syndrome, fibromyalgia and chronic fatigue syndrome, but also vulvodynia, headaches and temporomandibular disorder’. The change in terminology (from IC) to Bladder Pain Syndrome (or sometimes Painful Bladder Syndrome or PBS) came about because not every patient fits the criteria of having ulcerations of the bladder lining (called Hunner’s Ulcerations); so really IC is neither interstitial nor is it cystitis!
Interstitial cystitis/bladder pain syndrome (IC/BPS) is most definitely not a psychological disorder, but the symptoms can be worsened by stress, anxiety, depression, and other psychological factors. Although there have been many ‘IC Diets’, there is huge variability in what may or may not be a bladder irritant – for some, the consumption of tomatoes, spicy foods, citrus or dairy may be a trigger, but other patients report no effect.
What we do know is that the optimal treatment for someone who has BPS (or PBS or IC…) will be integrative and functional and will focus not only on pelvic health, including downtraining overactivity in the pelvic floor muscles, vulvar care, supporting good bowel habits but also includes education about pain management, the importance of nutrition, good sleep patterns and stress management. Knowing that you have a toolbox to manage flares is often the most valuable asset in a patient’s toolbox!
I had the pleasure of chatting recently with my friend and colleague, Jilly Bond, who I’m delighted to say will be doing a full presentation on the management of Bladder Pain Syndrome when she takes to the stage at Woman on Fire in Brighton in April 2018.
Hope you enjoy our conversation and you’ll come and join us for my unapologetically favourite women’s health event!