Experience From The Hubbard Clinic
Since 2000 one of the
main illnesses we treat at the Hubbard Clinic is Interstitial Cystitis with
over 1900 patients treated. We have learned a lot about the condition.
Statistically, it is believed 4-6% of all women suffer from it. If you take
Louisville and the surrounding 8 counties in Kentucky plus the 4 counties in
southern Indiana, a total of 27,580 ladies over 18 years old have some symptoms
from the illness. Men can also be affected but much less so than women.
We find the most
important diagnostic tool is getting a good history from the patient. CT Scans,
urine cytology, and cystoscopies under local are expensive and add little
information. The most common person we treat has been on antibiotics for long
periods with negative urine cultures and minimal relief of symptoms.
It is rewarding to
tell a patient "at their wits end" that we feel we know
what is causing the symptoms, it is treatable, it has nothing to do with cancer
or fertility and it will not take one day off their life but can drive them
crazy. Step one is gaining the patient's confidence that we will be there
for them to get things better. There is no magic pill that will get people well
immediately. Diet, allergies, and water intake are always step one. For those
with worse symptoms a cystoscopy under conscious sedation is done in the
office. The important findings are the stretchability of the bladder plus
degree of pain with distension. Bladder biopsies are taken to test the role
allergies may be playing.
(IC) is a chronic bladder syndrome that is usually characterized by excessive
urinary urgency and frequency day and night, pressure above the pubic area,
pelvic pain and pain during or after sexual intercourse. The most typical
symptom of IC is pelvic pain. The course of the disease is usually marked by
flare-ups and remissions. Many report even having some of these symptoms as a
IC is an engima
because we really don't know what causes it, nor do we currently have a
cure. However, it is a chronic condition that can be controlled with the
proper guidance. The most widely held theory at present is that clinical IC
begins with the development of an injury to the bladder epithelium
(lining). This injury may have occurred following a bladder
infection, childbirth, pelvic surgery or a traumatic sexual assault. In
addition, IC is also seen in patients with other chronic conditions such as
fibromyalgia, IBS, migraine headaches and endometriosis. Many believe
that IC has an autoimmune component but this theory is still being
researched. The variation seen in both the range of symptoms and patient
responses to different therapies suggest that multiple factors are involved in
this disease process.
Due to this
uncertainity, IC is often either undiagnosed or improperly diagnosed. A patient
many times consults with multiple specialists before a diagnosis is made. Yes,
there are doctors in this area who do not believe IC exists.
The diagnosis of IC is
often one of exclusion- other conditions such as chronic bacterial infections,
vulvar vestibulitis, endometriosis, and bacterial prostatitis must first be
ruled out. Presumptive diagnosis may be made based on a thorough patient
history, pelvic exam, and bladder diary. Confirmation diagnosis is then made
with cystoscopy with hydrodistension under conscious sedation.
At the Hubbard Clinic we
want to make sure the symptoms are indeed from IC then start treatment
The goal of treatment
for IC includes repairing epithelial dysfunction, reducing neurogenic
inflammation, and stabilizing mast cells. Given the possible multiple causes of
IC, it is unusual for patients to respond to a single treatment.
It is crucial in the
treatment of IC to establish a multimodal (more than one method) treatment
strategy. Diet modification has proven quite effective. Multimodal drug therapy
using antihistamines, antidepressants, urinary analgesics, Elmiron (for severe
cases) and/or bladder pain cocktails are all part of the treatment strategy.
Once this is accomplished Physical Therapy can then become quite helpful.
Because each patient is unique and symptoms vary, each patient must receive an
individualized treatment plan to get IC in remission.
Call 502-893-3510 to schedule an appointment for an evaluation of your symptoms now.