Interstitial Cystitis

　　The etiology of interstitial cystitis (IC) is not yet fully clear, and the following hypotheses are proposed:

　　1. Vascular and Lymphatic Obstruction
　　It was proposed that bladder fibrosis may be caused by pelvic surgery or infection, leading to obstruction of lymphatic vessels in the bladder wall and causing thrombotic angiitis or persistent small artery spasm due to vasculitis, but there is insufficient evidence.

　　2. Infection
　　It was proposed that bacterial, viral, or fungal infection may be the cause of IC, but there have been no reports of detecting the above three pathogens in IC patients.

　　3. Neurohumoral Factors
　　Mast cells are increased in the bladder proper membrane and detrusor muscle of IC patients. Cold, neuropeptides, drugs, trauma, toxins, etc., can activate mast cells, release vasoactive substances to sensitize sensory neurons, which further activate mast cells by releasing neurotransmitters or neuropeptides; mast cells can also directly cause vasodilation or bladder mucosal damage, leading to inflammation.

　　4. Immune Factors
　　The disease responds well to corticosteroid therapy, and some patients may detect anti-bladder mucosal antibodies in the blood. Many scholars have also found that autoantibodies or immune complexes produced against vascular antigens can deposit in the vascular wall, activate the complement system, and participate in the pathogenesis of IC.

　　5. Mucosal Permeability
　　It is speculated that IC is caused by the dysfunction of the bladder epithelium, which increases its permeability and allows urine to leak into the bladder wall through the transitional epithelium, causing bladder inflammation. Some people have confirmed that IC patients have an increase in TH protein in the superficial epithelium of the bladder, indicating an increase in mucosal permeability.

　　Interstitial cystitis patients often have long-term progressive frequency of urination, urgency, and increased nocturnal urination. In the late stage of interstitial cystitis, bladder contraction or ureteral reflux, ureteral stenosis can lead to renal calculus or pyelonephritis, even renal failure.

　　Interstitial cystitis patients often have long-term progressive frequency of urination, urgency, and increased nocturnal urination. Pain in the suprapubic area is obvious when the bladder is full, and pain in the urethra and perineum may also occur, which can be relieved after urination. Hematuria may occur occasionally, which is obvious when the bladder is overdistended. Some patients may have allergic diseases in their medical history.

　　The prevention of interstitial cystitis should pay attention to the following aspects in daily life:
　　1. Drink plenty of water to effectively avoid the possibility of bacterial invasion.
　　2. Pay attention to keeping your own body clean on a daily basis.
　　3. Try not to hold urine before sex, which is also very important for preventing the occurrence of cystitis.
　　4. Maintain the habit of urinating every 2-3 hours during the event period, and pay more attention to adding vitamins and lactic acid bacteria, etc.

　　In addition to clinical manifestations, interstitial cystitis also requires relevant auxiliary examinations. The commonly used examinations in clinical practice are as follows:
　　1. Laboratory examination
　　Most patients have normal urinalysis, and hematuria may occur.
　　2. Imaging examination
　　Excretory urography generally shows no abnormalities, and when there is reflux, the film shows renal pelvis hydrops and a decrease in bladder capacity.
　　3. Cystoscopy
　　Cystoscopy is an important method for diagnosing interstitial cystitis, and it is very painful for patients due to the decrease in bladder capacity. After liquid bladder dilation, small petechiae, hemorrhage, scars, fissures, or bleeding may be visible at the top of the bladder.

　　In addition to conventional treatment, attention should be paid to the following aspects in diet for interstitial cystitis:

　　First, suitable diet
　　1. Drink more water to maintain a daily urine output of at least 1500 milliliters or more.
　　2. Eat more diuretic foods such as watermelons, grapes, pineapples, celery, and pears.
　　3. Snails, corn, mung beans, and white scallions can help alleviate symptoms such as frequent urination, urgency, and dysuria.

　　Second,禁忌 drinking water
　　1. Avoid acidic and spicy刺激性 foods such as strong alcohol, chili, balsamic vinegar, and sour fruits.
　　2. Avoid eating citrus fruits because they can cause alkaline urine, which is conducive to bacterial growth.
　　3. Caffeine can cause bladder neck contraction and lead to spasmodic pain in the bladder, so one should drink less coffee.

　　Interstitial cystitis is treated with medication, bladder water balloon dilation, and surgery. Specific treatment methods are as follows:

　　1. Non-surgical Methods
　　Currently, treatment mainly adopts non-surgical methods to alleviate symptoms and improve the quality of life, such as bladder hydrodistension, medication, and nerve stimulation. Medication mainly includes oral medication and bladder irrigation. However, not every treatment method is suitable for all patients.

　　2. Surgical Treatment
　　When non-surgical treatment is ineffective, consider surgical treatment. Transurethral resection has good recent effects but is prone to recurrence. Bladder augmentation and total cystectomy are more traumatic and should be chosen with caution. Given the diversity and complexity of the causes of the disease, comprehensive treatment may be more effective.