New Approaches in Managing Interstitial Cystitis/Bladder Pain Syndrome

Amber Jerauld, PharmD, BCACP; Lyndsay Wormuth, PharmD, BCACP; Brent Carlson, PharmD, BCPS, BCCCP

Disclosures

US Pharmacist. 2016;41(9):29-33. 

In This Article

Pathogenesis

The etiology and pathogenesis of IC/BPS is not well understood. There may be several factors leading to the manifestation of this disease, and several varying mechanisms have been proposed. Urothelial abnormalities have been found in IC/BPS cases, including an autoimmune or immunologic response causing altered bladder epithelial expression of specific antigens, alterations in the glycosaminoglycan (GAG) layer, and altered cytokeratin profile.[1,6] The GAG layer helps protect the bladder from surface irritants, so if it is altered, irritants may leak from the urine into the bladder tissue, resulting in pain and inflammation. In some cases, the bladder wall is scarred or shows petechial hemorrhages known as glomerulations. In approximately 10% of IC/BPS cases, Hunner lesions or patches of broken skin on the bladder wall are present.[7]

Some information suggests that foods and beverages such as alcohol, caffeine, citrus fruits, tomatoes, and spicy foods may worsen symptoms; however, this is variable from patient to patient.[8]

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