The disease described by Francesca Neri in the book Come carne viva has the same symptoms as classic cystitis, but there are no signs of urinary infection. The therapy is uncertain: living with the disease requires many precautions in the diet and beyond
Actress Francesca Neri recently declared – and told in an autobiographical book Come carne viva – that she suffers from interstitial cystitis, a disabling, painful and chronic disease with unclear causes and uncertain therapy. But what exactly is this pathology and what differentiates it from “common” cystitis? Symptoms are the same as in “classic” cystitis: continuous need to urinate, burning, pelvic pain, but contrary to what happens in the “common form, there are no signs of urinary infection, the microbiological analyzes are in fact negative and the antibiotics have no effect.
Fortunately, the disease is rare, even more so in men, it can affect people of any age or sex. However, it occurs more frequently in women, aged between 20 and 50 years. At the origin of the inflammation there is an alteration of the bladder wall, but the causes of this inflammation are not known even if we think of infectious origins (unknown and undetectable), rather than hormonal, vascular, neurological or the consequences of an immune pathology. In women interstitial cystitis often associated with vaginal pain, such as to prevent sexual intercourse. The men instead they may suffer from pain in the testicles, scrotum and perineum and have painful ejaculations. Often sufferers also report migraines, muscle and joint pains, gastrointestinal problems and allergies to be affected.
The diagnosis, not at all easy and essentially clinical – explains Giario Conti, head of urology at the Sant’Anna hospital in Como – We proceed by exclusion, starting from the description of the symptoms and then passing to urine tests (to exclude the presence of infections from bacteria), to aultrasound of the urinary system and then to cystoscopy and bladder wall biopsy. The appearance on the bladder mucosa of lesions, called Hunner’s ulcers, a clear indication of interstitial cystitis even if they are not always present
Unfortunately there are no definitive cures, as Francesca Neri says we must learn to live with the disease, trying to reduce what could be the triggers including certain foods, such as hot or spicy ones, and alcohol. Better to forget about smoking too. All elements that contribute to bladder irritation. Reducing stress and strengthening the pelvic floor muscles can help improve symptoms. In some cases – adds Conti – botulinum toxin is also used to reduce bladder spasms and the need to urinate. And in others we can think of the “neuromodulation” that is used in cases of overactive bladder. On the pharmacological front, it is possible to intervene, for example, with instillations of sodium polysulphate pentosan which helps to re-establish the surface protective coating of the bladder, with supplements that counteract painful neuro-inflammatory processes, as well as, in general, with painkillers, anti-inflammatories and even antidepressants. In very serious cases and refractory to any therapy, one can also think of surgery which often involves removing the bladder and replacing it with an intestinal loop that is opened and reshaped and placed in the same place as the bladder. Good functional results are obtained without external pouches.
September 28, 2021 (change September 28, 2021 | 19:01)
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