This disease has several potential causes and causes various changes in urinary functioning. One of the main changes is epithelial dysfunction. This occurs when changes in the surface that line the impermeable bladder surface lead to permeability alterations (Kahn & Lombardi, 2016). This can allow potassium ions to traverse the urothelium, which leads to the activation of mast cells and can cause significant pain and changes to urinary patterns. It can also allow bacteria into the urothelial cells, causing recurrent infection in the bladder.
The urothelium also works as a mechanical sensor that allows the patient to know that there is bladder distension, increasing the urge to urinate. It works also as a chemical sensor of urine acidity and composition in healthy individuals (Davis et al., 2014). Changes in this can lead to understanding why this disorder causes sensory nervous system issues that lead to alterations in urinary functioning (Dyer & Twiss, 2014). The pain and discomfort associated with this disorder may be linked to changes in the neurological system which lead the patient to feel an increased urinary urgency and pain when urinating.
Another potential change in urinary function associated with this disease is that it may be linked to autoimmunity. The disorder is shares many features of autoimmune disease in that it is chronic, has remissions and incidences of severity, and can respond to steroids (Dyer & Twiss, 2014). The changes in urinary function associated with this disorder might be associated with the local bladder cell damage that is caused by these cells being attacked by the patient’s immune system. These changes may also be associated with the pain and discomfort that characterizes the disorder. Even though the etiology of the disease is not fully understood, these three factors highlight the potential pathophysiology of the illness and how it leads to the symptoms.
- Davis, N. F., Brady, C. M., & Creagh, T. (2014). Interstitial cystitis/painful bladder syndrome: epidemiology, pathophysiology and evidence-based treatment options. European Journal of Obstetrics & Gynecology and Reproductive Biology, 175, 30–37.
- Dyer, A. J., & Twiss, C. O. (2014). Painful bladder syndrome: an update and review of current management strategies. Current Urology Reports, 15(2), 1–10.
- Kahn, B. S., & Lombardi, T. (2016). Interstitial cystitis: Simplified diagnosis and treatment. Retrieved from http://contemporaryobgyn.modernmedicine.com/contemporary-obgyn/news/interstitial-cystitis-simplified-diagnosis-and-treatment?page=0%2C3