"I was in pain all the time": understanding painful bladder syndrome

Painful bladder syndrome (PBS), is a chronic condition that primarily affects the bladder and surrounding pelvic region.

For many women, this condition can significantly impact a woman's quality of life, leading to discomfort, pain, and urinary symptoms that may persist for years. And unfortunately, there isn't sufficient understanding into the cause of interstitial cystitis, which means that women are often left managing the condition for years without a light at the end of the tunnel.

So What is Painful Bladder Syndrome?

Painful bladder syndrome is characterised by recurring discomfort or pain in the bladder and surrounding pelvic area. Doctors don't know the cause of painful bladder, but it is thought to involve a combination of factors, including inflammation of the bladder lining, abnormalities in the protective lining of the bladder, pelvic floor dysfunction, and nerve-related issues.

Who Will Get Painful Bladder Syndrome?

Sarah was 35 when she started to experience symptoms of PBS. "I was in pain all the time. At 33, I felt too young to have a 'bladder problem' and I thought it was recent UTIs that had worsened"

Painful bladder syndrome can affect women of all ages, but it is most commonly diagnosed in individuals between the ages of 30 and 40. However, it is essential to note that women over the age of 35 are particularly susceptible to developing this condition. Additionally, women who have a history of urinary tract infections (UTIs), pelvic trauma, or autoimmune disorders may have a higher risk of developing PBS.

How Do Know If You Have PBS?

The symptoms of painful bladder syndrome can vary from person to person but often include:

• Urinary Urgency: A sudden and intense need to urinate.

• Frequent Urination: Having to urinate more often than usual, often in small amounts.

• Pelvic Pain: Discomfort or pressure in the pelvic region, which may worsen as the bladder fills.

• Painful Intercourse: Pain or discomfort during sexual intercourse, known as dyspareunia.

• Bladder Pain: A persistent, dull, or sharp pain in the bladder area.

• Nocturia: Waking up multiple times during the night to urinate.

These symptoms can significantly impact daily activities, social interactions, and emotional well-being, leading to stress and anxiety in affected individuals. If you think that you have any of these symptoms or suspect you might have PBS, it's important to discuss with your GP.

Diagnosing Painful Bladder Syndrome

Diagnosing painful bladder syndrome can be challenging due to its overlapping symptoms with other urinary and pelvic disorders.

Emma, 38, was diagnosed with Painful Bladder Syndrome last year. "Getting the diagnosis was a relief in some ways because it finally gave a name to the mysterious pelvic pain I had been experiencing for years. However, managing the symptoms has been an ongoing journey. I've had to make significant adjustments to my diet and lifestyle, and while some days are better than others, I'm grateful for the support of my healthcare team and fellow sufferers who understand what I'm going through."

However, healthcare professionals typically use a combination of medical history, physical examination, and diagnostic tests to reach a diagnosis.

1. Medical History: Your doctor will inquire about your symptoms, medical history, and any previous urinary tract infections or pelvic trauma.

2. Physical Examination: A pelvic examination may be performed to check for signs of inflammation, tenderness, or abnormalities in the pelvic region.

3. Diagnostic Tests: These may include urine tests to rule out infections, cystoscopy to examine the bladder lining, and bladder function tests to assess urinary patterns and bladder capacity.

Treatment Options for Painful Bladder Syndrome

While there is no cure for painful bladder syndrome, several treatment options can help manage symptoms and improve quality of life. Treatment plans are often tailored to each individual based on the severity of symptoms and their impact on daily life.

Lifestyle Changes

Making changes to your diet and lifestyle can help alleviate symptoms. This may include avoiding trigger foods and beverages such as caffeine, alcohol, spicy foods, and artificial sweeteners. Additionally, practicing stress-reduction techniques and maintaining a healthy weight can be beneficial.

Medication

Your doctor may prescribe medications to help relieve pain, reduce inflammation, or relax the bladder muscles. These may include oral medications, bladder instillations, or nerve pain medications.

Pelvic Floor Therapy

Pelvic floor physical therapy can help strengthen and relax the muscles of the pelvic floor, reducing pelvic pain and improving bladder function. This can be arranged via a referral by your GP - ask to see a Women's Health Physiotherapist.

Bladder Treatments

There are a few procedures that might help, such as bladder instillations, bladder distention, or botulinum toxin injections may be recommended for individuals with severe symptoms that do not respond to other treatments.

Alternative Therapies

Some women find relief from acupuncture, biofeedback, or bladder supplementation that soothes the bladder muscle. Hormone therapies may also offer benefits to women who are experiencing PBS and it's worth discussing further with your doctor if you would like to explore these options.

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