Bladder Epithelium Essay -- Health, Diseases, Biopsy of the Bladder

Researchers believe that normal repair of the epithelial lining of the bladder does not occur in patients who develop IC (ARHP, 2008). One theory proposes that the bladder epithelium or lining of glycosaminoglycans (GAG) is damaged due to bladder injury and exposes the sensory nerves to irritants and triggers a noxious sensation. The damaged epithelium allows absorption of potassium and urea into the bladder wall (Klutke & Klutke, 2008). The damaged epithelium may lead to mast cell activation and the release of histamine. It is proposed that vasoactive, nociceptive, and proinflammatory molecules released from mast cells create neuronal sensitization and emit neurotransmitters that continue to stimulate the mast cells in the bladder and play an important role in the chronic and painful symptoms of IC (Sant, Kempuraj, Marchand, & Theoharides, 2006). There may be a possibility that heredity may play a part in some forms of IC. In a few cases, IC has affected a mother and a daugh ter or two sisters, but it is not usually familial (Clemens, Joyce, Wise, & Payne, 2007). Data has also shown that patients with IC have a higher incidence of certain immunological or allergic conditions. These conditions include allergies, irritable bowel syndrome, sensitive skin, vulvodynia, fibromyalgia, and migraine headaches (ARHP, 2008). Interstitial cystitis is divided into two categories: ulcerative or classic and nonulcerative or Messing-Stamey types. The classic or ulcerative type clinically presents with a diffusely reddened appearance to the bladder surface epithelium associated with one or more ulcerative patches surrounded by mucosal congestion. The ulcers are called Hunner ulcers. Hunner ulcer upon cystoscopic examination is the ... ...nage this condition the patient must maintain a relationship with her primary care provider, be diligent with tracking her symptoms and managing her diet and medications (ARHP, 2008). Differential Diagnosis The ARHP suggest that the differential diagnosis of IC include other causes of pelvic pain and urinary complaints. These include urinary tract infections, overactive bladder, gynecological chronic pelvic pain, endometriosis, and bladder carcinoma. The effects of certain drugs may also cause these symptoms. These drugs include cyclophosphamide, aspirin, NSAIDs, and allopurinol (ARHP, 2008). These need to be excluded as part of the diagnostic process. Review of Literature Several research articles have been reviewed in order to identify the most recent evidence based practice techniques for diagnosing and managing patients with interstitial cystitis.