Interstitial Cystitis
Excerpts from Social Security Ruling 15-1p, policy statement
on Interstitial Cystitis.
This ruling rescinds and replaces a previous ruling,
SSR
02-2p.
I. What is Interstitial Cystitis?
A. IC
is a complex genitourinary disorder resulting in recurring pain or discomfort
in the bladder and pelvic region. The AUA and other medical experts
characterize IC, in part, as an unpleasant sensation (pain, pressure,
discomfort) perceived to be related to the urinary bladder, associated with
lower urinary tract symptoms of more than six weeks duration, in the absence of
infection or other identifiable causes. IC is most common in women and
sometimes occurs before age 18. It is not unusual for people to have prodromal
(early predictive) symptoms years or decades before they get IC. Prodromal
symptoms may include periodic episodes of urinary frequency, bladder pain, or
pelvic pain.
B. In
accordance with the AUA guidelines, a physician should make a diagnosis of IC
only after reviewing the person's medical history and conducting a physical
examination. The physician should also conduct laboratory tests to rule out
certain medical conditions that may result in the same or similar symptoms. For
example, the AUA guidelines recommend a basic laboratory examination that
includes urinalysis and urine culture. NIDDK notes that diagnostic tests
physicians may also use to rule out other conditions include cystoscopy, biopsy
of the bladder wall and urethra, distention of the bladder under anesthesia,
and, in men, culture of prostate secretions.
C. IC
may co-occur with fibromyalgia, chronic fatigue syndrome, irritable bowel
syndrome, inflammatory bowel disease, vulvodynia, chronic headaches, Sjögren's
syndrome, endometriosis, or systemic lupus erythematosus.
D. Treatments
for IC are mostly directed at symptom control. They include, but are not
limited to: changes in diet; physical therapy and pelvic floor strengthening
exercises; stress management; bladder distention; bladder instillation; oral
drugs, such as prescription drugs indicated for IC (for example, Elmiron and
dimethyl sulfoxide), antidepressants, antihistamines, antacids, anticoagulants,
and narcotic analgesics; transcutaneous electrical nerve stimulation; and
surgery, such as substitution cystoplasty or urinary diversion with or without
cystectomy. Treatment is not effective for everyone because response varies
among patients.
Effective on March 18, 2015. Federal Register, Vol. 80, No. 52, Page
14215.
Footnotes omitted here.
See full text at:
https://www.ssa.gov/OP_Home/rulings/di/01/SSR2015-01-di-01.html
