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528716 tn?1212777567

What could be causing these symptoms?

(have also posted this in the Urology forum)
Have history of Interstitial Cystitis and Spine DDD + Spinal Cord Compression (10 yrs dx'd with IC; Spinal stuff is 30+ years, am 48 yrs old).

The bladder symptoms have changed over the last few years and don't seem to be strictly IC.
The "new" symptoms are: mod/profuse sweating, heart racing, pounding headache, severe heartburn, flushing with bladder filling, voiding and post-voiding.
Night time symptoms are severe, with need to void at a minimum hourly, some times as often as every 15 minutes. Cannot ignore urgency/frequency without triggering above symptoms. Also have upper left quadrant sharp pain, feeling of distention (just below rib cage) which can be quite severe.
Endocrinologist suspected bladder pheo, as plasma dopamine levels were elevated (more than double upper normal limit); ordered MIBG scan which was negative

The spinal troubles are ongoing and there are disc protrusions in the thoracic spine, screws extending into ventral canal in the cspine and moderate spinal stenosis (cspine, throughout fused levels, c45, c56, c67)

In researching IC, I am not seeing this type of bladder/voiding symptoms "fitting" IC (described above).

Is it possible that the IC is getting worse? Or, could this possibly be connected to the spinal stuff? What type of doctor could help me figure this out?

The new symptoms are impossible to ignore and are getting worse. I am not sure what to do or who to see at this point, but definitely need a hand here.
4 Responses
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509188 tn?1211224731
MEDICAL PROFESSIONAL
You have a complicated history with multiple neurologic problems as well as the local bladder problem of IC. Overall I suspect multiple factors are contributing to your complaints.  First, herniated discs compressing nerves in the lumbar and sacral spinal cord, or a spinal stenosis in the cervical cord can affect bladder function.  Patients often have difficulty starting their stream, or can't empty their bladder due to a weak contraction of the bladder.  Many patients also get an overactive bladder type picture with urgency, frequency.
Your main problem, however may be caused by autonomic dysreflexia (AD).  AD occurs in patients with a spinal cord injury above the 6th thorasic vertebrae.  Stimulation from a full bladder/full rectum can cause a sympathetic nervous system discharge (imbalance) resulting in a rise in blood pressure and headache, slow heart rate or rapid heart rate, flushing and intense sweating.  Other symptoms include possible anxiety, agitation, blurred vision and nausea.  
I recommend that, if posible, you take your baseline blood pressure then take it during the sweating and pounding headache.  If the blood pressure is significaltly higher than baseline you may have AD.  The condition can be dangerous but there is treatment to block the symptoms.  You need to talk ASAP to your neurologist. These symptoms may be a sign of progression of your neurologic disease.  Although you have IC (frequency, urgency, pain) I suspect your extensive neurologic findings are the major cause of your current bladder symptoms.  Good Luck.
Helpful - 1
509188 tn?1211224731
MEDICAL PROFESSIONAL
In general Interstitial Cystitis begins in the bladder.  Something, like an injury or a bad UTI triggers an inflammatory process that becones a vicious cycle causing more inflammation.  This reaction affects the sensory nerves in the bladder and sends signals into the spinal cord.  These signals can cause changes in the spinal cord that perpetuate the pain, and make other organs in the pelvis painful thru a process called central sensitization. Eventually even if you have your bladder removed surgically  you can still have "bladder pain" because of this nervous system prosess.  This refractory form of IC is very difficult to treat. Treatments focused on the spine include the Interstim Sacral Nerve Rood Stimulator, spinal nerve blocks and continuous spinal morphine pumps
Good Luck.
  
Helpful - 0
Avatar universal
I was wondering if you feel I.C. is related to the Spinal Cord? I Have an extremely bad case.  My bladder holds 150 to 170CC's. My pain never gives up all the way, however my pain specialist helps a lot. I am sure that when I get upset it worsens. I was diagnosed in 2003. I sure don't want to be a ginney pig.  

Thanks for your time,

Bonnie

Helpful - 0
528716 tn?1212777567
Your response was very helpful and much appreciated. Thank you!
Helpful - 0

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