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== Recent changes ==
* The citations and references on this page are not formatted correctly. Can someone clean them up? I can also see quite a bit of ] that should be deleted. ] 16:26, 25 November 2006 (UTC)


You reverted the edits I had done on Interstitial Cystitis stating that I wasn't following the Mos. Could you please give me more feedback than that?? What caught your eye that I was doing wrong. I'm recovering from surgery and had some hours to spare.. and would hate to lose these updates.. especially when this page had been clearly changed by industry.. promoting neuromodulation, etc. etc. ] (]) 02:57, 25 September 2010 (UTC)Aruaidh
== Pentosan ==


:Look at how to ], and omit sentences such as "Substantiated claim". ] (]) 04:55, 25 September 2010 (UTC)
http://archinte.ama-assn.org/cgi/content/abstract/167/18/1922?etoc Systematic review finds pentosan moderately effective. ] | ] 05:24, 9 October 2007 (UTC)


::My bad. I was using a wikipedia guide that used "substantiated claim" as part of the reference text. I must have misunderstood their format. <small><span class="autosigned">—Preceding ] comment added by ] (] • ]) 18:15, 25 September 2010 (UTC)</span></small><!-- Template:Unsigned --> <!--Autosigned by SineBot-->


== Nomenclature Debate Continues ==
==Additional External Link==


I attempted several edits yesterday to include new research and protocols released during the AUA 2010 annual meeting. The nomenclature debate for IC has been going on for over a decade... and the problem that I have with the text as written is that it assumes that the world is now following the ESSIC name/criteria of Bladder Pain Syndrome. Simply not the case. The problem with the ESSIC criteria is that it excludes patients who have frequency/urgency without pain from a diagnosis. There are comparatively few practitioners in the rest of the world who follow these guidelines. I attended the NIH/NIDDK meeting at which this was discussed and there is, by no means, an international consensus of the ESSIC guidelines. They will never be implemented in the United States as written.
I think a good reference for those who want to read more about IC outside of Misplaced Pages is the (ICA). I would like to add this in as an External Link. ] (]) 21:38, 4 January 2008 (UTC)


In 2008, when the issued their standards, they chose the name "Hypersensitive Bladder Syndrome" to avoid the exclusion of patients without pain and because they felt that sensitivity was a more accurate description of what is happening in the bladder wall. This is quite likely the best article written on IC to date discussing the nomenclature debate.
:That link is available from the existing link. Unfortunately, WP does not allow links like that from within articles, see ]. ] 04:19, 2 May 2008 (UTC)
In 2009, the were released, revealing that they would be using the term "Interstitial Cystitis/Painful Bladder Syndrome."
In 2010, the American Urology Association introduced the and they will be using the name "Interstitial Cystitis/Bladder Pain Syndrome" for the foreseeable future in large part because our understanding of IC has changed so dramatically in the past year that what we thought we knew may be completely incorrect. Research now suggests that IC is an .. with systemic implications or, at the very least, a neurosensitivity disorder. Thus, if any name has the potential of being used in the future, it would be the Japanese approach.
For those who are interested, there are some webcasts from the AUA meeting which discuss the pros and cons of name changes and the


The other critical development is the new which now assesses AND TREATS patients with respect to six specific domains, including the presence of infection pelvic floor muscle tension, the presence of psycho social problems (anxiety, catastrophic thinking), organ specific issues (i.e. Hunner's Ulcers).. etc. etc.. which also blows out of the water the implication that IC is a bladder specific disease.
==Misleading claims==


I propose that we return to using IC or IC/BPS or IC/BPS/HBS... rather than BPS/IC for this discussion. Comments? Interestingly, the website uses IC/PBS/BPS/HBS in their discussions.
"Research has determined that the quality of life of IC patients is equivalent to those with end stage renal failure."


I attempted several edits that were reverted yesterday and would appreciate your review of these again. The treatment discussion, in particular, was poorly organized, did not differentiate between oral medications, intravesical instillations, etc. The neuromodulation area was misleading at best given the fact that there is substantial risk, including numerous fatalities when using this methodology. Please check those out and give me feedback. I am recovering from surgery so am still in a painful recovery process.
This is true for a sizable percentage of people diagnosed with IC, but not all. Some patients experience lighter, less frequent problems, and different symptom triggers. Some IC sufferers can avoid symptoms altogether simply by changing their diets. I think it's important to elaborate on this and avoid generalizing the symptoms too much. ] (]) 22:43, 26 July 2008 (UTC)


] (]) 18:14, 25 September 2010 (UTC) Aruaidh
::This is a medical page on Misplaced Pages. We do not go by what people think is important, but rather by what research has stated. ] 02:07, 27 July 2008 (UTC)


:Some comments:
:::This is what medical research has '''already''' concluded about IC. I'm just surprised it hasn't already been elaborated on. I will add the information and references myself. ] (]) 17:46, 27 July 2008 (UTC)
:#Misplaced Pages follows, it does not lead. Nor is wikipedia a ], looking forward into the future, or a place to debate nomenclature. Until clarity emerges on naming, the oldest form ("IC") should be used in the article, but the other forms should all be noted and perhaps made into ].
:#Speculation about theories of etiology, such as gating deficiencies, should be included as theories. I inserted a citation to the theory yesterday, under the "Stress" subsection.
:#Please do not make personal disclosures about your health status here. This is ].
:#I suggest you continue editing the page again, but make changes slowly and piecemeal, over a period of time, so that they can be reviewed by others and modified when necessary. ] (]) 02:30, 26 September 2010 (UTC)


Mild and even moderate IC are largely ignored in statements like the one above. I think this is because until very recently, only people who had extremely severe IC were diagnosed with the condition. It is unfortunate because I think it needlessly frightens many people with IC symptoms about what their lives may become. <span style="font-size: smaller;" class="autosigned">—Preceding ] comment added by ] (]) 20:55, 23 September 2008 (UTC)</span><!-- Template:UnsignedIP --> <!--Autosigned by SineBot-->


I think that reference to NRSI and SSRI drug entries could be more generalized. Duloxetine and amitryptaline (and escitalopram) may provide a therapeutic effect in a small subset of cases. Given that people who read this may be desperately seeking pain relief, and may have not tried all drugs, all should be mentioned as possible treatments with efficacy in a subset of cases. Let the patient pursue the best treatment given their own response.
==Pain Control==
] (]) 06:21, 11 February 2011 (UTC)
I am undoing the undo on my changes re: CAM and pain control. Just saying "there is evidence, go check PubMed" doesn't cut it. Provide references, or stop making these claims. Specifically, provide references to studies published in reputable, peer-reviewed journals that show that acupuncture, biofeedback, and massage have been shown to alleviate pain in people suffering from interstitial cystitis. All I've found are studies that do not show any effects like . --'''<font color="800080">]''' <sup><small>(] &bull; ])</small></sup></font> 03:03, 7 April 2009 (UTC)


==A number of issues ==
::It's a shame you are not prepared to do a proper job for the encyclopedia. I'm putting it back with citations. Do not revert until I am finished, 24hrs. ] 03:27, 7 April 2009 (UTC)
This article should be referenced to high quality sources such as review articles rather than to primary research papers and the popular press. ] (] · ] · ]) (if I write on your page reply on mine) 12:08, 5 October 2012 (UTC)
:Do you have any suggested references to add or to use in place of the research papers currently used as references in the body of this article? ] (]) 23:41, 5 October 2012 (UTC)
::I can help you identify sources if you need help finding them, please message me at my talk page. Forgive me for being critical on the article, but right now I see the sentence "A Harvard University study concluded, 'the impact of interstitial cystitis on quality of life is severe and debilitating' " in the lead. I don't know of a reason to name drop "Harvard" like this (see ]). Tha paper is from 2000 and is a primary research paper. Per ], we try to use recent review articles if possible. I see it has been cited by three review articles. The most recent is {{PMID|19548999}} "Clinical guidelines for interstitial cystitis and hypersensitive bladder syndrome". That would be a good source to rewrite content with. And then we have "A Harvard Medical School guide...", which sounds like further name dropping and it is cited to a ] source, which is not ideal in this case. A ] is one type of secondary ] and ] are another. These should be cited for most of the content in a medical article (when they can be located). I came here because I noticed this article was put up for good article review. In my opinion it lacks basic verifiability because it is tagged as having potentially self published material, and in general strays from the guideline of ], by citing questionable sources such as old primary research. For example, the statement "Neuromodulation can be successful in treating IC/BPS symptoms, including pain" is cited to a 1994 paper. That's not how we write articles, unfortunately. ] (]) 20:29, 16 October 2012 (UTC)


{{Talk:Interstitial cystitis/GA1}}
::It's a shame that ''you'' don't seem to understand how citations are supposed to work. One would think that bit of knowledge was critical to doing a "proper job for the encyclopedia," and one might question who is really failing to do a proper job here.
::Please do add your references - that way they can be properly checked. Asking readers to do the legwork to support unsupported claims is clearly unacceptable, and I honestly don't know how you can say otherwise.
::I'll gladly give you as much time as you need to find proper sources - if you need more than 24 hours, that's fine. Just let me know when you're done. Depending on what you provide, and how my week goes, it could take me some time to review them. All I ask is that you provide links so that I can actually read the studies (and not just summaries without the actual information).
::I await your response. --'''<font color="800080">]''' <sup><small>(] &bull; ])</small></sup></font> 03:54, 7 April 2009 (UTC)
:::Hahaha! "Asking the readers to do the legwork" -- what do you think I am, other than a reader too? You have not the most basic understanding of how this community encyclopedia works. Funny. ] 03:56, 7 April 2009 (UTC)


== DMSO ==
:::Oh and BTW, there is no requirement in Misplaced Pages that I link you to the full study texts. Links to published abstracts suffice. ] 04:00, 7 April 2009 (UTC)
The DMSO page mentions use for treatment - yet this page lacks any mention.
Shirley SW, Stewart BH, Mirelman S.; Stewart; Mirelman (March 1978). "Dimethyl Sulfoxide in Treatment of Inflammatory Genitourinary Disorders". Urology. 11 (3): 215–220. {{doi|10.1016/0090-4295(78)90118-8}}. {{PMID|636125}}. <!-- Template:Unsigned IP --><small class="autosigned">—&nbsp;Preceding ] comment added by ] (]) 16:33, 6 March 2017 (UTC)</small> <!--Autosigned by SineBot-->


:::What do I think you are other than a reader? I'll avoid the temptation to be impolite (clearly not an important Misplaced Pages guideline to ''you'') and instead state the obvious: in this case, you are acting as an ''editor'' and not merely as a reader. In your capacity as an editor, you were defending statements that had no references and asking others to go do the legwork that you didn't want to do. I'm pretty sure if you check the policies that references need to be more than "go check on pubmed."


== Quantify tags ==
:::And yes, I know you're not required to link to full studies. It just tends to make references more useful for readers and editors alike. But of course you are free to stick to the minimum effort required for your contributions, as your reply makes clear.
I put quantify after "IC/BPS can result" in the lead because it is vague. Is it 1/1000 or 4/10? ] (]) 16:04, 13 December 2012 (UTC)
:Good question. I'm really not sure to be honest but I can't seem to get a hold of any studies right now that will satisfactorily answer this question. We'll have to wait in the meanwhile until a good review source on quality of life in interstitial cystitis emerges.] (]) 06:39, 5 February 2013 (UTC)


== Kegels ==
:::I'll review your sources when I can, and I'll let you know what I find. Since only two of six are linked, you've made my job (and the job of the readers, I might add) more difficult, as I'm sure you realize. But by all means, keep laughing. Well done. --'''<font color="800080">]''' <sup><small>(] &bull; ])</small></sup></font> 04:24, 7 April 2009 (UTC)


My edit on Kegel exercises was reversed, but the text still has essentially the same meaning, except it's unclear, hinting that kegels can help IC. I'm not aware of papers that claim they are helpful. Got any? ] (]) 07:19, 14 July 2015 (UTC)
::::By editing out material as you have done, <u>you too</u> are an editor. Surprise, surprise! That's why you are doing a bad job, not checking pubmed and improving WP by adding the citations ''yourself''. But looking at your history, I see you are a ] with an agenda, so no wonder. ] 04:51, 7 April 2009 (UTC)
:::::You also incorrectly say that "only 2 of the 6 are linked". They are all linked. You are clearly new at this, aren't you? ] 05:03, 7 April 2009 (UTC)


== Link to gluten ==
Yes, I am also a reader and an editor. That obvious point didn't escape me. The same way that the obvious point that you are also a reader didn't escape me a few paragraphs up. But please go ahead and continue to erroneously treat these points as "revelations" to me so that you can laugh and pretend it's at my expense. And please continue to criticize ''my'' editing practices when ''you'' tried to use "there is evidence, go check PubMed" written in a history as a reference. I'm sure that's just how it's supposed to be done. And yes, I do have an agenda. My agenda is to make sure that misinformation and patent nonsense don't make their way into Misplaced Pages. Shame on me. I am rightfully chastised.


The study in question references another study by the same author (see it ) where the claim is made that IC is linked to gluten somehow with frequency "undetermined". No data is presented in this original study, and no sources for the claim. I see they also linked "ingrown hairs" to gluten, and other unfounded claims. Junk science. Gluten probably ''IS'' linked to IC, but this is not proof. ] (]) 01:24, 16 March 2016 (UTC)
You are correct that all six are linked. It didn't appear that way on my BlackBerry last night. So yes, I also understand what a link is, how html works, how to use a mouse, and what colors are, before you decide to make your own day by building a few more useless, inane straw men. I honestly have nothing more to say to you until I review your references.


:Dear {{u|Ratel}}
To that end, I have looked at your references for massage. One is a study that included 10 patients with IC. That seems to me to be a terribly low number. In part, that's because only a small subset of those studied had IC, while the rest had other conditions. I would recommend removing that reference. The other study had 21 participants, also not great, but better than 10. That said, it indicated that Thiele Massage was statistically effective for their participants. How about we modify the wording so that ''thiele'' massage is called out as beneficial to some patients? That way, it doesn't sound like we're saying that a Swedish massage or reflexology can make the pain go away?


:To support the inclusion of non-celiac gluten sensitivity, I used this paper {{PMID|26605537}} (Table 1 - The clinical manifestations of NCGS), which is a ]. This is a secondary source, PubMed indexed, published in ''Annals of Nutrition and Metabolism'' November 2015, which is a peer-reviewed scientific journal, with an .
I also checked your acupuncture references. One is a review that states: "There are hardly any controlled studies on alternative curative procedures although rather good results have been obtained in chronic pelvic pain syndrome with acupuncture as an additional therapeutic modality." That's all the abstract says and the review (not a study) isn't focused on acupuncture at all. The other review leans on acupuncture as actually manipulating Yin and Yang in the body, even though there is no scientific evidence that Yin and Yang (or chi or meridiens) exist. The review refers to a 1987 study that I can't locate online (not surprisingly). I checked the main article on ], and I would suggest the following expansion to this section for both massage and acupuncture:


:The study you cited and you misprize http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4488826/ is not by "the same" author but a group of the most prestigious experts worldwide in celiac diseases and non-celiac gluten sensitivity (Catassi C, Elli L, Bonaz B, Bouma G, Carroccio A, Castillejo G, Cellier C, Cristofori F, de Magistris L, Dolinsek J, Dieterich W, Francavilla R, Hadjivassiliou M, Holtmeier W, Körner U, Leffler DA, Lundin KE, Mazzarella G, Mulder CJ, Pellegrini N, Rostami K, Sanders D, Skodje GI, Schuppan D, Ullrich R, Volta U, Williams M, Zevallos VF, Zopf Y, Fasano A). It was published in '']'' June 2015 and PubMed indexed ({{PMID|6096570}}). ''Nutrients'' is a peer-reviewed scientific journal and have a (as ).
::Theile ]<ref name="pmid15533464">{{cite journal |author=Oyama IA, Rejba A, Lukban JC, ''et al'' |title=Modified Thiele massage as therapeutic intervention for female patients with interstitial cystitis and high-tone pelvic floor dysfunction |journal=Urology |volume=64 |issue=5 |pages=862–5 |year=2004 |month=November |pmid=15533464 |doi=10.1016/j.urology.2004.06.065 |url=}}</ref> has shown promise in relieving the pain associated with Interstitial cystitis, though studies with larger sample sizes are needed.


:It's a shame that all these experts and reviewers have not noticed all that "other unfounded claims" that there are in the article, in your opinion.
::Although ]<ref name="pmid18663671">{{cite journal |author=Binder I, Rossbach G, van Ophoven A |title= |language=German |journal=Aktuelle Urol |volume=39 |issue=4 |pages=289–97 |year=2008 |month=July |pmid=18663671 |doi=10.1055/s-2008-1038199 |url=}}</ref><ref name="pmid16986031">{{cite journal |author=Whitmore KE |title=Complementary and alternative therapies as treatment approaches for interstitial cystitis |journal=Rev Urol |volume=4 Suppl 1 |issue= |pages=S28–35 |year=2002 |pmid=16986031 |pmc=1476005 |doi= |url=}}</ref> has been reported to alleviate pain associated with Interstitial cystitis in several cases, it is important to note that there is no known ] or ] basis for the existence of ] or meridians.<ref name="Mann F.">]. '''', vol 1 issue 4, Aug. 2006, "The Final Days of Traditional Beliefs? - Part One"</ref><ref name="NIH-1997consensus"/> In addition, at least one study found that acupuncture "seems to alleviate pain just barely better than sticking needles into nonspecified parts of the body" <ref name="sham acupuncture"></ref> and concluded that some of acupuncture's effects may be due to the ].


:You said "''no data, and there are no other studies linking IC to gluten''". In Medicine are considered not only studies, also documented cases. And yes, there is some case report, such as this one {{PMID|23204003}}, published in '']'' 30 November 2012. .
I don't want to go too far in describing acupuncture on this page, but I do think it's important to let people know more than "acupuncture is beneficial to some patients." There is no evidence for the entire premise of acupuncture (chi, meridiens, etc.), and the reviews cited don't make their case anywhere near well enough to eschew that fact. I was okay with the addition of my general statement that these treatments lack scientific evidence, but since that was removed, the only other thing I can think of is expanding the descriptions thusly.


:Misplaced Pages states: . All of these diseases, at least in some cases, are linked to celiac disease or ] and improve with a gluten-free diet.<ref name=RossiDiLollo2015>{{cite journal | vauthors = Rossi A, Di Lollo AC, Guzzo MP, Giacomelli C, Atzeni F, Bazzichi L, Di Franco M | title = Fibromyalgia and nutrition: what news? | journal = Clin Exp Rheumatol | volume = 33 | issue = 1 Suppl 88 | pages = S117-25 | date = 2015 | pmid = 25786053 | url = http://www.ncbi.nlm.nih.gov/pubmed/25786053 |type=Review }}</ref><ref name=LoganWong2001>{{cite journal | vauthors = Logan AC, Wong C| title = Chronic fatigue syndrome: oxidative stress and dietary modifications | journal = Altern Med Rev | volume = 6| issue = 5| pages = 450–9| date = Oct 2001| pmid = 11703165|url= http://www.altmedrev.com/publications/6/5/450.pdf |type=Review}}</ref><ref name=SanMauroGaricano2014>{{cite journal|vauthors=San Mauro I, Garicano E, Collado L, Ciudad MJ|title= |journal=Nutr Hosp|volume=30|issue=6|pages=1203–10|date=Dec 2014|pmid=25433099|doi=10.3305/nh.2014.30.6.7866|type=Review}}</ref><ref name=FasanoSapone2015>{{cite journal|vauthors=Fasano A, Sapone A, Zevallos V, Schuppan D|title=Nonceliac gluten sensitivity|journal=Gastroenterology|volume=148|issue=6|pages=1195-204|date=May 2015|pmid=25583468|doi=10.1053/j.gastro.2014.12.049|type=Review}}</ref><ref name=VoltaCaio2015>{{cite journal|vauthors=Volta U, Caio G, De Giorgio R, Henriksen C, Skodje G, Lundin KE| title=Non-celiac gluten sensitivity: a work-in-progress entity in the spectrum of wheat-related disorders|journal=Best Pract Res Clin Gastroenterol|volume=29| issue=3| pages=477–91| date=Jun 2015| pmid=26060112|doi=10.1016/j.bpg.2015.04.006|type=Review}}</ref><ref name=WalkerMurray2011>{{cite journal|vauthors= Walker MM, Murray JA|title= An update in the diagnosis of coeliac disease|date= Aug 2011|journal= Histopathology|volume= 59|issue= 2|pages=166-79|doi=10.1111/j.1365-2559.2010.03680.x|url= https://www.researchgate.net/publication/47698503_An_update_in_the_diagnosis_of_coeliac_disease|pmid= 21054494|type=Review}}</ref><ref name=Fasano2005Pediatric>{{cite journal|author=Fasano A|title=Clinical presentation of celiac disease in the pediatric population|journal=Gastroenterology|volume=128|issue=4 Suppl 1|pages=S68-73|date=Apr 2005|pmid=15825129|doi=10.1053/j.gastro.2005.02.015|type=Review}}</ref> So... why be surprised?
I'll post what I learn as a result of the biofeedback references, and make appropriate suggestions for that section at that time. For now, I'll open the above two modifications for comment. --'''<font color="800080">]''' <sup><small>(] &bull; ])</small></sup></font> 14:35, 7 April 2009 (UTC)


:Anyway, I agree to withdraw the NCGS of that list and include it apart, with "less weight". And I will add: ''There is also some evidence of an association with ] in some patients''.<ref name=Catassi2015>{{cite journal|author= Catassi C|title=Gluten Sensitivity|year=2015|journal=Ann Nutr Metab|volume=67 Suppl 2|pages=16-26|doi=10.1159/000440990|url= http://www.karger.com/Article/FullText/440990
:::This is not the place for ] or a synthesis of available studies and our own judgement as to what is worthwhile. Please review ]. WP is a tertiary source, and we rely mostly on secondary sources, especially where medical topics are concerned. If there is a peer-reviewed, published review study that reports acupuncture or staring at the Moon as beneficial, we insert it, even if we think it is hogwash. This is not the place for you to give free reign to your hatred of alternative and traditional healing methods like acupuncture (ironically with links to papers that in fact validate "modern" acupuncture). So we insert such data. And for that purpose, abstracts are perfectly acceptable. Now you are encouraged to insert countervailing studies that suggest otherwise, of course. Regarding massage, yes, it should be more specific in describing what sort of massage is being discussed. Are you aware of the new research linking UCPPS (includes IC) to trigger points, thereby validating both internal and external pelvic massage? I'm not sure of your training, but unless you are a urologist, best not to barge in here. On second thoughts, even if you ''are'' a uro, take care, because many are not up to speed on the latest research. ] 15:11, 7 April 2009 (UTC)
|pmid= 26605537|type=Review}}</ref>


:Best regards. --] (]) 10:21, 16 March 2016 (UTC)
::::Indeed this is not the place for original research. What do you view as original research in my suggested text? I added a statement saying that there is no proof for the existence of chi or meridiens (surely that isn't the part you are questioning as there are no studies that prove that these energies exist), and another stating that a meta-analysis (not done by me) found that acupuncture doesn't differ from sham acupuncture, with a link to an article (should have linked to the BMJ abstract instead. The only thing I can think of that you feel is original research is the statement that the placebo effect is at work, but that is also discussed in the article I linked to. So what original research are you talking about? I don't see any.


{{reflist-talk}}
::::And yes, I'm fine inserting the references you provided for acupuncture (which is why I left them intact in my version), but simply inserting them and walking away isn't enough, in my opinion. The statements I made ''after'' those references are also valid, and are also backed up by references. So by your own logic, they must also be included here.


{{od}}Yes, I agree that there is "some evidence" of an association of NCGS with chronic pelvic pain (IC and ]), but as you have discovered yourself, it all goes back to anecdotal evidence, as in the case report you offer above (who also seems to be the source of all the other "undetermined" maladies, like "ingrown hairs"). I accept your modification, but rather than citing only the review study (Carlo Catassi reviewing his own studies), I'll insert a cite to the case report too. ] (]) 21:54, 16 March 2016 (UTC)
::::And no, I'm not aware of the other massage research you mentioned. Nor are the readers of Misplaced Pages at this time. What I am aware of is that Thiele massage has been shown to have some effect here (with small sample sizes), and I think that is a perfectly valid statement to make. If and when studies for other types of massage are referenced, they can also be reviewed and added as appropriate. Are you okay with the modification proposed re: Thiele massage? --'''<font color="800080">]''' <sup><small>(] &bull; ])</small></sup></font> 15:42, 7 April 2009 (UTC)


== Associated with other disorders ==
::::I do see a problem with my text, though it's with the massage section and not the acupuncture section. My statement that larger sample sizes are needed reads like my opinion. So if this is what you mean, Ratel, I concur.


{{u|Doc James}}, you reference to links to fibromyalgia and IBS. But ''"For example, epidemiological studies have revealed that IC/BPS is commonly associated with other chronic pain conditions, including fibromyalgia, irritable bowel syndrome and chronic fatigue syndrome."'' This from a review study, and Pubmed full of other evidence to support. Please re-insert. ] (]) 21:06, 6 October 2016 (UTC)
::::Alternatives would seem to be to either to backup that claim, or to change the wording to just point out the nature of the study cited without drawing any further inferences. I'm fine with the latter. That said, the fact that the sample size was small, there was no control group, and no blinding in this study is important (yes, I agree it is probably difficult to enact proper blinding with a treatment like this). So how about:
::We still say "Many of those affected also have irritable bowel syndrome and fibromyalgia."? ] (] · ] · ]) 21:28, 6 October 2016 (UTC)
:::And CFS? ] (]) 21:39, 6 October 2016 (UTC)
::::Do we need to list them all in the lead? There are lots of associations. ] (] · ] · ]) 00:05, 7 October 2016 (UTC)


== Covering hyaluronic acid (Cystistat) ==
:::::Thiele ], a form of transvaginal massage, has shown promise in relieving the pain associated with Interstitial cystitis in preliminary studies.<ref name="pmid15533464">{{cite journal |author=Oyama IA, Rejba A, Lukban JC, ''et al'' |title=Modified Thiele massage as therapeutic intervention for female patients with interstitial cystitis and high-tone pelvic floor dysfunction |journal=Urology |volume=64 |issue=5 |pages=862–5 |year=2004 |month=November |pmid=15533464 |doi=10.1016/j.urology.2004.06.065 |url=}}</ref>


I would like to see some coverage of . When I first looked at the literature there seemed like a lot of good studies of it - for example (2011) found half in remission after five years which is discussed in (2015) but without much in the way of interesting commentary or critique. Apparently Cystistat is approved in many countries (Canada, EU per ) but not the U.S. ] | (] - ]) 21:49, 12 February 2017 (UTC)
::::Finally, I'd prefer to move this one away from acupuncture and biofeedback. Massage, used in this way, isn't CAM. It's more physical therapy. Thoughts? --'''<font color="800080">]''' <sup><small>(] &bull; ])</small></sup></font> 17:05, 7 April 2009 (UTC)
:Also on the topic of instillation, sort of, is on the effect on pH on pain: no effect. ] | (] - ]) 21:57, 12 February 2017 (UTC)


== Alternative therapies ==
::::Alternately, we could describe the study instead of calling it preliminary:


Hey {{User|Doc James}}, what is the problem with the source added ? ] | (] - ]) 17:55, 14 February 2017 (UTC)
:::::Thiele ], a form of transvaginal massage, has shown promise in relieving the pain associated with Interstitial cystitis in at least one uncontrolled, unblinded, ].<ref name="pmid15533464">{{cite journal |author=Oyama IA, Rejba A, Lukban JC, ''et al'' |title=Modified Thiele massage as therapeutic intervention for female patients with interstitial cystitis and high-tone pelvic floor dysfunction |journal=Urology |volume=64 |issue=5 |pages=862–5 |year=2004 |month=November |pmid=15533464 |doi=10.1016/j.urology.2004.06.065 |url=}}</ref>
::It is an internet based survey (a primary source). The conclusion is "Randomized, placebo-controlled studies are needed to demonstrate which therapies may indeed control IC symptoms". What percentage of people in such a survey say an alt med treatment is useful or not does not mean much. ] (] · ] · ]) 00:36, 15 February 2017 (UTC)
:::Hmm, I might be able to find a review which summarizes at a high level, although perhaps not for a few months. But to your comment, I think it misses the point a bit: the intent of a medical article is not solely to identify effective treatments. The intent of any article is to inform readers of important content in a neutral manner with reliable sources. It seems quite appropriate and effective, in the sense of writing to help people understand the topic (which should be the goal!), to lead off this section with an overview of number of treatments that people have tried and some basic information about them. Maybe there's a different way to approach that, but this section should start with a very high-level survey. That's not to suggest that these are effective, but as I said in the first sentence, that's not always the point. I also don't think it's a reasonable bar that everything has to be passed through RCTs to be mentioned. These are "alternative treatments", so we wouldn't expect there to be a lot of RCTs. As an aside, I am going to push back - and always will - against the idea that all medical content needs to be in a medical review. I was there in the discussion when MEDRS was promoted (as were you), and that certainly wasn't how it was presented at the time. I doubt it would've become a guideline if it had. Meanwhile, it's not wholly uncommon for non-peer-reviewed articles to be used to directly contradict peer-reviewed sources by long-term editors circling the medical project, such as the discussion over at ] right now. My hope is that Misplaced Pages doesn't end up a ghostly place occupied by a handful of people enforcing a byzantine and frankly arbitrary set of rules. It should be open, a bit democratic, and even fun. ] | (] - ]) 08:21, 15 February 2017 (UTC)
::::There are lots of great review articles on this topic. A survey is basically testimonials. The conclusion of the paper is really that no evidence exists on the effectiveness of alt med not that half of them "work". ] (] · ] · ]) 09:01, 15 February 2017 (UTC)
:::::I agree with James that an internet-based survey is a low-quality source and should be avoided. I'm confident there are reviews discussing the use of alternative medicine modalities in IC and the level of study these modalities have received. If they haven't gone through high-quality RCTs, then you'd be hard-pressed to say that they're proven to work. Anecdote means very little when stacked against evidence since various biases (cognitive or otherwise) skew our view on such matters. Since this is a medical article, I too will insist that ]-compliant reviews are used for such content. Primary sources such as internet-based surveys are inappropriate (even if you disagree, II). If the information is not yet available, we can wait and improve other sections of the article in the meantime. ] (]) 13:40, 15 February 2017 (UTC)
::::::By all means, it's not a perfect or even good source source, and I'll admit it's probably a good idea to remove it (as my user page states, "to change your mind and to follow him who sets you right is to be nonetheless the free agent that you were before"). With that said, if the bar for contributing to Misplaced Pages is to do a complete lit review and identify the best source possible... well, it's no wonder that few will bother. If you glance at the history of this article, in terms of substantive content work it's basically been two people for the last five years: Doc James and TylerDurden. And probably a similar statement could be made for most medical articles.
::::::Also, while I appreciate the calm tone, Tyler, I feel like it kind of talks past my above comment, as if my point was not really understood. Demonstrating some sort of efficacy is not the point. That patients reported half helped could be removed entirely while accomplishing the purpose, perhaps by instead mentioning that "84.2 % had tried complementary therapies and 55 % said that physicians had recommended complementary therapies". Starting with a broad number and survey of a wide number of potential therapies, with a hint of the patient perspective, is the point. With a survey showing patients responses, the nice thing is that it is ''obviously poor evidence'' and there is less temptation to single individual therapies out, as compared to a review covering a bunch of low-powered, misleading RCTs ("" (2005)). I suppose there may be a difference in perspective: to me, it seems that most of our readers would recognize that a survey isn't good evidence.
::::::Anyhow, I dug a bit deeper and found . In addition to covering some RCTs (which are rather tricky to analyze), it spends a paragraph on the survey. Not up for dealing with the hassle of trying to predict/figure out what content might be worth adding, though - maybe in a few months. ] | (] - ]) 07:22, 17 February 2017 (UTC)
:::::::I acknowledge that I've contributed quite a bit to the article; however, I disagree with the assumption that most readers will critique a survey as a low form/unreliable form of evidence. Every day people are bombarded with sensationalist news headlines horribly distorting scientific findings and the vast majority parrot what they hear without being able to critically appraise the evidence. I agree that sorting out the quality of RCTs and studies, in general, can be a herculean task, but it's one that's worth doing so we know what works and what doesn't. I see little value in adding a survey of self-reported claims from IC patients were surveyed and thought X, Y, and Z worked for them. That's anecdote (not evidence) and I disagree that it has a place in an encyclopedic entry in an article about a medical condition (aside from, perhaps, a society & culture section about what patients perceive to work best for them but that's often not consistent with more objective forms of evidence). Millions of people will swear to you that ] make them feel 100% better but it's still implausible pseudoscientific nonsense. The systematic review might potentially be worth including but it will have to undergo the same scrutiny by the community as all other papers considered for inclusion in the article. I don't know if I would characterize "the bar" as doing a complete literature review but Misplaced Pages is meant to be an encyclopedia, a tertiary source, built on high-quality/reliable (primarily) secondary sources. I think that's important if this is going to be a well-sourced high-quality article. ] (]) 03:28, 18 February 2017 (UTC)
Decent source. Added a summary of it here.


Yes to bring Misplaced Pages to the next level of quality is going to be hard work. It however is much much less difficult editing WP than trying to publish in a major peer reviewed medical journal. And peer reviewed medical journals have no lack of people interested in writing in them.
::::--'''<font color="800080">]''' <sup><small>(] &bull; ])</small></sup></font> 00:34, 8 April 2009 (UTC)


I am not convinced that the difficulty of editing Misplaced Pages is the cause for the flat lining of our editor numbers. Part of the evidence I see for this is what little effect VE had on people editing. VE is much easier to edit with but it did not lead to an increase in editors. ] (] · ] · ]) 09:46, 18 February 2017 (UTC)
:::::This is why a little knowledge can be dangerous. In the massage area, you are not even using the correct search terms on Pubmed because you are not aware of nomenclature changes and options for this condition. (Hint: PMID 15509457 ). ] 05:02, 8 April 2009 (UTC)


==Reference==
::::::What I can or cannot find on PubMed has nothing to do with this discussion. ''You'' provided these sources, not me. I just checked them. I have no idea what you're talking about here. Here are the opening sentences of the source ''you'' linked to:
Source of more information:
*https://www.cdc.gov/ic/index.html<!--<ref name= ic>{{Cite web|url=https://www.cdc.gov/ic/index.html|title=What is Interstitial Cystitis (IC)?|last=|first=|date=February 9, 2016|website=www.cdc.gov|publisher=Centers for Disease Control and Prevention|language=en-us|archive-url=|archive-date=|dead-url=|access-date=2017-12-19}}{{PD-notice}}</ref>-->
:]&nbsp;<span style="color: darkred;">]&nbsp;]</span> 23:22, 19 December 2017 (UTC)


== Could Ketamine be a cause? ==
:::::::OBJECTIVES: To evaluate the effectiveness of transvaginal manual therapy of the pelvic floor musculature (Thiele massage) in symptomatic female patients with interstitial cystitis and high-tone dysfunction of the pelvic floor. METHODS: A total of 21 women with documented interstitial cystitis and high-tone pelvic floor dysfunction underwent transvaginal massage using the Thiele technique twice a week for 5 weeks.


Singapore Med J. 2015 Dec; 56(12): 660–665. doi: 10.11622/smedj.2015185 PMCID: PMC4678404 PMID: 26702160 The clinical presentation and diagnosis of ketamine-associated urinary tract dysfunction in Singapore
::::::From this alone, it is clear that Thiele massage is a type of transvaginal manual therapy (or massage), that 21 women were included in the study, and that all 21 received the same treatment (hence uncontrolled, unblinded). Looking at another source for this same study (), we can see that it is classified as a ], which we can use in place of "preliminary study". So how about:


Jacklyn Yek, MBBS, MRCS,1 Palaniappan Sundaram, MBBS, MRCS,1 Hakan Aydin, MB, Am Bd Pathology,2 Tricia Kuo, MBBS, MRCS,1 and Lay Guat Ng, MBBS, FRCS1 1. Winstock AR, Mitcheson L, Gillatt DA, Cottrell AM. The prevalence and natural history of urinary symptoms among recreational ketamine users. BJU Int. 2012;110:1762–6.
:::::::Thiele ], a form of transvaginal massage, has shown promise in relieving the pain associated with Interstitial cystitis in at least one ], ].<ref name="pmid15533464">{{cite journal |author=Oyama IA, Rejba A, Lukban JC, ''et al'' |title=Modified Thiele massage as therapeutic intervention for female patients with interstitial cystitis and high-tone pelvic floor dysfunction |journal=Urology |volume=64 |issue=5 |pages=862–5 |year=2004 |month=November |pmid=15533464 |doi=10.1016/j.urology.2004.06.065 |url=}}</ref>


Chu PS, Ma WK, Wong SC, et al. The destruction of the lower urinary tract by ketamine abuse: a new syndrome? BJU Int. 2008;102:1616–22.
::::::This has nothing to do with how well I understand IC - it is simply about checking a source and parsing what is written there. As such, my sample language for massage is valid. If you have a specific issue with it, please ''spell it out''. If someone who knows more about, say, massage/PT and IC than either of us decides to weigh in, now or later, they can certainly do so. But until then, we have an obligation to make this the best section we can make it, and the way it reads today certainly doesn't qualify. So yes, I agree that someone with more knowledge in the field of PT and IC could improve this section greatly, but look at what's there today, and help me understand how my text isn't a clear improvement over ''that'':


Middela S, Pearce I. Ketamine-induced vesicopathy: a literature review. Int J Clin Pract. 2011;65:27–30.
:::::::Complementary therapies such as acupuncture, massage, and biofeedback are also beneficial to some patients.


Tsai TH, Cha TL, Lin CM, et al. Ketamine-associated bladder dysfunction. Int J Urol. 2009;16:826–9.
::::::That tells readers next to nothing. In fact, it leaves the impression that massage is CAM (in this case, it certainly is ''not''), and it leaves open what kinds of massage have been shown to be effective (Reflexology? Shiatsu? Swedish massage? I'd bet most people wouldn't come up with transvaginal massage from the statement above). In my version, I simply tried to accurately represent the study presented. And for the record, I have no issues with using targeted massage to treat specific pain. There is no scientific consensus that this type of treatment shouldn't work, so I'm not trying to make a case against this approach. I'm just trying to improve on the vague, misleading (IMO) text that appears now.


Hanno PM, Burks DA, Clemens JQ, et al. Diagnosis and treatment of interstitial cystitis/bladder pain syndrome, amended 2014. American Urological Association Available at: https://www.auanet.org/education/guidelines/ic-bladder-pain-syndrome.cfm .
::::::For acupuncture, my language is likewise sourced and valid, and it complies with WP policies and guidelines on how to treat such issues () - your source presents acupuncture as successful, and mine explains that acupuncture is not statistically different from sham acupuncture, and that there is no scientific evidence for chi or meridiens. One study makes a claim, another says "yes, but..." and the readers can decide what to make of it.


Lee CL, Jiang YH, Kuo HC. Increased apoptosis and suburothelial inflammation in patients with ketamine-related cystitis: a comparison with non-ulcerative interstitial cystitis and controls. BJU Int. 2013;112:1156–62.
:::::::] has been reported to alleviate pain associated with Interstitial cystitis in several cases.<ref name="pmid18663671">{{cite journal |author=Binder I, Rossbach G, van Ophoven A |title= |language=German |journal=Aktuelle Urol |volume=39 |issue=4 |pages=289–97 |year=2008 |month=July |pmid=18663671 |doi=10.1055/s-2008-1038199 |url=}}</ref><ref name="pmid16986031">{{cite journal |author=Whitmore KE |title=Complementary and alternative therapies as treatment approaches for interstitial cystitis |journal=Rev Urol |volume=4 Suppl 1 |issue= |pages=S28–35 |year=2002 |pmid=16986031 |pmc=1476005 |doi= |url=}}</ref> However, it is important to note that there is no known ] or ] basis for the existence of ] or meridians.<ref name="Mann F.">]. '''', vol 1 issue 4, Aug. 2006, "The Final Days of Traditional Beliefs? - Part One"</ref><ref name="NIH-1997consensus"/> In addition, at least one study found that acupuncture "seems to alleviate pain just barely better than sticking needles into nonspecified parts of the body" <ref name="sham acupuncture"></ref> and concluded that some of acupuncture's effects may be due to the ].


] (]) 16:45, 10 August 2019 (UTC)
::::::So if you have specific issues with any of my text, please spell them out. Otherwise, let's use them. --'''<font color="800080">]''' <sup><small>(] &bull; ])</small></sup></font> 14:12, 8 April 2009 (UTC)


== Accuracy ==
:::::I don't have the time for debating this with you. Go ahead and make your changes and I'll alter them ''in situ''. ] 00:57, 9 April 2009 (UTC)


I have had IC for 24 years. The information on this page is so wrong I can’t even believe it.
Okay - I'll review the biofeedback references, and rework that section similarly to how I reworked acupuncture. Then I'll add these into the Pain Control section, which will likely require some reorganization of the section (as I said, Thiele massage should probably be under PT, not CAM). It'll probably take me a day or two to get it done.


We (my grandmother and mother) all had cystograms which identified the deterioration of the lining of the bladder. That is what IC is. What kind of crack pot wrote this description I can’t imagine. It’s not a ruling out disease. You make it seem like a mental health issue. We live in chronic pain. The best treatment is cystostat which is inserted via catheter. ] (]) 19:32, 2 August 2023 (UTC)
Despite what you may think, my goal is to improve this section, not to squash any mention of alt med. I hope you review my revisions in that light. --'''<font color="800080">]''' <sup><small>(] &bull; ])</small></sup></font> 03:28, 9 April 2009 (UTC)
<br><br>
----
===Edits===
My edits regarding Pain Control are now in place. Here's a summary of what I did, and my rationale for each change.


:The current evidence points to most cases of IC being chronic infections missed by lousy tests (much too low sensitivity to refute the overwhelming prior probability of infection, given symptoms). The best current treatment is full-dose narrow-spectrum urinary antibiotics and/or methenamine, taken for long enough.
1) '''Created sub-headers under Pain Control.''' As discussed, Thiele massage isn't a CAM treatment, but really is Physical Therapy (that is made clear in the reference). As such, I created a sub-header for PT. I also moved the information about drugs to a Drug Treatment sub-header, and created a sub-header for CAM to house the information on acupuncture and biofeedback.
:* {{cite journal|doi=10.1007/s00192-018-3569-7 |title=Recalcitrant chronic bladder pain and recurrent cystitis but negative urinalysis: What should we do? |date=2018 |last1=Swamy |first1=Sheela |last2=Barcella |first2=William |last3=De Iorio |first3=Maria |last4=Gill |first4=Kiren |last5=Khasriya |first5=Rajvinder |last6=Kupelian |first6=Anthony S. |last7=Rohn |first7=Jennifer L. |last8=Malone-Lee |first8=James |journal=International Urogynecology Journal |volume=29 |issue=7 |pages=1035–1043 |pmid=29556674 |pmc=6004281 }}
:* {{cite journal|doi=10.1007/s00192-018-3846-5 |title=Cross-over data supporting long-term antibiotic treatment in patients with painful lower urinary tract symptoms, pyuria and negative urinalysis |date=2019 |last1=Swamy |first1=Sheela |last2=Kupelian |first2=Anthony S. |last3=Khasriya |first3=Rajvinder |last4=Dharmasena |first4=Dhanuson |last5=Toteva |first5=Hristina |last6=Dehpour |first6=Tara |last7=Collins |first7=Linda |last8=Rohn |first8=Jennifer L. |last9=Malone-Lee |first9=James |journal=International Urogynecology Journal |volume=30 |issue=3 |pages=409–414 |pmid=30564872 |pmc=6394536 }}
:] (]) 22:48, 2 August 2023 (UTC)


== Correction ==
2) '''Moved Pain Control to the bottom of the Treatment section.''' Leaving it where it was made the flow of headers difficult to understand as it wasn't immediately clear that the following three headers were sub-headers to Pain Control and not their own sub-headers under Treatment.


IC is not exclusive to females. I am male and have been dealing with it for 5 years. About 2% of sufferers are male. ] (]) 17:09, 27 March 2024 (UTC)
3) '''Massage'''. I called out Thiele massage instead of just referring to massage since that is the technique that was used in the study referenced. I explained that Thiele massage is a form of transvaginal therapy to make it clear that we aren't talking about something you can get at a Day Spa. I did call out that the trial was open (no control, no blinding) and a pilot study (these qualifiers are stated in the study itself). I did this because, compared to the study referenced for drug therapy for example, it should be clear that currently there is significantly less evidence backing up this treatment.

4) '''TENS and PTNS.''' I moved these under PT as this is how they are categorized in their respective Misplaced Pages articles. I also marked these statements as needing citations. In addition, there is a statement listed under "Other Treatments" that says: "Neurostimulation techniques are not FDA approved for IC." TENS and PTNS are forms of neurostimulation. It is unclear what the FDA position is on using neurostimulation for IC symptoms - some sources I have seen say that some devices are approved for some symptoms. I have marked this statement as needing a reference for now, and moved it up to the bottom of the section on TENS and PTNS. Note that I haven't altered any of the material in this section - it is all still worded as I found it. I merely moved it all to one section, and added citation tags. In my opinion, ''everything stated in the TENS and PTNS section is in need of assistance.''

5) '''Biofeedback.''' In the studies mentioned, and in line with the general understanding of what biofeedback is, I identified biofeedback as a relaxation technique aimed at allowing people to control various autonomic functions. The references both treated biofeedback as a complementary relaxation therapy to be used ''in addition to'' drugs and/or hydrodistention of the bladder - neither tested biofeedback as a standalone treatment. As such, I called out the tested use of biofeedback as one part of a multimodal approach.

6) '''Acupuncture.''' I left both references claiming that acupuncture is effective in alleviating IC pain. I then went on to mention that (contrary to one of these references) there is no scientific basis for the existence of acupuncture points or meridians (with references to backup that claim). I also linked to an analysis in the British Medical Journal that concluded that sham acupuncture works just as well as real acupuncture. This, I believe, is a properly balanced write-up on the use of acupuncture to treat IC pain as it presents information on both sides of the debate, weighted proportionately.

Please let me know if anyone has any questions or concerns. --'''<font color="800080">]''' <sup><small>(] &bull; ])</small></sup></font> 20:01, 9 April 2009 (UTC)

::I reorganised most of it and removed the critique of acupuncture, which is not appropriate on this page (add it to the acupuncture page please). I'm still not happy with this page, which is waaaaay behind the page at ], the male version of the condition. ] 00:45, 10 April 2009 (UTC)

:::Nice work. I think you've improved upon the entire treatment section significantly with your latest edit. But I don't agree with your edit on the acupuncture entry. As it reads right now, I believe the entry is giving undue weight to a minority view on the efficacy of acupuncture in general, and for this condition. This is what one of the cited sources says about acupuncture and IC:

:::''<blockquote>Acupuncture is over 5000 years old. '''Neuromodulation through acupuncture occurs by re-establishing a balanced flow of energy, termed Yin and Yang, throughout the body through 12 meridians and 1000 acupoints'''. A rebalance of energy flow is thought to occur by increasing endorphin production and pain ablation by stimulating A delta, large-diameter, myelinated sensory nerve fibers with the inhibition of unmyelinated sensory C-fibers. Rapkin and Kames reported the results of a study of 14 patients with pelvic pain who had 6–8 weeks of acupuncture therapy twice a week. Eleven patients had a >50% reduction in pain. Our experience at the Pelvic Floor Institute shows that IC patients need 10–20 acupuncture treatment sessions in order to achieve symptom relief. Further studies are needed to determine the efficacy of acupuncture therapy in patients with IC.</blockquote>''

:::This source is clearly stating that acupuncture points and meridians and chi (yin and yang here) are behind the success of acupuncture, in general and for IC. Belief in the existence of chi falls under the header of , and it is clearly a minority point of view (]). From the policy concerning pseudoscience and minority points of view:

:::''<blockquote>Please be clear on one thing: '''the Misplaced Pages neutrality policy certainly does not state, or imply, that we must "give equal validity" to minority views'''. It does state that we must not take a stand on them as encyclopedia writers; but '''that does not stop us from describing the majority views as such; from fairly explaining the strong arguments against the pseudoscientific theory'''; from describing the strong moral repugnance that many people feel toward some morally repugnant views; and so forth.</blockquote>''

:::So yes, I agree that this is not the place to debunk acupuncture. However, the deleted text concerning the majority view about chi and acupuncture points should be added back in order to properly balance the minority view with the current scientific consensus which is that chi and acupuncture points are not real. I haven't added it back at this time, and I welcome your comments, but I feel very strongly that it cannot be omitted. --'''<font color="800080">]''' <sup><small>(] &bull; ])</small></sup></font> 02:16, 10 April 2009 (UTC)

::::If you can find a study that criticises acu. ''in the context of IC/PBS'', then go ahead and add it in. However, any criticism of acupuncture itself is a matter for the ] page, otherwise it's merely you ]. It's also verging on ] to state this argument in the IC context. And it's definitely a ]. (BTW, you seem unaware that one of the sources you gave states that acu. may work for complex neurological reasons, quite apart from all the chi/meridian mumbo-jumbo.) ] 03:27, 10 April 2009 (UTC)

:::::I'm sorry, but I disagree with you on all counts. I'm not soapboxing, and this isn't even vaguely original research (that one's a ''real'' stretch). It also isn't a synthesis of data as evidenced by the fact that I have sources that ''say exactly what I'm saying here.'' What data had to be synthesized? Here's a quote from the NIH Consensus document:

:::::''<blockquote>Despite considerable efforts to understand the anatomy and physiology of the "acupuncture points," the definition and characterization of these points remain controversial. '''Even more elusive is the scientific basis of some of the key traditional Eastern medical concepts such as the circulation of Qi, the meridian system, and other related theories, which are difficult to reconcile with contemporary biomedical information''' but continue to play an important role in the evaluation of patients and the formulation of treatment in acupuncture.</blockquote>''

:::::There's no need for me to synthesize data or do original research when the NIH document clearly states that there is no scientific basis for Qi, meridians, etc. So please stop leaning on the argument that I'm doing original research when that claim is demonstrably untrue.

:::::Here's the thing: your source states ''quite plainly'' that acupuncture works by realigning Yin and Yang energies at work in the body. My sources states that this is not the majority view of science. And that's why it should be (and, frankly, needs to be) included. So no, I do not have to find a study that criticizes acupuncture in the context of treating IC - that's a red herring, plain and simple, and I reject that assertion outright. My text should be added back because leaving out my text gives undue weight to a minority view in pseudoscience. Including my text remedies that problem.

:::::For the record (and off the record as this is merely my opinion), acupuncture may well be able to relieve pain through a combination of the placebo effect and one or more physiological affects (e.g. release of endorphins/opioids). So yes, I am quite aware of the other contents of the reference you are talking about - that's not a "gotcha" to me. Of course, any effects beyond placebo are still not proven, but ''that'' doesn't fall under the heading of pseudoscience. Chi ''does''. If this article is going to claim that acupuncture works by way of these pseudoscientific claims by citing a source that says just that, then it must also take care to make the majority view of science abundantly clear. --'''<font color="800080">]''' <sup><small>(] &bull; ])</small></sup></font> 04:16, 10 April 2009 (UTC)

::::::I think you'll find that adding your own cautionary words to modify the conclusions of a published study is indeed ]. It's not for us to find a conclusion here, a statement there, and tie them together to show cause. ] 04:27, 10 April 2009 (UTC)

:::::::I haven't added ''my'' words at all. I've explained where the information came from. I've referenced the WP policies that you mentioned and explained why this text isn't soapboxing, original research, or synthesis of data. Here's the description of synthesis of data:

:::::::''<blockquote>Do not put together information from multiple sources to reach a conclusion that is not stated explicitly by any of the sources.</blockquote>''

:::::::Here's what the source I referenced says:

:::::::''<blockquote>Despite considerable efforts to understand the anatomy and physiology of the "acupuncture points," the definition and characterization of these points remain controversial. '''Even more elusive is the scientific basis of some of the key traditional Eastern medical concepts such as the circulation of Qi, the meridian system, and other related theories, which are difficult to reconcile with contemporary biomedical information''' but continue to play an important role in the evaluation of patients and the formulation of treatment in acupuncture.</blockquote>''

:::::::Here's what I'd like to add to the article:

:::::::''<blockquote>However, it is important to note that there is no known ] or ] basis for the existence of ] or ]</blockquote>''

:::::::It seems clear to me that this statement follows directly from the source material - the fact that there is no scientific basis for qi ''et al''. But if you prefer, we can say:

:::::::''<blockquote>However, it is important to note that there is no known ] basis for ], and that there is no scientific basis for the existence of ] or ].</blockquote>''

:::::::This revised text now directly mirrors the source material, without simply copy/pasting it. Problem (whether it existed or not) solved.

:::::::And how about the rest of my deleted text? That reads:

:::::::''<blockquote>In addition, at least one study found that acupuncture "seems to alleviate pain just barely better than sticking needles into nonspecified parts of the body" and concluded that some of acupuncture's effects may be due to the ].</blockquote>''

:::::::No synthesis of data there. This comes directly from the source materials. So again, ''let's add it back''.

:::::::I've explained my rationale for why this text must be added back, and I've cited WP policies backing up my assertion. If you have no actual, valid arguments against adding this information back to the article, then we need to do so. The latest version of the deleted text now reads:

:::::::''<blockquote>However, it is important to note that there is no known ] basis for ], and that there is no scientific basis for the existence of ] or ].<ref name="NIH-1997consensus">{{cite web |author=NIH Consensus Development Program |title=Acupuncture --Consensus Development Conference Statement |url=http://consensus.nih.gov/1997/1997Acupuncture107html.htm |date=November 3-5, 1997 |publisher=National Institutes of Health |accessdate=2009-04-09}}</ref> In addition, at least one study found that acupuncture "seems to alleviate pain just barely better than sticking needles into nonspecified parts of the body"<ref>{{cite web |author=Seppa, Nathan |title=Needles can stick it to pain: Acupuncture lessens various kinds of pain, but so does a sham version |publisher=ScienceNews |year=2009 |month=February |url=http://www.sciencenews.org/view/generic/id/40535/title/Needles_can_stick_it_to_pain |accessdate=2009-04-09}}</ref> and concluded that some of acupuncture's effects may be due to the ].<ref>{{cite journal|author=Matias Vested Madsen, Peter C Gøtzsche, Asbjørn Hróbjartsson |title=Acupuncture treatment for pain: systematic review of randomised clinical trials with acupuncture, placebo acupuncture, and no acupuncture groups |journal=BMJ |volume=338 |year=2009 |pmid= |doi=10.1136/bmj.a3115 |url=http://www.bmj.com/cgi/content/full/338/jan27_2/a3115}}</ref></blockquote>''

:::::::I've dropped the Mann reference. I see why it was used in the acupuncture article (statement against interests and all), but I'm happy to rely on the NIH consensus statement here if it will help you to see that there is no synthesis of data. So let's add this text (above) back. --'''<font color="800080">]''' <sup><small>(] &bull; ])</small></sup></font> 13:26, 10 April 2009 (UTC)

* No, it's not going back in and here's why: it ''is'' ]. You need to read the SYN page more carefully. I'll paste the relevant text:

<blockquote><span style="background-color:#f9fec1">Editors should not make the mistake of thinking that if A is published by a reliable source, and B is published by a reliable source, then A and B can be joined together in an article to reach conclusion C. This would be a synthesis of published material that advances a new position, and that constitutes original research. "A and B, therefore C" is acceptable only if '''a reliable source has published the same argument''' in relation to '''the topic of the article.'''</span></blockquote>

::So as I said, ''find a study that voices these warnings in relation to IC/PBS'' or it is a soapboxing piece of OR. Thank you. ] 14:06, 10 April 2009 (UTC)

Your example is patently incorrect, as I've explained already. ''I am not taking two sources and coming up with a statement.'' I am taking ''one source'' - the NIH Consensus - and using ''that one source'' to make a statement. I showed that definitively above. Simply repeating this assertion without acknowledging that fact isn't productive because your assertion ''doesn't apply at all to what I've actually done.''

If you want to continue to make this assertion, then ''I'' assert that you have to step through what you see as my synthesis of data, or original research. Show me where and how I did that for my deleted text. Show me the two (or more) sources that I have combined. Show me how what I've said isn't stated in the NIH source alone. Frankly if my text was any more similar to the NIH text it would border on plagiarism, so I don't see how any rational person could come to the conclusion that it's WP:SYN.

There are two other statements made in my deleted text. One part says:

''<blockquote>In addition, at least one review of acupuncture studies found that acupuncture "'''seems to alleviate pain just barely better than sticking needles into nonspecified parts of the body'''"<ref>{{cite web |author=Seppa, Nathan |title=Needles can stick it to pain: Acupuncture lessens various kinds of pain, but so does a sham version |publisher=ScienceNews |year=2009 |month=February |url=http://www.sciencenews.org/view/generic/id/40535/title/Needles_can_stick_it_to_pain |accessdate=2009-04-09}}</ref>...</blockquote>''

(Note that I replaced "study" with "review of acupuncture studies" above.) As indicated, this is a quote from the referenced source, which says the exact same thing:

''<blockquote>Acupuncture, the ancient Chinese practice of sticking needles into a patient at specific points to relieve pain and treat other conditions, '''seems to alleviate pain just barely better than sticking needles into nonspecified parts of the body''', a new analysis shows.</blockquote>''

It's a direct quote. Nothing could be farther from WP:SYN. The other part of my deleted text says:

''<blockquote>...and concluded that some of acupuncture's effects may be due to the ].<ref>{{cite journal|author=Matias Vested Madsen, Peter C Gøtzsche, Asbjørn Hróbjartsson |title=Acupuncture treatment for pain: systematic review of randomised clinical trials with acupuncture, placebo acupuncture, and no acupuncture groups |journal=BMJ |volume=338 |year=2009 |pmid= |doi=10.1136/bmj.a3115 |url=http://www.bmj.com/cgi/content/full/338/jan27_2/a3115}}</ref></blockquote>''

Read the analysis - it clearly says that the placebo effect may be at work based on what they found. In fact, this is a pretty watered down statement, I think. The study also says, among other things:

''<blockquote>The analgesic effect of acupuncture is small and cannot be distinguished from bias resulting from incomplete blinding.</blockquote>''

I didn't even address that part, though it's a clear conclusion of the review. If you'd rather use that in the text, I'm fine with that ''and it's a direct quote''.

The bottom line is that each part of my deleted text can be directly attributed to a single source. ''So please stop making this assertion''.

I've read the WP:SYN page carefully. ''You'', I think, need to look at what I've done more carefully. I stepped through each part of the the deleted text and showed precisely which single source each part came from. There is ''one source'' that backs up (and directly states) each position that I am asking to put back into the article. ''That isn't WP:SYN'' no matter how many times you say it is. So if that's the only argument you have against reinserting my text, ''then you don't have an argument''. I'd love to be able to build a consensus here, and I don't want to get into an edit war, but frankly it doesn't seem that you're interested in rational discourse.

So if your position is "no, it's not going back in," then my position is that it is unacceptable to have the section as it is without my text or some reasonable version of it added back. The statement on acupuncture ''cannot stand as it is''. Leaving it violates NPOV by giving undue weight to a minority, pseudoscientific view, ''as I explained above'' and to which you've never responded. So if you aren't willing to have an actual discussion on this, then the only thing to do is to temporarily remove the section until we can reach a consensus. I don't want to do that, but as it is right now, it is not acceptable. I am, as I have been, ready to discuss this rationally, whenever you are, and I hope we can agree on appropriate wording.

For the record, here's the way I'd like the section to read. There is definitively no synthesis of data, no original research and no soapboxing, and it conforms to the NPOV sections I linked to above:

''<blockquote>] has been reported to alleviate pain associated with IC/PBS in several cases.<ref name="pmid18663671">{{cite journal |author=Binder I, Rossbach G, van Ophoven A |title= |language=German |journal=Aktuelle Urol |volume=39 |issue=4 |pages=289–97 |year=2008 |month=July |pmid=18663671 |doi=10.1055/s-2008-1038199 |url=}}</ref><ref name="pmid16986031">{{cite journal |author=Whitmore KE |title=Complementary and alternative therapies as treatment approaches for interstitial cystitis |journal=Rev Urol |volume=4 Suppl 1 |issue= |pages=S28–35 |year=2002 |pmid=16986031 |pmc=1476005 |doi= |url=}}</ref> However, it is important to note that there is no known ] basis for ], and that there is no scientific basis for the existence of ] or ].<ref name="NIH-1997consensus">{{cite web |author=NIH Consensus Development Program |title=Acupuncture --Consensus Development Conference Statement |url=http://consensus.nih.gov/1997/1997Acupuncture107html.htm |date=November 3-5, 1997 |publisher=National Institutes of Health |accessdate=2009-04-09}}</ref> In addition, at least one review of acupuncture studies found that acupuncture "seems to alleviate pain just barely better than sticking needles into nonspecified parts of the body"<ref>{{cite web |author=Seppa, Nathan |title=Needles can stick it to pain: Acupuncture lessens various kinds of pain, but so does a sham version |publisher=ScienceNews |year=2009 |month=February |url=http://www.sciencenews.org/view/generic/id/40535/title/Needles_can_stick_it_to_pain |accessdate=2009-04-09}}</ref> and concluded that "the analgesic effect of acupuncture is small and cannot be distinguished from bias resulting from incomplete blinding."<ref>{{cite journal|author=Matias Vested Madsen, Peter C Gøtzsche, Asbjørn Hróbjartsson |title=Acupuncture treatment for pain: systematic review of randomised clinical trials with acupuncture, placebo acupuncture, and no acupuncture groups |journal=BMJ |volume=338 |year=2009 |pmid= |doi=10.1136/bmj.a3115 |url=http://www.bmj.com/cgi/content/full/338/jan27_2/a3115}}</ref></blockquote>''

If you want to change the last part back to the statement about the placebo effect at work, I'm fine with that, too. But the bottom line is that we have to add this back in, and let the readers make an informed decision. That's what this is all about.

I'm trying to reach an agreement here. All I ask is that you do the same. --'''<font color="800080">]''' <sup><small>(] &bull; ])</small></sup></font> 17:38, 10 April 2009 (UTC)

=== Synthesis not acceptable ===

You said that <span style="background-color:lightgrey">"Your example is patently incorrect, as I've explained already. ''I am not taking two sources and coming up with a statement.'' I am taking ''one source'' - the NIH Consensus - and using ''that one source'' to make a statement. I showed that definitively above. Simply repeating this assertion without acknowledging that fact isn't productive because your assertion ''doesn't apply at all to what I've actually done.''</span>

I'm going to explain this one last time. You are taking negative comments about acupuncture generally from one source (where IC/PBS is not discussed), then taking studies about IC/PBS from another source (where acupuncture is found to be beneficial), then using the negative source/s to qualify the positive sources. We cannot do that as editors of a tertiary source. You need to find a source that discusses the drawbacks of acu. in the context of IC/PBS. Unless you can find that, your attempts to insert this information here are your own synthesis of data. If you are not happy with this, put it to a RfC. ] 00:55, 11 April 2009 (UTC)

:Let's say you make a statement that colorfully wrapped gifts appear under the tree at Christmas time in Bulgaria, and you link to an article as reference that says that gifts do, in fact, appear and that the method behind this appearance of gifts is a jolly old man called Santa Claus who rides in his sleigh around the world and drops off presents every Christmas Eve. Then let's say I see that, and add text stating that the consensus view is that there is no scientific basis for the existence of Santa Claus, with citations, thereby directly addressing the validity of your claim. Now, in this scenario, would you delete my text and tell me that unless I can find a study that explicitly addresses how Santa Claus doesn't deliver gifts ''in Bulgaria'' that my addition should be removed? Because that's what's going on here, and it's 100% improper, and logically unsound. You are wrong.

:I am referring to a ''consensus view'' of the NIH on acupuncture. Do you understand what a consensus view is? It isn't limited to one condition - they looked at numerous studies across numerous conditions to derive a ''consensus view''. You are speaking as if you aren't aware of that fact, though you certainly must be. How you can say that a consensus view of the NIH isn't relevant here is beyond me. And how you can claim that it's WP:SYN simply boggles the mind.

:In addition, you still have not addressed my statements that leaving my text out doesn't meet the requirements of ] as doing so gives undue weight to a minority, pseudoscientific view. Never once have you even tried to counter this argument. So I may yet take this to RfC or some other means of dispute resolution.

:That said, even though I don't agree at all with what you're saying, I will comply with your request to reference a study that directly addresses acupuncture and IC treatment. That, at least, will get some of the actual science addressed in the short term. My edits are going in now. Please note that, after these edits, I still don't consider the section to be acceptable - it's just a step in the right direction. --'''<font color="800080">]''' <sup><small>(] &bull; ])</small></sup></font> 03:40, 11 April 2009 (UTC)

::Undue weight does not apply here. It ''would'' apply here if there were studies criticising acupuncture in relation to IC/PBS, and I were trying to exclude them and only allow studies that ''support'' the use of acupuncture for IC/PBS. But I'm not doing that. I see you managed to find a negative study about acu. and IC/PBS. Now that's the way to go. ] 06:28, 11 April 2009 (UTC)

:::Actually you're still wrong. The section still gives undue weight to pseudoscience because right now it gives equal weight to each side. That is undue weight. Not allowing a consensus view that contradicts the referenced fringe view is in violation of WP:UNDUE.

:::Also it's frustrating for you to delete my references that criticize acu, then delete my further reading link to the same thing by saying that it references something that isn't discussed ''because you deleted it''. Of course it ''is'' discussed because one of your refs supports the existence of qi, so you're wrong about that, too.

:::Either put back the further reading link or remove the questionable ref that refers to yin and yang. In fact if you remove that ref, I'd agree that the section is doing right by WP:UNDUE and call it acceptable because that way it presents two studies with conflicting results with no mention of any mystical forces. No consensus view needed, no further reading link needed - just a section stating that tests of acu for IC have been conflicting.

:::What do you say? --'''<font color="800080">]''' <sup><small>(] &bull; ])</small></sup></font> 13:42, 11 April 2009 (UTC)

:::I say you should make your arguments on the ] page where they belong. The word ''acupuncture'' is wikilinked and readers can read the various arguments, pro and con, on that page, where they logically belong. Otherwise you will end up doing something illogical and invalid (and against the WP rules), which is to edit every single page acupuncture is mentioned on wikipedia to insert your warnings. I am not going to debate this further with you. Please ask for 3rd opinions or RfC. ] 15:06, 11 April 2009 (UTC)

===Request for Opinions: Acupuncture and IC===

Please note, Ratel, that I don't expect a reply from you as I am aware of your position and your statement that you are not going to discuss this further.

Quite honestly, I don't have the time to take this through formal dispute resolution. I've been hoping (and I continue to hope) that another editor (or editors) will see this and weigh in on the talk page. I will restate my position here to make it easier for someone to do so. If this doesn't garner any more commentary, I may move to ] or ] at some point when I have more time.

To be clear, if it wasn't for the reference that pushes the pseudoscientific fringe theory of qi and meridians, I don't think the problem would be so severe. I would still think that the NIH consensus view and the review that concluded that acupuncture doesn't seem to have any effect ''in general'' would be good additions, but they wouldn't be ''critical''. That's why I suggested removing what I see as a bad reference. After all, it is a link to an article in which the ''who performs acupuncture'' states a psuedoscientific view about how the procedure works ''without providing any evidence to backup that claim''. Here is that quote:

''<blockquote>Acupuncture is over 5000 years old. '''Neuromodulation through acupuncture occurs by re-establishing a balanced flow of energy, termed Yin and Yang, throughout the body through 12 meridians and 1000 acupoints'''. A rebalance of energy flow is thought to occur by increasing endorphin production and pain ablation by stimulating A delta, large-diameter, myelinated sensory nerve fibers with the inhibition of unmyelinated sensory C-fibers. Rapkin and Kames reported the results of a study of 14 patients with pelvic pain who had 6–8 weeks of acupuncture therapy twice a week. Eleven patients had a >50% reduction in pain. Our experience at the Pelvic Floor Institute shows that IC patients need 10–20 acupuncture treatment sessions in order to achieve symptom relief. Further studies are needed to determine the efficacy of acupuncture therapy in patients with IC.</blockquote>''

This source is clearly stating that acupuncture points and meridians and chi (yin and yang here) are behind the success of acupuncture, in general and hence for IC. Belief in the existence of chi falls under the header of , and it is clearly a minority point of view (]). From the policy concerning pseudoscience and minority points of view:

''<blockquote>Please be clear on one thing: '''the Misplaced Pages neutrality policy certainly does not state, or imply, that we must "give equal validity" to minority views'''. It does state that we must not take a stand on them as encyclopedia writers; but '''that does not stop us from describing the majority views as such; from fairly explaining the strong arguments against the pseudoscientific theory'''; from describing the strong moral repugnance that many people feel toward some morally repugnant views; and so forth.</blockquote>''

Having a source that asserts the existence of yin, yang, acupoints and meridians without balancing that with the scientific consensus that none of these things exist and with a recent review conducted on studies ''across many conditions'' which concludes that acupuncture isn't effective ''in general'' (and hence, not effective for IC either) violates ] by giving undue weight to a pseudoscientific fringe theory. That's why I want to take action ''on this article'' but not on every article that mentions acupuncture (each article should be looked at on a case-by-case basis, of course).

In order to restore proper balance, I believe that at least one of the following has to happen (I'd prefer a combination of these):

1) '''Remove the questionable reference that Ratel added.''' ''It is itself an unsourced statement by a potentially biased group (they make money in part by performing acupuncture) espousing the validity of a pseudoscientific theory. It should not be included as a reliable source in a medical article.''

2) '''Add back the text that Ratel deleted which shows the scientific consensus on acupuncture'''. ''This includes a reference to the National Institutes of Health consensus statement on acupuncture, and a reference to a recent (2009) review which concluded that the evidence for acupuncture ''in general'' was lacking. Here is that text:''
:In addition, the consensus view is that there is no known scientific basis for the existence of ], ] or ],<ref name="NIH-1997consensus">{{cite web |author=NIH Consensus Development Program |title=Acupuncture --Consensus Development Conference Statement |url=http://consensus.nih.gov/1997/1997Acupuncture107html.htm |date=November 3-5, 1997 |publisher=National Institutes of Health |accessdate=2009-04-09}}</ref> and a February 2009 review of acupuncture studies found the data in favor of acupuncture lacking.<ref>{{cite web |author=Seppa, Nathan |title=Needles can stick it to pain: Acupuncture lessens various kinds of pain, but so does a sham version |publisher=ScienceNews |year=2009 |month=February |url=http://www.sciencenews.org/view/generic/id/40535/title/Needles_can_stick_it_to_pain |accessdate=2009-04-09}}</ref><ref>{{cite journal|author=Matias Vested Madsen, Peter C Gøtzsche, Asbjørn Hróbjartsson |title=Acupuncture treatment for pain: systematic review of randomised clinical trials with acupuncture, placebo acupuncture, and no acupuncture groups |journal=BMJ |volume=338 |year=2009 |pmid= |doi=10.1136/bmj.a3115 |url=http://www.bmj.com/cgi/content/full/338/jan27_2/a3115}}</ref>

3) '''Add back the further reading link that Ratel deleted which links to a specific section of the WP article on acupuncture.''' ''At least this allows a reader to follow the link to read about the consensus view that there is no evidence supporting the theory behind acupuncture (chi, etc.). Here is that link:''
:{{Further|]}}

I floated all three of these ideas in an attempt to reach a compromise, but ultimately no compromise was possible as each of these suggestions were either reverted or refused (see long discussion above). Ideally, I'd like to see a combination of these added, but at least one of these is necessary in order to satisfy ], in my opinion.

If anyone would like to comment, please do so. --'''<font color="800080">]''' <sup><small>(] &bull; ])</small></sup></font> 19:52, 14 April 2009 (UTC)

* That is not how you ask for comments. Go to Help, then type in rfc. ] 23:07, 14 April 2009 (UTC)

*Yes, thanks, I know that. That's why I started my comment with a statement that I don't have time for a formal RfC or 3O right now. I'm well aware of the formal process, and in fact I even linked to ] and ] above, but there's nothing wrong with trying something less formal first. --'''<font color="800080">]''' <sup><small>(] &bull; ])</small></sup></font> 00:12, 15 April 2009 (UTC)

::Hmmm, fine, I suppose, but if you check the edit history of the IC/PBS page you'll see that you are unlikely to get comments that way (low traffic). ] 00:58, 15 April 2009 (UTC)

:::Unlikely, perhaps, though there are readers (like myself) who came here seeking information, and instead found this remarkable discussion. Ratel, in your Wiki expertise, you seem to have ignored ], and I apologize for having to do so myself in order to point out that you've done it. The majority of the first half of your collection of responses to Transity were snide, smug remarks that entirely ignored the topic of discussion, and despite a few salient responses, that tendency has not abated. Please stay on track. You can safely assume that those who take the time to edit here are as easily able to keep abreast of the WP policies and features as you are.

:::I agree with Transity's contentions. If you are to have a source referenced on a page that claims any sort of pseudoscience as true, then a contradicting reference is quite called for, in keeping with the true spirit of ] and ].

:::Further, the assertion that a ''general'' debunking of any field of pseudoscience does not qualify as a counterpoint to a ''specific'' claim within that field of pseudoscience is nonsensical. Transity's Santa Claus example, while perhaps difficult to relate to this discussion, is a decent analogy. For a more direct comparison, please hypothesize that a WP entry states (or links to sources that state) that iron disintegrates when subjected to water, at room temperature, that has been dyed blue. A source that indicates that metals have never been shown to disintegrate when subjected to water at any temperature would be both appropriate and valuable to a reader attempting to learn from an article on the properties of iron, whether or not it mentions blue-dyed water or the specific metal, iron. Bringing such a claim into the article in the first place opens the door to a ''general'' debunking of the basis of the claim. If the original claim which cites pseudoscience is included, then a citation that debunks such claims in general is not only appropriate, but necessary.

:::Your discussion of readers v. editors is an odd one (and more evidence of your tendency toward defying ]), but brings up the point: making things directly accessible (not necessarily "easy" or "simple") for casual (and non-savvy) readers should be one of the major goals of a repository of information like WP. There was misleading information on this page, and an effort was made to help casual readers find further information on the subject. Remember ] and ], and, contradictorily, stop quoting policy and focus more on the discussion at hand. Obviously, I (and other readers) came to this page for specific reasons, and readers may or may not have the time, resources, or savvy to trawl through twenty WP entries to find out everything we're attempting to learn. Just as obviously, I (and other editors - your apparent misrepresentation of the readers/editors dichotomy seemed to be purely an attack on Transity, and I would like to think you have a better understanding of it than that) would like to make sure that any entry is comprehensive enough to counter baseless claims within the context of the entry itself, so that readers can easily find accurate information.

:::Finally, and preemptively, please refrain from lobbing ] at me. I came to this entry for my personal reasons as a reader, and joined WP and this discussion as an editor when I saw your behavior in this discussion; if my contribution results in any well-written and/or formatted copy, that would be due to my particular professional skills. I joined this discussion specifically because, as I read it, I felt that you were not staying on topic, were not exhibiting an interest in improving the entry, and were not following etiquette in your interactions; simultaneously, I was swayed by Transity's arguments. So keep the ] shots to a minimum. You've already tried it (just as pointlessly) on one user in this discussion, and I find it to be counter to the whole point of Misplaced Pages. Misplaced Pages's entire purpose is to collect accurate and documented information; no one user can know all information; plenty of individual users can know quite a lot about one specific topic or field of interest. I would posit that the "single-purpose account" you sneer at should be valued as a specialist, providing insight and information regarding a particular specialty (as theorized on ] itself). I'd rather have a neurosurgeon taking part in my brain surgery than some guy who likes to read neurology books in his spare time, and I'd certainly prefer the neurosurgeon to a casual trepanation enthusiast. Unless you have evidence of an "agenda" that runs counter to the purpose of collecting and presenting accurate information, jabbing at another editor with ] is irrelevant and, once again, off-topic (]). The point of this discussion should be how to improve the content of the page it pertains to; not to argue policy or take on another editor's agenda (again, ]).

:::In that light, I would second Transity's suggestions; at the very least, if any citation is made which includes, in its content, baseless and unproven pseudoscience, I, as both a reader and editor of WP, believe that a citation debunking that pseudoscience, either in the specified context or across the board, is both appropriate and required. My apologies for having to quote policy in order to make this point, but try to refrain from ]-ing me. ] (]) 04:14, 15 April 2009 (UTC)

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Recent changes

You reverted the edits I had done on Interstitial Cystitis stating that I wasn't following the Mos. Could you please give me more feedback than that?? What caught your eye that I was doing wrong. I'm recovering from surgery and had some hours to spare.. and would hate to lose these updates.. especially when this page had been clearly changed by industry.. promoting neuromodulation, etc. etc. Aruaidh (talk) 02:57, 25 September 2010 (UTC)Aruaidh

Look at how to format citations, and omit sentences such as "Substantiated claim". RxWatch (talk) 04:55, 25 September 2010 (UTC)
My bad. I was using a wikipedia guide that used "substantiated claim" as part of the reference text. I must have misunderstood their format. —Preceding unsigned comment added by Aruaidh (talkcontribs) 18:15, 25 September 2010 (UTC)

Nomenclature Debate Continues

I attempted several edits yesterday to include new research and protocols released during the AUA 2010 annual meeting. The nomenclature debate for IC has been going on for over a decade... and the problem that I have with the text as written is that it assumes that the world is now following the ESSIC name/criteria of Bladder Pain Syndrome. Simply not the case. The problem with the ESSIC criteria is that it excludes patients who have frequency/urgency without pain from a diagnosis. There are comparatively few practitioners in the rest of the world who follow these guidelines. I attended the NIH/NIDDK meeting at which this was discussed and there is, by no means, an international consensus of the ESSIC guidelines. They will never be implemented in the United States as written.

In 2008, when the Japanese Urology community issued their standards, they chose the name "Hypersensitive Bladder Syndrome" to avoid the exclusion of patients without pain and because they felt that sensitivity was a more accurate description of what is happening in the bladder wall. This is quite likely the best article written on IC to date discussing the nomenclature debate. In 2009, the Indian Guidelines were released, revealing that they would be using the term "Interstitial Cystitis/Painful Bladder Syndrome." In 2010, the American Urology Association introduced the AUA Guidelines and they will be using the name "Interstitial Cystitis/Bladder Pain Syndrome" for the foreseeable future in large part because our understanding of IC has changed so dramatically in the past year that what we thought we knew may be completely incorrect. Research now suggests that IC is an afferent gating disorder.. with systemic implications or, at the very least, a neurosensitivity disorder. Thus, if any name has the potential of being used in the future, it would be the Japanese approach.

For those who are interested, there are some webcasts from the AUA meeting which discuss the pros and cons of name changes What's in a name: What Happened to Interstitial Cystitis and the new AUA standards.

The other critical development is the new phenotyping methodology which now assesses AND TREATS patients with respect to six specific domains, including the presence of infection pelvic floor muscle tension, the presence of psycho social problems (anxiety, catastrophic thinking), organ specific issues (i.e. Hunner's Ulcers).. etc. etc.. which also blows out of the water the implication that IC is a bladder specific disease.

I propose that we return to using IC or IC/BPS or IC/BPS/HBS... rather than BPS/IC for this discussion. Comments? Interestingly, the website UROTODAY uses IC/PBS/BPS/HBS in their discussions.

I attempted several edits that were reverted yesterday and would appreciate your review of these again. The treatment discussion, in particular, was poorly organized, did not differentiate between oral medications, intravesical instillations, etc. The neuromodulation area was misleading at best given the fact that there is substantial risk, including numerous fatalities when using this methodology. Please check those out and give me feedback. I am recovering from surgery so am still in a painful recovery process.

Jill Osborne - Interstitial Cystitis Network President & Founder (talk) 18:14, 25 September 2010 (UTC) Aruaidh

Some comments:
  1. Misplaced Pages follows, it does not lead. Nor is wikipedia a crystal ball, looking forward into the future, or a place to debate nomenclature. Until clarity emerges on naming, the oldest form ("IC") should be used in the article, but the other forms should all be noted and perhaps made into redirecting links.
  2. Speculation about theories of etiology, such as gating deficiencies, should be included as theories. I inserted a citation to the theory yesterday, under the "Stress" subsection.
  3. Please do not make personal disclosures about your health status here. This is not a forum.
  4. I suggest you continue editing the page again, but make changes slowly and piecemeal, over a period of time, so that they can be reviewed by others and modified when necessary. RxWatch (talk) 02:30, 26 September 2010 (UTC)


I think that reference to NRSI and SSRI drug entries could be more generalized. Duloxetine and amitryptaline (and escitalopram) may provide a therapeutic effect in a small subset of cases. eg. this article promotes duloxetine for IC Given that people who read this may be desperately seeking pain relief, and may have not tried all drugs, all should be mentioned as possible treatments with efficacy in a subset of cases. Let the patient pursue the best treatment given their own response. StephenSmith (talk) 06:21, 11 February 2011 (UTC)

A number of issues

This article should be referenced to high quality sources such as review articles rather than to primary research papers and the popular press. Doc James (talk · contribs · email) (if I write on your page reply on mine) 12:08, 5 October 2012 (UTC)

Do you have any suggested references to add or to use in place of the research papers currently used as references in the body of this article? TylerDurden8823 (talk) 23:41, 5 October 2012 (UTC)
I can help you identify sources if you need help finding them, please message me at my talk page. Forgive me for being critical on the article, but right now I see the sentence "A Harvard University study concluded, 'the impact of interstitial cystitis on quality of life is severe and debilitating' " in the lead. I don't know of a reason to name drop "Harvard" like this (see WP:MEDREV). Tha paper is from 2000 and is a primary research paper. Per WP:MEDDATE, we try to use recent review articles if possible. I see it has been cited by three review articles. The most recent is PMID 19548999 "Clinical guidelines for interstitial cystitis and hypersensitive bladder syndrome". That would be a good source to rewrite content with. And then we have "A Harvard Medical School guide...", which sounds like further name dropping and it is cited to a teriary source, which is not ideal in this case. A clinical practice guideline is one type of secondary WP:MEDRS and review articles are another. These should be cited for most of the content in a medical article (when they can be located). I came here because I noticed this article was put up for good article review. In my opinion it lacks basic verifiability because it is tagged as having potentially self published material, and in general strays from the guideline of WP:MEDRS, by citing questionable sources such as old primary research. For example, the statement "Neuromodulation can be successful in treating IC/BPS symptoms, including pain" is cited to a 1994 paper. That's not how we write articles, unfortunately. Biosthmors (talk) 20:29, 16 October 2012 (UTC)

GA Review

GA toolbox
Reviewing
This review is transcluded from Talk:Interstitial cystitis/GA1. The edit link for this section can be used to add comments to the review.

Reviewer: Biosthmors (talk · contribs) 20:53, 16 October 2012 (UTC)

Unfortunately I say this article does not yet meet the good article criteria. It appears to need a cleanup and updating in sourcing. Right now I see the sentence "A Harvard University study concluded, 'the impact of interstitial cystitis on quality of life is severe and debilitating' " in the lead. Although, there shouldn't be a reason to name drop "Harvard" like this (see WP:MEDREV). That paper is from 2000 and is a primary research paper. Per WP:MEDDATE, we try to use recent review articles if possible, and I see it has been cited by three review articles. The most recent is PMID 19548999 "Clinical guidelines for interstitial cystitis and hypersensitive bladder syndrome" (2009). That would be a good source to rewrite content with. And then we have "A Harvard Medical School guide...", which sounds like further name dropping and it is cited to a teriary source, which is not ideal in this case. A clinical practice guideline is one type of secondary WP:MEDRS and review articles are another. These should be cited for most of the content in a medical article (when they can be located, and it appears they can be in this case). I have tagged the article as needing WP:MEDRS, because it cites questionable sources such as old primary research. For example, the statement "Neuromodulation can be successful in treating IC/BPS symptoms, including pain" is cited to a 1994 paper. I encourage the nominator to work on the article and contact me if help identifying secondary sources would be helpful. If the nominator would like to work on this article for the next few weeks, I can leave this review open. Biosthmors (talk) 20:53, 16 October 2012 (UTC)

Thanks Biosthmors, I'll work on replacing the old primary/questionable sources with newer, more reliable review articles to improve the article's quality. I appreciate your leaving the review open. I think with some more work it can reach GA status after these improvements are made. Also, the sentence about neuromodulation's actually from a 2003 paper but the sentence immediately after it about TENS is from 1994. I'll see if I can find something more current. TylerDurden8823 (talk) 22:20, 16 October 2012 (UTC)

Comments for improvement

The history section should be prose and sourced to secondary sources. It's OK for good articles to have some short sections, so perhaps three sentences is all that is needed here. Right now there are all these , , etc. things that make no sense and look like an old copy/paste job from a former version. Biosthmors (talk) 17:10, 18 October 2012 (UTC)

There appears to be an excessive amount of sections in the body of the article, which makes for a long table of contents. See Dengue fever for an idea of how many subsections are generally acceptable. There is also a tendency for the article to have one paragraph sentences, which is not ideal. Can we consolidate things into more prose/paragraphs? Biosthmors (talk) 23:14, 18 October 2012 (UTC)

Okay, I've dealt with the excessive amount of sections in the body of the article. I think you'll find that it's much better now in that regard.I've fixed up the history section as well though I haven't found secondary sources for that just yet. If you have any suggestions for some I'll be sure to put them in right away but for now it's at least in prose format now. TylerDurden8823 (talk) 21:41, 21 October 2012 (UTC)
I also had another thought for some things that might improve the article (that I don't know how to do and I don't think would be required for good article status but may be useful for after that). I was thinking that adding pictures of a cystoscopy with hydrodistention showing Hunner's Ulcers might be a good addition to the article and perhaps a picture showing the urothelium or a less than optimal urothelium conceptually for IC. TylerDurden8823 (talk) 04:48, 23 October 2012 (UTC)
Thanks. Biosthmors (talk) 05:01, 23 October 2012 (UTC)

The WP:LEAD currently contains a paragraph discussing how the condition is disabling. I don't understand why this is necessary. Trim? I think this it is currently WP:UNDUE and against WP:MEDMOS. Biosthmors (talk) 05:01, 23 October 2012 (UTC)

The lead also talks about the epidemiology in this way: a 2009 study said X. a 2010 study and y, and a 2012 study said z! But this is a poor format. We are an encyclopedia and we are based off of WP:SECONDARY sources, not primary sources. We state the best evidence without trying to give a quasi-historical play by play of recent primary studies. This is also undue in my opinion. Biosthmors (talk) 05:01, 23 October 2012 (UTC)

Sentences such as " In 2005, understanding of IC/BPS improved dramatically and these therapies are now no longer used." are historical statements. They belong in the history section, not the medication section, where we should summarize the most current WP:MEDRS, in my opinion. Biosthmors (talk) 05:01, 23 October 2012 (UTC)

Agreed, someone else recently added the 2012 RICE epidemiology stuff. I'll work on shortening the lead to the current understanding/epidemiology and keep it to a minimum moving the rest of that to the history section (I agree that the history section is a more suitable section for information like this or an epidemiology section instead). Any secondary source recommendations? Are you referring more to reviews instead of using primary papers as they did? TylerDurden8823 (talk) 05:06, 23 October 2012 (UTC)
This issue seems to be one that develops constantly on Misplaced Pages. Can we pilot something new? If I single out a primary paper, and you need to see if any reviews have cited it, can you start a new section at my talk page (for each primary study) and mention the study either by its PMID or doi? Then I'll reply there, letting you know about what has cited it. Or does that sound too convoluted? Thanks! Biosthmors (talk) 05:15, 23 October 2012 (UTC)
That does seem a tad convoluted. I'm not sure exactly what you mean by piloting something new. I'll look around (and if you find anything let me know on my talk page or here) for secondary articles, reviews, etc. to replace some of those primary references. In the meanwhile, I have shortened the lead, made some grammar changes, and reformatted those sentences from the In this study: format to more prose-like format. Let me know if the current version looks better, same, worse, etc. Also, I'm not 100% clear on wikipedia policy on primary papers, do we need to remove all of them in favor of secondary sources? Or is it okay to leave some of them and just try and balance it more in favor of reviews than is currently the case? TylerDurden8823 (talk) 05:24, 23 October 2012 (UTC)
Gotcha. As I interpret WP:MEDRS, (see in particular WP:MEDREV), in general, we should remove every citation to a primary study that has already been cited by a review article. You can see deep vein thrombosis as an example. Nearly every reference is either to a review article or a clinical practice guideline. And please allow me to be more straightforward. =) I'm trying to shift some of the research burden onto you. I shouldn't have to identify any secondary sources to perform a good article review in an ideal nomination, but I am offering to help. In return, I expect you to make it easy for me. If you give me a doi or PMID, I will look. Do you want to post the doi or PMID here, or at my talk page? Please make a separate comment/section for each primary study, whether here or at my talk page. (FYI, review articles are just one type of secondary source, but they are a favored type per WP:MEDRS.) Biosthmors (talk) 05:54, 23 October 2012 (UTC)
Sure thing, now that I'm clear on exactly what a secondary source is from wikipedia and that reviews are preferred and now that I know that we pretty much want to remove all primary sources that we can, I'll get right on that but it will take me a little bit of time. I'll be sure to send you sources on your talk page for you to give me the okay. I'll try and start substituting primary papers with review articles. I'll make it easy for you =) TylerDurden8823 (talk) 06:02, 23 October 2012 (UTC)
Sounds good. Just leave me a doi or PMID, and I'll reply with the doi of all the reviews that cite that study. I take it you don't have access to Web of Science? Because if you do, then you could do it! Thanks. Biosthmors (talk) 16:15, 23 October 2012 (UTC)
Yeah, I don't have the Web of Science thing you mentioned (and unfortunately I don't have time to learn it atm but it does look like an awesome tool). I'll be sure to leave you DOIs or PMIDs or a link as you've asked. TylerDurden8823 (talk) 21:55, 23 October 2012 (UTC)
Ah it's pretty easy! When you identify an article, it says how many times it has been cited, and then one can just click on that number then select and click again to filter for reviews. Biosthmors (talk) 19:56, 28 October 2012 (UTC)

A numbered list (Misplaced Pages:Manual_of_Style/Lists#Numbered_lists -- ignore the html box) could be done for the "six step" guideline portion. However, first line, second line, etc. suggests order of prominence, while "six step" sounds like all things should be done in succession. Clarify by saying something like, "the following six options are suggested, with lower numbers indicating more preferred treatement options"? Biosthmors (talk) 19:16, 28 October 2012 (UTC)

Sure, I'll work on modifying that list. TylerDurden8823 (talk) 19:21, 28 October 2012 (UTC)
I think the list looks clearer now and conforms to the appropriate list format. TylerDurden8823 (talk) 23:20, 28 October 2012 (UTC)

Comment. I closed this review due to being short on time with the consent of the nominator and under the expectation this article will go to peer review, get comments, and then be resubmitted for GA status. Biosthmors (talk) 18:35, 10 November 2012 (UTC)

DMSO

The DMSO page mentions use for treatment - yet this page lacks any mention.

Shirley SW, Stewart BH, Mirelman S.; Stewart; Mirelman (March 1978). "Dimethyl Sulfoxide in Treatment of Inflammatory Genitourinary Disorders". Urology. 11 (3): 215–220. doi:10.1016/0090-4295(78)90118-8. PMID 636125.  — Preceding unsigned comment added by 108.243.106.82 (talk) 16:33, 6 March 2017 (UTC)


Quantify tags

I put quantify after "IC/BPS can result" in the lead because it is vague. Is it 1/1000 or 4/10? Biosthmors (talk) 16:04, 13 December 2012 (UTC)

Good question. I'm really not sure to be honest but I can't seem to get a hold of any studies right now that will satisfactorily answer this question. We'll have to wait in the meanwhile until a good review source on quality of life in interstitial cystitis emerges.TylerDurden8823 (talk) 06:39, 5 February 2013 (UTC)

Kegels

My edit on Kegel exercises was reversed, but the text still has essentially the same meaning, except it's unclear, hinting that kegels can help IC. I'm not aware of papers that claim they are helpful. Got any? Ratel (talk) 07:19, 14 July 2015 (UTC)

Link to gluten

The study in question references another study by the same author (see it here ) where the claim is made that IC is linked to gluten somehow with frequency "undetermined". No data is presented in this original study, and no sources for the claim. I see they also linked "ingrown hairs" to gluten, and other unfounded claims. Junk science. Gluten probably IS linked to IC, but this is not proof. Ratel (talk) 01:24, 16 March 2016 (UTC)

Dear Ratel
To support the inclusion of non-celiac gluten sensitivity, I used this paper Ann Nutr Metab. 2015;67 Suppl 2:16-26. doi: 10.1159/000440990. Epub 2015 Nov 26. Gluten Sensitivity. Catassi C1. (Review) PMID 26605537 (Table 1 - The clinical manifestations of NCGS), which is a medical reliable source. This is a secondary source, PubMed indexed, published in Annals of Nutrition and Metabolism November 2015, which is a peer-reviewed scientific journal, with an impact factor of 2.618, ranked 34/77.
The study you cited and you misprize http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4488826/ is not by "the same" author but a group of the most prestigious experts worldwide in celiac diseases and non-celiac gluten sensitivity (Catassi C, Elli L, Bonaz B, Bouma G, Carroccio A, Castillejo G, Cellier C, Cristofori F, de Magistris L, Dolinsek J, Dieterich W, Francavilla R, Hadjivassiliou M, Holtmeier W, Körner U, Leffler DA, Lundin KE, Mazzarella G, Mulder CJ, Pellegrini N, Rostami K, Sanders D, Skodje GI, Schuppan D, Ullrich R, Volta U, Williams M, Zevallos VF, Zopf Y, Fasano A). It was published in Nutrients June 2015 and PubMed indexed (PMID 6096570). Nutrients is a peer-reviewed scientific journal and have a 2016 impact factor of 3.27, and is ranked 21/77 (as 2015).
It's a shame that all these experts and reviewers have not noticed all that "other unfounded claims" that there are in the article, in your opinion.
You said "no data, and there are no other studies linking IC to gluten". In Medicine are considered not only studies, also documented cases. And yes, there is some case report, such as this one BMJ. 2012 Nov 30;345:e7982. doi: 10.1136/bmj.e7982. A Patient's Journey. Non-coeliac gluten sensitivity. Rostami K1, Hogg-Kollars S. PMID 23204003, published in The BMJ 30 November 2012. The BMJ's impact factor is 17.445, ranking it fifth among general medical journals.
Misplaced Pages states: "Some people with IC/BPS have been diagnosed with other conditions such as irritable bowel syndrome (IBS), fibromyalgia, chronic fatigue syndrome, allergies, Sjogren's syndrome". All of these diseases, at least in some cases, are linked to celiac disease or non-celiac gluten sensitivity and improve with a gluten-free diet. So... why be surprised?
Anyway, I agree to withdraw the NCGS of that list and include it apart, with "less weight". And I will add: There is also some evidence of an association with non-celiac gluten sensitivity in some patients.
Best regards. --BallenaBlanca (talk) 10:21, 16 March 2016 (UTC)

References

  1. Rossi A, Di Lollo AC, Guzzo MP, Giacomelli C, Atzeni F, Bazzichi L, Di Franco M (2015). "Fibromyalgia and nutrition: what news?". Clin Exp Rheumatol (Review). 33 (1 Suppl 88): S117-25. PMID 25786053.
  2. Logan AC, Wong C (Oct 2001). "Chronic fatigue syndrome: oxidative stress and dietary modifications" (PDF). Altern Med Rev (Review). 6 (5): 450–9. PMID 11703165.
  3. San Mauro I, Garicano E, Collado L, Ciudad MJ (Dec 2014). " ". Nutr Hosp (Review). 30 (6): 1203–10. doi:10.3305/nh.2014.30.6.7866. PMID 25433099.
  4. Fasano A, Sapone A, Zevallos V, Schuppan D (May 2015). "Nonceliac gluten sensitivity". Gastroenterology (Review). 148 (6): 1195–204. doi:10.1053/j.gastro.2014.12.049. PMID 25583468.
  5. Volta U, Caio G, De Giorgio R, Henriksen C, Skodje G, Lundin KE (Jun 2015). "Non-celiac gluten sensitivity: a work-in-progress entity in the spectrum of wheat-related disorders". Best Pract Res Clin Gastroenterol (Review). 29 (3): 477–91. doi:10.1016/j.bpg.2015.04.006. PMID 26060112.
  6. Walker MM, Murray JA (Aug 2011). "An update in the diagnosis of coeliac disease". Histopathology (Review). 59 (2): 166–79. doi:10.1111/j.1365-2559.2010.03680.x. PMID 21054494.
  7. Fasano A (Apr 2005). "Clinical presentation of celiac disease in the pediatric population". Gastroenterology (Review). 128 (4 Suppl 1): S68-73. doi:10.1053/j.gastro.2005.02.015. PMID 15825129.
  8. Catassi C (2015). "Gluten Sensitivity". Ann Nutr Metab (Review). 67 Suppl 2: 16–26. doi:10.1159/000440990. PMID 26605537.

Yes, I agree that there is "some evidence" of an association of NCGS with chronic pelvic pain (IC and CP/CPPS), but as you have discovered yourself, it all goes back to anecdotal evidence, as in the case report you offer above (who also seems to be the source of all the other "undetermined" maladies, like "ingrown hairs"). I accept your modification, but rather than citing only the review study (Carlo Catassi reviewing his own studies), I'll insert a cite to the case report too. Ratel (talk) 21:54, 16 March 2016 (UTC)

Associated with other disorders

Doc James, you removed reference to links to fibromyalgia and IBS. But "For example, epidemiological studies have revealed that IC/BPS is commonly associated with other chronic pain conditions, including fibromyalgia, irritable bowel syndrome and chronic fatigue syndrome." This from a review study, and Pubmed full of other evidence to support. Please re-insert. Ratel (talk) 21:06, 6 October 2016 (UTC)

We still say "Many of those affected also have irritable bowel syndrome and fibromyalgia."? Doc James (talk · contribs · email) 21:28, 6 October 2016 (UTC)
And CFS? Ratel (talk) 21:39, 6 October 2016 (UTC)
Do we need to list them all in the lead? There are lots of associations. Doc James (talk · contribs · email) 00:05, 7 October 2016 (UTC)

Covering hyaluronic acid (Cystistat)

I would like to see some coverage of Cystistat. When I first looked at the literature there seemed like a lot of good studies of it - for example Long-term results of intravesical hyaluronan therapy in bladder pain syndrome/interstitial cystitis. (2011) found half in remission after five years which is discussed in Review of intravesical therapies for bladder pain syndrome/interstitial cystitis (2015) but without much in the way of interesting commentary or critique. Apparently Cystistat is approved in many countries (Canada, EU per this) but not the U.S. II | (t - c) 21:49, 12 February 2017 (UTC)

Also on the topic of instillation, sort of, is this study on the effect on pH on pain: no effect. II | (t - c) 21:57, 12 February 2017 (UTC)

Alternative therapies

Hey Doc James (talk · contribs), what is the problem with the source added here? II | (t - c) 17:55, 14 February 2017 (UTC)

It is an internet based survey (a primary source). The conclusion is "Randomized, placebo-controlled studies are needed to demonstrate which therapies may indeed control IC symptoms". What percentage of people in such a survey say an alt med treatment is useful or not does not mean much. Doc James (talk · contribs · email) 00:36, 15 February 2017 (UTC)
Hmm, I might be able to find a review which summarizes at a high level, although perhaps not for a few months. But to your comment, I think it misses the point a bit: the intent of a medical article is not solely to identify effective treatments. The intent of any article is to inform readers of important content in a neutral manner with reliable sources. It seems quite appropriate and effective, in the sense of writing to help people understand the topic (which should be the goal!), to lead off this section with an overview of number of treatments that people have tried and some basic information about them. Maybe there's a different way to approach that, but this section should start with a very high-level survey. That's not to suggest that these are effective, but as I said in the first sentence, that's not always the point. I also don't think it's a reasonable bar that everything has to be passed through RCTs to be mentioned. These are "alternative treatments", so we wouldn't expect there to be a lot of RCTs. As an aside, I am going to push back - and always will - against the idea that all medical content needs to be in a medical review. I was there in the discussion when MEDRS was promoted (as were you), and that certainly wasn't how it was presented at the time. I doubt it would've become a guideline if it had. Meanwhile, it's not wholly uncommon for non-peer-reviewed articles to be used to directly contradict peer-reviewed sources by long-term editors circling the medical project, such as the discussion over at alkaline diet right now. My hope is that Misplaced Pages doesn't end up a ghostly place occupied by a handful of people enforcing a byzantine and frankly arbitrary set of rules. It should be open, a bit democratic, and even fun. II | (t - c) 08:21, 15 February 2017 (UTC)
There are lots of great review articles on this topic. A survey is basically testimonials. The conclusion of the paper is really that no evidence exists on the effectiveness of alt med not that half of them "work". Doc James (talk · contribs · email) 09:01, 15 February 2017 (UTC)
I agree with James that an internet-based survey is a low-quality source and should be avoided. I'm confident there are reviews discussing the use of alternative medicine modalities in IC and the level of study these modalities have received. If they haven't gone through high-quality RCTs, then you'd be hard-pressed to say that they're proven to work. Anecdote means very little when stacked against evidence since various biases (cognitive or otherwise) skew our view on such matters. Since this is a medical article, I too will insist that WP:MEDRS-compliant reviews are used for such content. Primary sources such as internet-based surveys are inappropriate (even if you disagree, II). If the information is not yet available, we can wait and improve other sections of the article in the meantime. TylerDurden8823 (talk) 13:40, 15 February 2017 (UTC)
By all means, it's not a perfect or even good source source, and I'll admit it's probably a good idea to remove it (as my user page states, "to change your mind and to follow him who sets you right is to be nonetheless the free agent that you were before"). With that said, if the bar for contributing to Misplaced Pages is to do a complete lit review and identify the best source possible... well, it's no wonder that few will bother. If you glance at the history of this article, in terms of substantive content work it's basically been two people for the last five years: Doc James and TylerDurden. And probably a similar statement could be made for most medical articles.
Also, while I appreciate the calm tone, Tyler, I feel like it kind of talks past my above comment, as if my point was not really understood. Demonstrating some sort of efficacy is not the point. That patients reported half helped could be removed entirely while accomplishing the purpose, perhaps by instead mentioning that "84.2 % had tried complementary therapies and 55 % said that physicians had recommended complementary therapies". Starting with a broad number and survey of a wide number of potential therapies, with a hint of the patient perspective, is the point. With a survey showing patients responses, the nice thing is that it is obviously poor evidence and there is less temptation to single individual therapies out, as compared to a review covering a bunch of low-powered, misleading RCTs ("Why Most Published Research Findings Are False" (2005)). I suppose there may be a difference in perspective: to me, it seems that most of our readers would recognize that a survey isn't good evidence.
Anyhow, I dug a bit deeper and found Complementary therapies for bladder pain syndrome: a systematic review. In addition to covering some RCTs (which are rather tricky to analyze), it spends a paragraph on the survey. Not up for dealing with the hassle of trying to predict/figure out what content might be worth adding, though - maybe in a few months. II | (t - c) 07:22, 17 February 2017 (UTC)
I acknowledge that I've contributed quite a bit to the article; however, I disagree with the assumption that most readers will critique a survey as a low form/unreliable form of evidence. Every day people are bombarded with sensationalist news headlines horribly distorting scientific findings and the vast majority parrot what they hear without being able to critically appraise the evidence. I agree that sorting out the quality of RCTs and studies, in general, can be a herculean task, but it's one that's worth doing so we know what works and what doesn't. I see little value in adding a survey of self-reported claims from IC patients were surveyed and thought X, Y, and Z worked for them. That's anecdote (not evidence) and I disagree that it has a place in an encyclopedic entry in an article about a medical condition (aside from, perhaps, a society & culture section about what patients perceive to work best for them but that's often not consistent with more objective forms of evidence). Millions of people will swear to you that homeopathic products make them feel 100% better but it's still implausible pseudoscientific nonsense. The systematic review might potentially be worth including but it will have to undergo the same scrutiny by the community as all other papers considered for inclusion in the article. I don't know if I would characterize "the bar" as doing a complete literature review but Misplaced Pages is meant to be an encyclopedia, a tertiary source, built on high-quality/reliable (primarily) secondary sources. I think that's important if this is going to be a well-sourced high-quality article. TylerDurden8823 (talk) 03:28, 18 February 2017 (UTC)

Decent source. Added a summary of it here.

Yes to bring Misplaced Pages to the next level of quality is going to be hard work. It however is much much less difficult editing WP than trying to publish in a major peer reviewed medical journal. And peer reviewed medical journals have no lack of people interested in writing in them.

I am not convinced that the difficulty of editing Misplaced Pages is the cause for the flat lining of our editor numbers. Part of the evidence I see for this is what little effect VE had on people editing. VE is much easier to edit with but it did not lead to an increase in editors. Doc James (talk · contribs · email) 09:46, 18 February 2017 (UTC)

Reference

Source of more information:

Barbara (WVS)   23:22, 19 December 2017 (UTC)

Could Ketamine be a cause?

Singapore Med J. 2015 Dec; 56(12): 660–665. doi: 10.11622/smedj.2015185 PMCID: PMC4678404 PMID: 26702160 The clinical presentation and diagnosis of ketamine-associated urinary tract dysfunction in Singapore

Jacklyn Yek, MBBS, MRCS,1 Palaniappan Sundaram, MBBS, MRCS,1 Hakan Aydin, MB, Am Bd Pathology,2 Tricia Kuo, MBBS, MRCS,1 and Lay Guat Ng, MBBS, FRCS1 1. Winstock AR, Mitcheson L, Gillatt DA, Cottrell AM. The prevalence and natural history of urinary symptoms among recreational ketamine users. BJU Int. 2012;110:1762–6.

Chu PS, Ma WK, Wong SC, et al. The destruction of the lower urinary tract by ketamine abuse: a new syndrome? BJU Int. 2008;102:1616–22.

Middela S, Pearce I. Ketamine-induced vesicopathy: a literature review. Int J Clin Pract. 2011;65:27–30.

Tsai TH, Cha TL, Lin CM, et al. Ketamine-associated bladder dysfunction. Int J Urol. 2009;16:826–9.

Hanno PM, Burks DA, Clemens JQ, et al. Diagnosis and treatment of interstitial cystitis/bladder pain syndrome, amended 2014. American Urological Association Available at: https://www.auanet.org/education/guidelines/ic-bladder-pain-syndrome.cfm .

Lee CL, Jiang YH, Kuo HC. Increased apoptosis and suburothelial inflammation in patients with ketamine-related cystitis: a comparison with non-ulcerative interstitial cystitis and controls. BJU Int. 2013;112:1156–62.

95.146.100.219 (talk) 16:45, 10 August 2019 (UTC)

Accuracy

I have had IC for 24 years. The information on this page is so wrong I can’t even believe it.

We (my grandmother and mother) all had cystograms which identified the deterioration of the lining of the bladder. That is what IC is. What kind of crack pot wrote this description I can’t imagine. It’s not a ruling out disease. You make it seem like a mental health issue. We live in chronic pain. The best treatment is cystostat which is inserted via catheter. 70.50.99.74 (talk) 19:32, 2 August 2023 (UTC)

The current evidence points to most cases of IC being chronic infections missed by lousy tests (much too low sensitivity to refute the overwhelming prior probability of infection, given symptoms). The best current treatment is full-dose narrow-spectrum urinary antibiotics and/or methenamine, taken for long enough.
Spidermario (talk) 22:48, 2 August 2023 (UTC)

Correction

IC is not exclusive to females. I am male and have been dealing with it for 5 years. About 2% of sufferers are male. JW0419 (talk) 17:09, 27 March 2024 (UTC)

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