Interstitial Cystitis

Interstitial cystitis is a chronic condition that causes the bladder wall to become irritated or inflamed. This may lead to scarring and stiffening of the bladder and pinpoint bleeding in the bladder lining. Symptoms of interstitial cystitis include pain in the bladder and surrounding pelvic area, an urgent and frequent need to urinate, and reduced bladder capacity. Treatment options include self-help measures, medications, and bladder manipulation techniques.

 

What Is Interstitial Cystitis?

Interstitial cystitis (also known as IC, bladder cystitis, or painful bladder syndrome) is a chronic condition that can cause discomfort or pain in the bladder and the surrounding pelvic region. People with interstitial cystitis have an inflamed or irritated bladder wall. This inflammation can lead to:
 
  • Scarring and stiffening of the bladder.
  • Less bladder capacity (the bladder is able to hold less urine).
  • Pinpoint bleeding in the bladder lining. In rare cases, ulcers form in the bladder lining (called Hunner's ulcers).
     
Severe cases of interstitial cystitis can be disabling. Of the more than 800,000 Americans estimated to have interstitial cystitis, over 90 percent are women.
  

Causes of Interstitial Cystitis

No one knows the exact cause or causes of interstitial cystitis. Researchers are working to understand possible causes and to find effective treatments. Current theories being studied as possible causes of interstitial cystitis include:
 
  • An autoimmune response
  • Irritating substances in the urine
  • Genetics.
     

Symptoms of Interstitial Cystitis

Interstitial cystitis symptoms vary from person to person, and even in the same person. People with symptoms of interstitial cystitis commonly have any of the following:
 
  • Mild discomfort, pressure, tenderness, or intense pain in the bladder and surrounding pelvic area, which may increase as the bladder fills and decrease as it empties.
  • Urgent need to urinate (urgency).
  • Frequent need to urinate (frequency), both day and night.
  • Reduced bladder capacity. People with severe symptoms may urinate as many as 60 times during a 24-hour period.
  • Painful sexual intercourse.
  • In men, discomfort or pain in the prostatic area.
     

Diagnosing Interstitial Cystitis

An interstitial cystitis diagnosis is made based on:
 
  • The presence of urinary urgency, urinary frequency, or bladder/pelvic pain
  • Bladder wall inflammation -- including pinpoint bleeding or ulcers -- found by cystoscopy
  • The absence of other diseases that could cause the symptoms.
     
Diagnostic tests that help in ruling out other diseases include:
 
  • Cystoscopy
  • Distention of the bladder under anesthesia
  • Urinalysis
  • Urine culture
  • Biopsy of the bladder wall
  • Urine cytology
  • Laboratory examination of prostate secretions.
     

Treating Interstitial Cystitis

There is no interstitial cystitis cure. All doctors can do is try to relieve the symptoms, a challenging task, because they vary from person to person. People may have flare-ups and remissions, and different patients respond to different interstitial cystitis treatment. A particular type of treatment may work for a while and then lose its effectiveness. Sometimes, stress or a change of diet triggers symptoms. Occasionally, interstitial cystitis goes into remission spontaneously.
 
Treatment options can include:
 
  • Bladder distention
  • Bladder instillation
  • Medication
  • Transcutaneous electrical nerve stimulation (TENS)
  • Self-help strategies.
     
Surgery is considered a treatment of last resort, as it does not necessarily improve symptoms.
 
(Click Interstitial Cystitis Surgery for more information on this interstitial cystitis treatment option.)
 

Living With Interstitial Cystitis

Living with interstitial cystitis is not easy. Some people find they need help coping with the emotional and practical aspects of their disease. Studies have found that patients who learn about interstitial cystitis and become involved in their own healthcare tend to do better than patients who do not.
 
At this point, research scientists conducting interstitial colitis clinical studies have not been able to find a link between diet and interstitial cystitis. However, many people with the condition find that certain foods make their symptoms worse.
 
(Click Interstitial Cystitis Diet for more information about foods that can affect people with this condition.)
 

Statistics on Interstitial Cystitis

An estimated 847,000 adults aged 20 or older report having been diagnosed with interstitial cystitis; 90 to 94 percent of affected adults were women.
 

Interstitial Cystitis Versus Painful Bladder Syndrome

Because interstitial cystitis varies so much in symptoms and severity, most researchers believe that it is not one, but several, diseases. In recent years, scientists have started to use the term painful bladder syndrome (PBS) to describe cases with painful urinary symptoms that may not meet the strictest definition of interstitial cystitis. The term "interstitial cystitis" or "painful bladder syndrome" includes all cases of urinary pain that can't be attributed to other causes, such as a urinary tract infection (UTI) or urinary stones.
 
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Written by/reviewed by: Arthur Schoenstadt, MD
Last reviewed by: Arthur Schoenstadt, MD