What Is Interstitial Cystitis?

Interstitial cystitis (IC) is a chronic condition that causes pain, pressure, and/or discomfort in the bladder. Although IC is not caused by an infection, its symptoms may feel like a bladder infection. To be considered IC, symptoms must persist for at least six weeks. Sometimes, when a person is experiencing bladder pain but there are no visible abnormalities in the organ, the condition is referred to as painful bladder syndrome (PBS). Together, IC and PBS are classified under the umbrella term: bladder pain syndrome (BPS).

Who gets interstitial cystitis? 

Both women and men can develop IC, but it occurs more frequently in women. Estimates vary, but some experts suggest that IC is two to three times more common in women than in men, while others estimate that nine out of ten IC patients are women.

What are the symptoms?

The symptoms of IC vary from person to person. They may be mild to severe, persistent (always present) or intermittent (they come and go), and they may be aggravated by certain cycles, situations, or activities. For example, symptoms might get worse in times of heightened stress, during sexual activity, or when a woman has her period. Common IC symptoms include:

• Pain in the bladder
• Pelvic pain (sometimes felt in the urethra, lower abdomen, and/or lower back)
• Pain between the vagina and anus (for women) or between the scrotum and anus (for men)
• Frequent need to urinate, both day and night
• Urgent need to urinate that may not go away even after just urinating
• Increased pressure or discomfort as the bladder fills
• Reduced bladder capacity
• Pain during sexual intercourse

How might interstitial cystitis affect one’s sexual health?

Both men and women may have sexual problems due to IC. Women may experience pain during penetration as a result of the bladder’s proximity to the vagina. Men, on the other hand, may notice painful orgasms with IC or have pain the following day.

What causes it?

Currently, the cause of IC is unknown. Although it is not caused by a virus or bacterial infection, IC symptoms may get worse if a person develops a urinary tract infection as well. A prevalent theory among experts is that a person with IC has a defect in the protective lining of their bladder that leaves the bladder wall vulnerable to the irritating substances in urine. Another possible cause of IC is a change in the nerve activity in the area that causes painful sensations to be sent to the brain when a normally painless event (like the bladder filling) is taking place. Finally, some cases of IC are thought to be caused by an autoimmune response like that of rheumatoid arthritis, in which the body’s immune system attacks a part of the body (in this case, the bladder).

How do I know if I have interstitial cystitis?

If you are experiencing any of the symptoms described above, schedule a visit with your health care provider. Through a physical exam and an in-depth medical history, your provider can help you determine if your symptoms may be related to IC, or if they could be due to another condition such as a urinary tract infection or sexually transmitted infection (STI). Your health care professional will likely ask you about your pain (location, intensity, and duration), as well as about your urination frequency and urgency. He or she may need to collect a urine sample to test for infection or use a cystoscope, which is a tiny camera attached to a thin tube that is inserted into the urethra, to check for inflammation or ulcers inside your bladder. Finally, you may be asked to document the volume of fluids you drink and the amount of urine you produce in a bladder diary.

How is interstitial cystitis treated/managed?

Unfortunately, there is no simple treatment for IC. However, people with IC can experiment with various strategies to manage their symptoms and reduce pain and discomfort. As with many health issues, it is generally advisable to start with the least invasive measures available to manage IC symptoms and gradually progress to more involved measures if necessary. Here are some methods IC patients can use to manage their symptoms:

• Lifestyle changes: Some people find that their symptoms improve when they cut out or limit citrus fruits, tomatoes, chocolate, coffee, alcohol, caffeine, carbonated beverages, and spicy foods. Reducing stress, exercising, wearing loose clothing, and quitting smoking may also help reduce pain from IC symptoms.
• Medication: Over-the-counter and/or prescription medications including anti-inflammatory drugs, select antidepressants, and antihistamines may help alleviate pain and reduce the frequency/urgency of urination.
• Bladder distention: Sometimes, people with IC find some relief after bladder distention, a procedure in which one’s bladder is overfilled with fluid and stretched. If the improvement is long-term, bladder distention can be repeated if symptoms come back in the future.
• Surgery: Very few IC patients undergo surgery, but it may be considered in severe cases in which the person with IC has not responded to any other form of treatment.

Resources:

International Urogynecological Association. (2021). Interstitial Cystitis. https://www.yourpelvicfloor.org/conditions/interstitial-cystitis/

Mayo Clinic. (2019, September 14). Interstitial Cystitis. https://www.mayoclinic.org/diseases-conditions/interstitial-cystitis/symptoms-causes/syc-20354357

Urology Care Foundation. (2021). What is Interstitial Cystitis (IC)/Bladder Pain Syndrome? https://www.urologyhealth.org/urology-a-z/i/interstitial-cystitis