Interstitial Cystitis

Interstitial cystitis (IC) is a condition that causes discomfort or pain in the bladder and a need to urinate frequently and urgently.

It is far more common in women than in men. The symptoms vary from person to person. Some people may have pain without urgency or frequency. Others have urgency and frequency without pain. Women's symptoms often get worse during their periods. They may also have pain with sexual intercourse.

The cause of Interstitial Cystitis (IC) isn't known. There is no one test to tell if you have it. Doctors often run tests to rule out other possible causes of symptoms. There is no cure for IC, but treatments can help most people feel better.

They include:

  • Distending, or inflating, the bladder
  • Bathing the inside of the bladder with a drug solution
  • Oral medicines
  • Electrical nerve stimulation
  • Physical therapy
  • Lifestyle changes
  • Bladder training
  • In rare cases, surgery

 

The condition most often occurs between ages 30 to 40, although it has been reported in younger people.

Women are 10 times more likely to have IC than men.

 

Some of the symptoms of IC resemble those of bacterial infection, but medical tests reveal no organisms in the urine of people with IC. Furthermore, people with IC do not respond to antibiotic therapy. Researchers are working to understand the causes of IC/PBS and to find effective treatments.

Many women with IC have other conditions such as irritable bowel syndrome and fibromyalgia. Scientists believe IC may be a bladder manifestation of a more general condition that causes inflammation in various organs and parts of the body.

Researchers are beginning to explore the possibility that heredity may play a part in some forms of IC. In a few cases, IC has affected a mother and a daughter or two sisters, but it does not commonly run in families.

 

Symptoms of IC are chronic. They have a tendency to come and go with periods of lesser or worse severity.

Common symptoms include:

  • Bladder pressure or discomfort 
  • Urge to urinate often
  • Burning pain in the pelvic area
  • Pain during intercourse

Many people who have long-term interstitial cystitis are also depressed because of the pain and changes to their lifestyle.

 

Your health care provider will look for other causes of your symptoms.

These include:

  • Sexually transmitted infections
  • Bladder cancer
  • Bladder infections
  • Kidney or ureteral stones

Tests are done on your urine to look for infection or cells that suggest cancer inside the bladder. During a cystoscopy, the provider uses a special tube with a small camera on the end to look inside your bladder. A sample or biopsy of the lining of your bladder may be taken.

Tests at your provider's office may also be done to show how much urine must be in the bladder before you feel the need to urinate.

 

There is no cure for IC, and there are no standard treatments. Treatment is based on trial and error until you find relief. Results vary from person to person.

Diet and Lifestyle Changes 

Some people find that making changes in their diet can help control symptoms. Try to avoid foods and beverages that can cause bladder irritation. Stop eating certain foods, one at a time, to see if your symptoms get better. Reduce or stop consuming caffeine, chocolate, carbonated beverages, citrus drinks, and foods with a high level of vitamin C.

Other foods that the Interstitial Cystitis Association lists as possibly causing bladder irritation are:
  • Aged cheeses
  • Alcohol
  • Artificial sweeteners
  • Fava and lima beans
  • Meats that are cured, processed, smoked, canned, aged, or that contain nitrites
  • Most fruits, except blueberries, honeydew melon, and pears
  • Nuts, except almonds, cashews, and pine nuts
  • Onions
  • Rye bread
  • Seasonings that contain MSG
  • Sour cream
  • Sourdough bread
  • Soy
  • Tea
  • Tofu
  • Tomatoes
  • Yogurt

You and your provider should discuss methods you can use for bladder training. These may include training yourself to urinate at specific times or using biofeedback to relieve pelvic floor muscle spasms.

Medicine and Procedures

Combination therapy may include medicines such as:
  • Pentosan polysulfate sodium, the only medicine taken by mouth that is approved for treating IC
  • Tricyclic antidepressants, such as amitriptyline, to relieve pain and urinary frequency
  • Vistaril, an antihistamine that causes sedation and helps reduce urinary frequency
Other therapies include:
  • Over-filling the bladder with fluid while under general anesthesia
  • Medicines placed directly into the bladder
  • Bladder removal for extremely difficult cases

 

Treatment results vary. Some people respond well to simple treatments and dietary changes. Others may require extensive treatments or surgery.