What Is Interstitial Cystitis?

Interstitial cystitis (IC), also known as painful bladder syndrome, is a chronic condition that causes bladder pressure, bladder pain, and sometimes pelvic pain. Unlike typical urinary tract infections (UTIs), IC is not caused by bacteria and does not respond to antibiotics. It can significantly affect quality of life, especially due to frequent urination and discomfort.

What Causes Interstitial Cystitis?

The exact cause is not fully understood, but possible contributing factors include:

• Defects in the bladder lining (allowing irritating substances to pass through)
• Autoimmune response
• Nerve dysfunction (overactive pain signaling)
• Chronic inflammation
• Genetic predisposition
• Previous infections or injuries

It’s likely that multiple factors contribute to the condition in different individuals.

What Are the Symptoms of Interstitial Cystitis?

Common symptoms include:

• Chronic pelvic pain or discomfort
• Frequent urination (often more than 8 times a day)
• Urgency to urinate, even if the bladder isn’t full
• Burning sensation during urination
• Pain during sexual intercourse
• Pain that worsens with bladder filling and improves after urination
• Pressure or tenderness in the bladder or pelvic area

Symptoms can vary in severity and may flare up periodically, especially due to stress, certain foods, or menstruation.

How Is Interstitial Cystitis Diagnosed?

There is no single test for IC, so diagnosis is usually made by ruling out other conditions. This may include:

• Medical history and physical examination
• Urinalysis and urine culture (to exclude infection)
• Cystoscopy – using a scope to examine the bladder lining
• Urodynamic tests – to check bladder function
• Potassium sensitivity test (sometimes used to detect bladder lining issues)

Other conditions that may mimic IC, like bladder infections, overactive bladder, or endometriosis, need to be excluded first.

How Is Interstitial Cystitis Treated?

There is no cure, but many treatments help reduce symptoms:

Lifestyle & Dietary Modifications:

• Avoid bladder irritants (like caffeine, alcohol, acidic foods)
• Bladder training to gradually increase time between urination
• Stress management techniques (e.g., meditation, therapy)

Medications:

• Oral medications such as:
  • Pentosan polysulfate sodium (Elmiron)
  • Antihistamines (e.g., hydroxyzine)
  • Tricyclic antidepressants (e.g., amitriptyline)
• Bladder instillations – medications inserted directly into the bladder
• Pain relievers for symptom management

Procedures:

• Bladder distension – stretching the bladder under anesthesia
• Nerve stimulation (TENS or sacral neuromodulation) – to reduce pain signals
• Surgery – rarely used and considered a last resort

Is Interstitial Cystitis a Serious Condition?

While not life-threatening, IC can be debilitating and impact daily life, sleep, emotional well-being, and sexual health. Early treatment and symptom management improve quality of life for most people.