Interstitial Cystitis

Summary about Disease


Interstitial cystitis (IC), also known as bladder pain syndrome (BPS), is a chronic bladder condition that causes bladder pressure, bladder pain, and sometimes pelvic pain. The pain ranges from mild to severe. With IC, you may feel the frequent need to urinate, and you may urinate often.

Symptoms


Symptoms of IC vary from person to person. Common symptoms include:

Urgency (feeling the need to urinate immediately)

Frequency (urinating often)

Pelvic pain

Pain between the vagina and anus in women, and between the scrotum and anus in men

Pain during sexual intercourse

Pain/discomfort that worsens when the bladder fills and improves after urination

Causes


The exact cause of IC is unknown. Possible contributing factors include:

Defect in the bladder lining (allowing irritating substances in urine to irritate the bladder wall)

Mast cell activation (release of histamine and other chemicals involved in inflammation)

Nerve irritation

Autoimmune reaction

Infection (although this is debated)

Heredity

Medicine Used


There is no cure for IC, but medications can help manage symptoms. Common medications include:

Oral Medications:

Pentosan polysulfate sodium (Elmiron): Believed to help repair or protect the bladder lining.

Tricyclic antidepressants: (e.g., amitriptyline) Help reduce pain and urinary frequency.

Antihistamines: (e.g., hydroxyzine) May help reduce urgency and frequency by blocking histamine.

Pain relievers: Over-the-counter or prescription pain medications may be used.

Bladder Instillations:

Dimethyl sulfoxide (DMSO): Reduces inflammation and pain.

Lidocaine: A numbing agent to relieve pain.

Is Communicable


No, interstitial cystitis is not communicable. It is not contagious and cannot be spread from person to person.

Precautions


Lifestyle modifications and self-care strategies can help manage IC symptoms:

Dietary Changes: Identify and avoid trigger foods and beverages (e.g., caffeine, alcohol, acidic foods, spicy foods, artificial sweeteners).

Bladder Training: Practice techniques to gradually increase the time between urination.

Stress Management: Use relaxation techniques such as meditation, yoga, or deep breathing exercises to manage stress.

Gentle Exercise: Low-impact exercises may help relieve symptoms.

Loose Clothing: Avoid tight clothing that can put pressure on the bladder.

Smoking Cessation: Smoking can irritate the bladder.

How long does an outbreak last?


IC is a chronic condition, not an infection, so the term "outbreak" isn't perfectly accurate. Symptom flare-ups can last for days, weeks, or even months. There may be periods of remission where symptoms improve or disappear altogether, followed by periods of increased symptom intensity.

How is it diagnosed?


Diagnosis of IC often involves a process of elimination. No single test can definitively diagnose the condition. The following may be included:

Medical History and Physical Exam: Discussion of symptoms and a physical examination to rule out other conditions.

Urinalysis and Urine Culture: To rule out a urinary tract infection.

Cystoscopy: Examination of the bladder lining with a camera to look for abnormalities. (sometimes with biopsy)

Bladder Biopsy: Taking a small tissue sample from the bladder for examination under a microscope.

Potassium Sensitivity Test: (rarely performed now) Assessing how the bladder reacts to potassium chloride solution.

Bladder Diary: Recording urination frequency and volume.

Timeline of Symptoms


The onset and progression of IC symptoms vary greatly. Some people experience a sudden onset, while others have a gradual worsening of symptoms over time. There is no predictable timeline. Symptoms can fluctuate in intensity, with periods of remission and flare-ups.

Important Considerations


IC is a chronic condition, and managing it effectively often requires a multidisciplinary approach involving doctors, physical therapists, and other healthcare professionals.

Finding the right combination of treatments and lifestyle modifications that work best for you may take time and experimentation.

Support groups can provide valuable emotional support and information sharing.

IC can have a significant impact on quality of life, so it's important to seek help and advocate for your needs.