Interstitial Cystitis

What is interstitial cystitis?

Interstitial cystitis is a poorly understood bladder pain condition unrelated to infection. With this condition, you may feel pelvic pressure, discomfort or pain, and you may need to go to the bathroom frequently or urgently. For some, the symptoms are constant; for others, the symptoms come and go.

Progressive changes bladder wall can lead to scarring, sores and bleeding. Scarring can cause the wall of your bladder to thicken and become less pliable. As a result, the bladder’s capacity to hold urine may decrease.

The cause of interstitial cystitis is not known. It can be difficult to diagnose because its symptoms resemble those of a bladder infection and other conditions that can affect your bladder or bowel. Sometimes it takes years for the diagnosis to be made. Interstitial cystitis is 10 times more common in women than in men and most commonly occurs between the ages of 30 and 40 (Source: PubMed).

Although there is no cure for interstitial cystitis and no single treatment works for everyone who has it, many people who have it are able to find relief. Dietary changes or medications can help some people, while others find relief with bladder training, physical therapy, or surgery.

Although interstitial cystitis can cause significant discomfort and disruption in your life, serious complications that require emergency care are uncommon. Seek immediate medical care (call 911) for high fever (higher than 101 degrees Fahrenheit), the inability to urinate, or severe pain.

Seek prompt medical care if you have such symptoms as pelvic pain, pressure or discomfort, or if you need to go to the bathroom frequently or urgently. You should also seek prompt medical care if you are being treated for interstitial cystitis but symptoms recur or are persistent.

What are the symptoms of interstitial cystitis?

Symptoms of interstitial cystitis include pelvic pain, pressure or discomfort and the need to urinate urgently or frequently. Blood may occasionally be present in the urine. Over time, the bladder may not be able to hold as much urine.

Common symptoms of interstitial cystitis

Symptoms of interstitial cystitis vary. If you have interstitial cystitis, you may experience some or all of these symptoms:

Bloody or pink-colored urine (hematuria)
Difficult or painful urination, or burning with urination (dysuria)
Frequent urination that often produces only a small amount of urine
Pain during sexual intercourse
Pelvic pain, pressure or discomfort
Sleep disturbance
Urgent need to urinate

Serious symptoms that might indicate a life-threatening condition

In some cases, symptoms of interstitial cystitis can accompany a serious or potentially-life threatening condition. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

High fever (higher than 101 degrees Fahrenheit)
Inability to urinate
Severe pelvic pain

What causes interstitial cystitis?

Interstitial cystitis is a poorly understood bladder pain condition unrelated to infection. While the cause is not known, some experts think that an abnormality of the bladder lining or a decreased production of protective substances allows urine to irritate the bladder wall. Others suggest that it might be related to abnormalities of the immune system or to an increase in the number of cells that release chemicals ordinarily involved in inflammatory responses. Overactivity of nerve cells of the bladder may also play a role.

Interstitial cystitis seems to be more common in people who have pain syndromes, such as fibromyalgia (chronic condition that causes pain, stiffness and tenderness), irritable bowel syndrome (IBS; digestive discomfort that does not cause intestinal damage or serious disease), or chronic fatigue syndrome.

What are the risk factors for interstitial cystitis?

A number of factors increase the risk of developing interstitial cystitis. Not all people with risk factors will get interstitial cystitis. Risk factors for interstitial cystitis include:

Age between 30 and 40
Allergies
Chronic fatigue syndrome
Depression
Female gender
Fibromyalgia (chronic condition that causes pain, stiffness and tenderness)
Irritable bowel syndrome (IBS; digestive discomfort that does not cause intestinal damage or serious disease)

How is interstitial cystitis treated?

Although there is no cure, many people who have interstitial cystitis are able to find relief. Unfortunately, no single treatment seems to be universally effective, so finding the best treatment for you may involve a process of trial and error. Dietary changes or medications help some people. Others find relief with bladder training, physical therapy, or surgery.

Common treatments for interstitial cystitis

Common treatments for interstitial cystitis include:

Antihistamines such as hydroxyzine (Vistaril) to reduce urinary frequency
Bladder training to help increase the amount of urine that can be held before the urge to urinate occurs
Fluid installation to stretch the bladder
Insertion of medications directly into the bladder to reduce pain
Narcotic pain relievers for severe pain
Non-narcotic pain relievers, such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), naprosyn (Naproxen, Aleve), or indomethacin (Indocin)
Pentosan polysulfate sodium (Elmiron) to coat and protect the inside of the bladder
Physical therapy and biofeedback to relieve spasms of the pelvic floor
Tricyclic antidepressants such as amitriptyline (Elavil) for the relief of pain and urinary frequency

What you can do to improve your interstitial cystitis

For some people, dietary modifications, exercise, and eliminating use of tobacco products seem to alleviate some of the symptoms of interstitial cystitis. You may be able to improve your interstitial cystitis symptoms by:

Avoiding acidic foods and drink
Avoiding alcohol
Avoiding artificial sweeteners
Avoiding caffeinated beverages
Avoiding carbonated beverages
Avoiding chocolate
Avoiding spicy foods
Avoiding use of tobacco products
Getting regular exercise

What are the potential complications of interstitial cystitis?

Complications of untreated interstitial cystitis can be serious. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of interstitial cystitis include: