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Interstitial Cystitis

What is interstitial cystitis?

Interstitial cystitis (IC) is an inflamed or irritated bladder wall. It can lead to scarring and stiffening of the bladder. The bladder can’t hold as much urine as it did in the past. It is a chronic disorder. IC may also be known as:

  • Painful bladder syndrome
  • Frequency-urgency-dysuria syndrome

What causes interstitial cystitis?

The cause of interstitial cystitis (IC) is unknown. Researchers are looking at many theories to understand the causes of IC and find the best treatments.

Most people with IC find that certain foods make their symptoms worse. These include:

  • Citrus fruits
  • Tomatoes
  • Chocolate
  • Coffee
  • Potassium-rich foods
  • Alcoholic beverages
  • Caffeinated beverages
  • Spicy foods
  • Some carbonated beverages

What are the symptoms of interstitial cystitis?

These are the most common symptoms of interstitial cystitis (IC):

  • Frequent urination
  • Urgency with urination
  • Feelings of pressure, pain, and tenderness around the bladder, pelvis, and the area between the anus and vagina or anus and scrotum (perineum)
  • Pain during sex
  • In men, discomfort or pain in the penis and scrotum
  • In women, symptoms may worsen around their period

Stress may also make symptoms worse, but stress does not cause symptoms.

The symptoms of IC may look like other conditions or medical problems. Always consult a health care provider for a diagnosis.

How is interstitial cystitis diagnosed?

No single test can diagnose IC. And symptoms of IC are a lot like those of other urinary disorders. For these reasons, a variety of tests may be needed to rule out other problems. Your doctor will start by reviewing your medical history and doing a physical exam. Other tests may include:

  • Urinalysis. Lab testing of urine to look for certain cells and chemicals. This includes red and white blood cells, germs, or too much protein.
  • Urine culture and cytology. Collecting and checking urine for white blood cells and bacteria. Also, if present, what kind of bacteria there are in the urine.
  • Cystoscopy. A thin, flexible tube and viewing device, is put in through the urethra to examine the bladder and other parts of the urinary tract. This checks for structural changes or blockages.
  • Bladder wall biopsy. A test in which tissue samples are removed from the bladder (with a needle or during surgery) and checked under a microscope to see if cancer or other abnormal cells are present.
  • Lab exam of prostate secretions (in men). This is done to look for inflammation and/or infection of the prostate.

How is interstitial cystitis treated?

There is no cure for IC and it can be hard to treat. Treatments are aimed at easing symptoms, and may include:

  • Bladder enlargement. This method increasing bladder capacity. It also interferes with pain signals being sent by the nerve cells in the bladder.
  • Bladder wash. The bladder is filled with a solution that is held for varying times, from a few seconds to 15 minutes. Then it is drained out through a catheter.
  • Medicine. Medicine may be taken by mouth or put right into the bladder. There are many different drugs that may be used.
  • Transcutaneous electrical nerve stimulation (TENS). Mild, electric pulses enter the body for minutes to hours, 2 or more times a day. The pulses are sent through wires placed on the lower back, or through special devices put into the vagina in women or into the rectum in men. For some people, TENS eases bladder pain and urinary frequency and urgency.
  • Bladder training.  You urinate at specific times and use relaxation techniques and distractions to help keep to the schedule. Over time, you try to lengthen the time between the scheduled voids.
  • Surgery. Surgery to remove all or part of the bladder may be done in severe cases, if other treatments do not work.

Management of IC may also include:

  • Diet changes. No proof links diet to IC, but some believe that alcohol, tomatoes, spices, chocolate, caffeinated and citrus beverages, and high-acid foods may contribute to bladder inflammation. Removing these from the diet may help to decrease some symptoms.
  • Not smoking. Many people with IC find that smoking makes their symptoms worse.
  • Exercise. Exercise may help ease symptoms or make them stop for a while.
  • Reducing stress. There is no proof that stress causes IC. But, if a person has IC, stress can make the symptoms worse.

Consult a health care provider with any questions of concerns you may have about this health problem.

Key points about interstitial cystitis

  • Interstitial cystitis (IC) is an inflamed or irritated bladder wall.
  • The cause of IC is unknown and it does not get better with antibiotics.
  • Symptoms of IC include changes in urination such as frequency and urgency; pressure, pain, and tenderness around the bladder, pelvis, and the area between the anus and vagina or anus and scrotum; and pain during sex.
  • There is no best way to diagnose IC. A variety of tests may be needed. Urine tests will be done and imaging tests may be used to look at the different parts of the urinary tract and make sure everything is normal. Tissue samples may be removed from the bladder (with a needle or during surgery) and examined under a microscope to see if cancer or other abnormal cells are present.
  • Treatments are aimed at easing symptoms. A variety of procedures, medications, and lifestyle changes may be advised.


Next steps

Tips to help you get the most from a visit to your health care provider:
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.
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