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What Is Interstitial Cystitis

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Source: Mt Nittany Medical Center

Interstitial Cystitis (IC) is a chronic urinary bladder disease sometimes referred to as Painful Bladder Syndrome (PBS) or IC/PBS. Interstitial Cystitis is a chronic condition characterized by uncomfortable bladder pressure, bladder pain and sometimes general pelvic pain. Some people say it is like having a chronic Urinary Tract Infection. The pain can range from mild burning to severe pain. While both men and women can get IC/PBS it tends to be far more common in women.  In the United States, some 3 to 6 percent of women -- 3 to 8 million of them -- have Interstitial Cystitis symptoms (source: American Urological Association ).


The exact causes of Interstitial Cystitis are unknown and may differ from person to person.  But what is clear is that real physicial changes occur in the bladder of people diagnosed with IC/PBS.  Perhaps as an autoimmune reaction, the protective lining of the bladder becomes thinner.  This protective lining inside the bladder (gag layer) plays an important roll in shielding the bladder from your body's liquid waste (urine).  As this layer becomes thinner, the patient experiences pain and discomfort.  Additionally, the walls of the bladder may stiffen and harden so that the bladder can't expand to hold urine resulting in bladder pressure and urinary frequency.  In rare instances, Hunner's ulcers may for form inside the bladder.

Disclaimer: Information provided on this site is not meant to replace or substitute for the advice of your physician or medical provider.

Interstitial Cystitis Symptoms

pelvic_pain_imageSymptoms can vary from person to person and may include one or more of the following: bladder pressure, bladder pain, urinary frequency and pelvic pain. The pain and discomfort may range from mild burning to severe pain.

Many people with Interstitial Cystitis complain of having chronic urinary tract infections (UTI).  However, when tested for urinary tract infections, their urine comes back negative.

The severity of symptoms can fluctuate from hour to hour and day to day. Diet can also affect symptoms and many people adopt a special diet to avoid trigger foods that irritate their bladder.

It's not uncommon for people with Interstitial Cystitis to develop various chemical sensitivities.

Interstitial Cystitis often goes undiagnosed as it tends to co-exist with other conditions such as Endometriosis, Vulvodynia, Vestibulitis, Pudendal Neuralgia, Chronic Pelvic Pain and Irritible Bowel Syndrome.

along_the_healing_pathClick Image to purchase from AmazonAccording to Dr. Maurice Chung, director of the Regional Center for Chronic Pelvic Pain, Lima, Ohio, there is a 70%-90% concordance between Endometriosis and Interstitial Cystitis.  In fact, Dr. Chung advices all Physicians and patients to think about interstitial cystitis before planning any invasive procedure to treat  for endometriosis or chronic pelvic pain.  The presence of interstitial cystitis may account for the high occurence of women still complaining of pelvic pain even after having surgery to treat endometriosis.


How Interstitial Cystitis Is Diagnosed

solving_IC_puzzleClick Image to Purchase from AmazonInterstitial Cystitis can be difficult to detect because it frequently co-exists with other conditions, and the signs and symptoms resemble those of other disorders. To diagnose interstitial cystitis, your doctor will take a complete medical history and ask you to describe your symptoms.

Tests for diagnosing interstitial cystitis include:

  • Complete Pelvic Exam: Because Interstitial Cystitis is frequently a diagnosis of exclusion, a complete pelvic exam is necessary to help rule other possible causes. A urinalysis and urine culture is conducted to rule out the possibility of UTI.   However, presence of a UTI does not rule out the presence of interstitial cystitis.

  • Potassium sensitivity test: Involves instilling the bladder with two different solutions — water and potassium chloride — one at a time. Patients are asked to rate on a scale of 0 to 5 the pain and urgency you feel after each solution is instilled. If you feel noticeably more pain or urgency with the potassium solution than with the water, your doctor may diagnose interstitial cystitis. People with normal bladders can't tell the difference between the two solutions.

  • Cystoscopy: Involves an examination of your bladder through a thin tube with a tiny camera (cystoscope) inserted through the urethra. Often used to rule out other potential causes of bladder pain. May also involve taking a biopsy.

Researchers continue to refine questionnaires and work on other tests that will help confirm the diagnosis of interstitial cystitis without requiring an invasive procedure.

Treating Painful Bladder Symptoms

While there is no known cure for Interstitial Cystitis at this time, there are several treatments and techniques available to help control the symptoms.  Over time, some patients may greatly reduce their symptoms or even go into remission.  However, the primary protocol for treating IC patients is symptom management.  Most patients are encouraged to pursue a multi-modal approach to achieve maximum benefits.

Diet Modification

Diet is the first line of defense for interstitial cystitis patients and the most widely followed diet guidelines are detailed in the 2009 IC/PBS Food List (aka IC Diet) which contains a list of bladder and prostate friendly foods.

Prescription Medications

Pentosan polysulfate sodium (Elmiron®) is the only oral medication approved by the Food and Drug Administration (FDA) for IC. Elmiron is a synthetic polysaccharide which is chemically similar to the GAG layer in the bladder.  It is thought to help coat teh bladder wall, thereby providing symptom relief.  Elmiron must be taken on a long-term basis to keep symptoms from recurring. Side effects include gastrointestinal discomfort and reversible hair loss.

Tricyclic antidepressents such as Amitriptyline (Elavil®) and doxepin (Sinequan®) are frequently prescribed in low doses as they may help to block pain, calm bladder spasms, reduce inflammation and help restore healthier sleep patterns.

Complimentary & Alternative Therapy

Complementary and alternative therapies refer to health care systems, practices, and products that are not part of conventional medicine (drugs, surgery and medical devices such as Interstim). The alternative therapies most often used to treat painful bladder symptoms in Interstitial Cystitis patients include physical therapy (pelvic floor rehabilitation), biofeedback, diet-based therapies, herbal remedies, massage, yoga, Pilates and Reiki.

Natural Supplements

Desert Harvest Aloe Vera, Quercitin Based Supplements, Grapefruit Seed Extract, and Marshmellow Root are just a few of the supplements often used to relieve Interstitial Cystitis symptoms.  See our article on Quick Bladder Pain Relief for more information.


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