Interstitial cystitis (IC) is complex, chronic disorder characterized by an inflamed or irritated bladder wall. It can lead to scarring and stiffening of the bladder, decreased bladder capacity, and glomerulations (pinpoint bleeding). IC may also be known as:
- Painful bladder syndrome
- Frequency-urgency-dysuria syndrome
The cause of IC is still unknown and patients do not respond to antibiotic medication. Researchers are investigating many theories to understand the causes of IC and to determine appropriate treatments. Most people with IC find that certain foods make their symptoms worse, including most commonly: citrus fruits, tomatoes, chocolate, and coffee, and potassium-rich foods. Other foods that bother many patients are alcoholic beverages, caffeinated beverages, spicy foods, and some carbonated beverages.
The following are the most common symptoms of IC. However, each individual may experience symptoms differently. Symptoms may include:
- Frequent urination
- Feelings of pressure, pain, and tenderness around the bladder, pelvis, and perineum (the area between the anus and vagina or anus and scrotum)
- Painful sexual intercourse
- In men, discomfort or pain in the penis and scrotum
- In most women, symptoms may worsen around the menstrual cycle
Stress may also intensify symptoms, but stress does not cause symptoms to occur.
The symptoms of IC may resemble other conditions or medical problems. Always consult your doctor for a diagnosis.
Because there is no definitive test to diagnose IC, and because symptoms of IC are similar to other urinary disorders, a variety of diagnostic tests and procedures may be necessary. In addition to a complete medical history and physical examination, diagnostic procedures for IC may include the following:
- Urinalysis. Laboratory examination of urine for various cells and chemicals, such as red blood cells, white blood cells, infection, or excessive protein.
- Urine culture and cytology
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Cystoscopy (also called cystourethroscopy). An examination in which a scope, a flexible tube and viewing device, is inserted through the urethra to examine the bladder and urinary tract for structural abnormalities or obstructions, such as tumors or stones.
- Bladder wall biopsy. A procedure in which tissue samples are removed (with a needle or during surgery) from the body for examination under a microscope to determine if cancer or other abnormal cells are present.
- Laboratory examination of prostate secretions (in men)
Specific treatment for IC will be determined by your doctor based on:
- Your age, overall health, and medical history
- Extent of the disease
- Your tolerance for specific medications, procedures, or therapies
- Expectations for the course of the disease
- Your opinion or preference
Currently, there is no specific way to diagnose IC, and no cure for IC, making it difficult to treat. Thus, treatments are primarily focused on relieving symptoms, and may include:
- Bladder distension. A procedure aimed at increasing bladder capacity and interfering with pain signals that are being transmitted by the nerve cells in the bladder.
- Bladder instillation (also called a bladder wash or bath). The bladder is filled with a solution that is held for varying periods of time, from a few seconds to 15 minutes, before being drained through a catheter.
- Transcutaneous electrical nerve stimulation (TENS). Mild, electric pulses enter the body for minutes to hours two or more times a day, either through wires placed on the lower back, or through special devices inserted into the vagina in women or into the rectum in men.
- Bladder training. The patient voids at designated times and uses relaxation techniques and distractions to help keep to the schedule. Gradually, the patient tries to lengthen the time between the scheduled voids.
Management of IC may also include:
- Diet modification. No scientific evidence links diet to IC, but some doctors and patients believe that alcohol, tomatoes, spices, chocolate, caffeinated and citrus beverages, and high-acid foods may contribute to bladder inflammation. Thus, eliminating these substances from the diet may help to eliminate some symptoms.
- Not smoking. Many people with IC feel that smoking makes their symptoms worse.
- Exercise. Exercise may help relieve symptoms or hasten remission. There is no evidence that stress causes IC; however, if a person has IC, physical or mental stress can make the symptoms worse.
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