• Urinary Tract Infection (UTI)
• Bladder Infection
• Infections

Interstitial Cystitis: Symptoms, Causes, and Treatment Options

Medically reviewed and edited by Dina Whiteaker, APRN

Interstitial cystitis is a complex and often misunderstood condition that affects millions of Americans in their lifetimes.

This condition can cause various uncomfortable symptoms and discomfort that can significantly affect your well-being. That’s why early detection and treatment is key.

What is Interstitial Cystitis?

Interstitial cystitis (IC) — also known as painful bladder syndrome (BPS) — is a chronic condition that causes discomfort in the pelvic area. The discomfort can range from mild to severe pain.

When you have IC, the walls of your bladder become irritated and inflamed. This is what leads to pain and the development of urinary symptoms.

It can affect people of all ages, but is most common in women over the age of 30.

If left untreated, IC can have a significant negative impact on your well-being and quality of life.

Symptoms of interstitial cystitis

The symptoms of IC can vary in intensity and frequency, often resembling those of other urinary infections or disorders. Common signs to look out for include:

• Persistent pelvic pain between the belly button and groin

• Increased urinary frequency and urgency

• Pain during urination and sexual activity

• Chronic bladder pressure or discomfort

• Urinary incontinence

• Blood in the urine

Many people may also experience periods of time without any noticeable IC symptoms. However, flare-ups can be triggered by factors like:

• Stress

• Menstrual cycle phases

• Caffeinated drinks

• Alcoholic beverages

• Spicy foods

• Acidic fruits

What are the Causes of Interstitial Cystitis?

The exact causes of IC aren’t fully understood, but most healthcare professionals agree that multiple factors can contribute to its development. These include:

• Defective bladder lining: Research indicates IC may be caused by a defect in the bladder lining (epithelium). Normally, this lining prevents urine from irritating the bladder wall. However, if you have IC, a leaky or thin bladder lining might be allowing toxic substances in your urine to come into contact with your bladder wall, leading to inflammation.

• Autoimmune response: Some researchers suggest that IC may be an autoimmune condition where the body's immune system mistakenly attacks the bladder. This autoimmune response could lead to inflammation and other symptoms associated with IC.

• Neurogenic inflammation: Studies also suggest that IC may involve neurogenic inflammation, where the nerves in the bladder become overly sensitive, causing pain and urinary symptoms.

• Pelvic floor dysfunction: Abnormalities in the pelvic floor muscles — which support the bladder and other organs — may make your IC symptoms worse. Pelvic floor dysfunction can lead to increased frequency and urgency of urination, as well as pelvic pain.

How is This Condition Diagnosed?

Because the exact cause of IC is still unknown, it’s often difficult to accurately diagnose this condition.

Its symptoms also overlap with many common urinary disorders, making it challenging to determine which condition you have.

There’s currently no single test that definitively diagnoses IC, so the process typically involves testing for other conditions and ruling those out.

Your doctor may follow these steps when diagnosing IC:

• Assessing your medical history, including discussing symptoms, their duration and severity, any potential triggers, and if you’ve had a urinary tract infection (UTI) in the past

• Requesting a symptom diary to help you determine urinary habits and identify triggers

• Performing a physical exam to check for infections and assess pelvic floor muscle function

• Requesting urine and potassium sensitivity tests to determine the underlying cause of your symptoms

In some cases, your doctor may request a cystoscopy — where they look inside the bladder with a small camera — to check for any issues with the bladder wall.

During a cystoscopy, your doctor will take a small sample of the bladder tissue to test and rule out cancer and other medical conditions.

Can Interstitial Cystitis be Treated?

Although there’s no cure for IC, there are several medications and management strategies you can use to mitigate symptoms.

These treatment options provide a long-term solution for living with IC and can significantly improve your quality of life, despite having this condition.

Oral medications

The first line of treatment for managing IC symptoms usually includes using oral medications. These may include:

• Heartburn medications: Although primarily used to reduce stomach acid, certain heartburn medications may also be effective for treating IC. They work by decreasing bladder irritation by reducing the amount of acid in urine.

• Antidepressants: Low doses of antidepressants can be effective in managing chronic bladder pain and urinary frequency associated with IC. They may help by blocking pain signals and increasing the bladder’s capacity.

• Antihistamines: These medications may be used to mitigate bladder wall inflammation and urinary frequency by helping to control the release of molecules from certain cells in the bladder lining. These molecules may be involved in triggering bladder irritation.

It's important to use these medications under the guidance of a medical professional.

Most of these drugs can cause adverse reactions if used incorrectly, and monitoring your side effects is essential to ensure safe usage.

Physical therapy

The main goal of physical therapy as an IC treatment is to relieve pelvic floor muscle tension and dysfunction — two components that often contribute to pain and urinary symptoms.

Using physical therapy to treat IC usually involves:

• Pelvic floor therapy that helps relieve spasms and improve muscle function

• Stretching and strengthening exercises to improve overall pelvic health and support

• Pain management techniques like heat and ice therapy

• Biofeedback to improve pelvic muscle awareness and function

Your physical therapist may also provide various educational guidelines that can improve your pelvic health. This may include:

• Posture correction

• Bladder training strategies

• Lifestyle modifications

Physical therapy sessions may be scheduled once or twice a week, depending on the severity of your condition and individual response to treatment.

Bladder instillations

This treatment involves inserting a catheter into the bladder and instilling a solution into it. The solution can include a combination of medications that can help alleviate symptoms.

When the medication is in direct contact with the bladder wall, it can coat the lining and provide protection from harmful substances in the urine.

This can help reduce pain and discomfort associated with IC and improve a person’s overall well-being.

Lifestyle adjustments

Lifestyle adjustments can play an important role in managing IC by reducing symptom flare-ups and improving your quality of life. Your doctor may recommend the following changes:

• Avoiding foods and drinks that trigger symptoms, including caffeinated and alcoholic beverages and spicy foods

• Implementing stress management techniques, like meditation, yoga, and deep breathing exercises

• Getting regular exercise to reduce stress and improve your overall health

• Quitting smoking and avoiding nicotine products

• Drinking enough fluids to keep yourself hydrated

• Wearing loose-fitting, comfortable clothing to reduce pressure on the bladder and pelvic area

It’s important to discuss your specific lifestyle with your doctor during a consultation to help them make specific recommendations that can help you alleviate IC symptoms.

Botox injections

Botox injections have emerged as a potential treatment option for IC, particularly for individuals who experience severe urinary urgency and frequency.

They work by injecting neurotoxins into the body that temporarily paralyzes muscles.

When injected into the bladder, Botox can reduce muscle spasms and decrease the need to urinate frequently. This may also help to increase bladder capacity.

Botox injections typically last for several months, but treatment will need to be repeated for long-term results and can become expensive.

Surgery

Surgery is typically only reserved for severe cases of IC or when individuals haven’t responded to any other forms of treatment. Procedures that your doctor may recommend include:

• Bladder augmentation: This procedure involves removing and replacing a segment of the bladder wall to increase capacity.

• Continent urinary diversion: This involves diverting urine to an opening in the abdomen, where it’s diverted to a pouch inside the body. The pouch can be drained by inserting a catheter into the opening.

• Bladder removal: For individuals struggling with debilitating symptoms, a complete removal of the bladder may be considered. This procedure will be followed by a bladder reconstruction or urinary diversion.

• Substitution cystoplasty: Parts of the bladder may be replaced with segments of the bowel to alleviate pain and improve function. It’s important to note that this is a major surgical procedure with significant risks and should only be performed as a last resort.

When Should You See a Doctor About Interstitial Cystitis?

If you suspect that you have IC, it’s important to seek medical attention and get a professional diagnosis.

This condition requires comprehensive treatment to help alleviate your symptoms and allow you to live a normal life.

You should also consult your doctor if you:

• Experience persistent or chronic pelvic pain that doesn’t improve

• Need to urinate more than usual, especially if it’s disrupting your sleep or daily routine

• Develop frequent urinary tract infections

• Are at risk of digestive and kidney diseases that may develop because of IC

• Suffer from conditions like irritable bowel syndrome (IBS)

• Don’t see any improvement in your symptoms with your current treatment regime

Making an appointment with your doctor as soon as you experience any abnormal symptoms can help them detect issues early on.

This is essential for preventing further complications — like reproductive issues or organ damage — that can develop if IC is left untreated.

Where Can You Learn More About Interstitial Cystitis and Similar Conditions?

If you’re concerned about your symptoms or want to know more about treating interstitial cystitis, LifeMD is here to help.

LifeMD can connect you to a team of medical professionals who can assist you with information and provide guidance on managing this condition while avoiding further complications.

Make an appointment today to get started.

Dina Whiteaker, APRN

Dina earned her MSN from the University of Nebraska Medical Center before becoming a Family Nurse Practitioner. She has 10ᐩ years of telemedicine experience. Dina is board certified and is a member of the American Academy of Nurse Practitioners.

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