What are the other Names for this Condition? (Also known as/Synonyms)

• Bladder Pain Syndrome (BPS)
• Non-Ulcerative Form of Interstitial Cystitis
• Ulcerative Form of Interstitial Cystitis

What is Interstitial Cystitis? (Definition/Background Information)

• Interstitial Cystitis is a condition of the urinary bladder that results in pain, pressure, and tenderness in the bladder and pelvic regions
• It can be associated with ulceration, and hence, there are 2 forms of the condition:
  • Ulcerative Form of Interstitial Cystitis
  • Non-Ulcerative Form of Interstitial Cystitis
• 90-95% of individuals with Interstitial Cystitis have a non-ulcerative form with hemorrhages on the bladder wall. The other 5-10% of the individuals have an ulcerative form with ulcers and bleeding on the bladder wall
• There is no known cause of Interstitial Cystitis, but any previous bladder damage or sensitivity can lead to pain. The condition often causes frequent and/or urgent urination as well as abdominal pain
• No specific tests are used in the diagnosis, but the symptoms, especially an urgent urination, is helpful in suspecting the condition. The diagnosis is made through the evaluation of medical history, physical exam, and supportive diagnostic tests
• Allergies, irritable bowel syndrome, and skin sensitivity often coincide with the presence of Interstitial Cystitis and can cause further complications
• There is no cure for Interstitial Cystitis; hence, treatments, such as bladder instillation and oral medication, are commonly used to relieve symptoms
• In general with suitable symptomatic treatment, the prognosis for Interstitial Cystitis is generally good. Lifestyle changes in diet and increased activity levels can help prevent an increase in severity of the symptoms

Who gets Interstitial Cystitis? (Age and Sex Distribution)

• The likelihood of getting Interstitial Cystitis increases with age
• Adult women are more likely to have the condition than men
• No particular racial or ethnic preference is noted

What are the Risk Factors for Interstitial Cystitis? (Predisposing Factors)

Certain risk factors are believed to lead to the development of Interstitial Cystitis. These include:

• Damage to the bladder from a previous surgery
• A distending bladder, which may occur when one regularly refrains from emptying the bladder
• Spinal cord damage
• Inflammation or sensitivity of the pelvic nerves
• Bacterial infection of the bladder
• Debilitated pelvic floor muscles due to old age. This results in improper functioning of the urinary bladder
• Autoimmune disorders such as systemic lupus erythematosus (SLE)

The above-mentioned risk factors are not direct causes, but they can cause irritation to the bladder, which can lead to the onset of Interstitial Cystitis.

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Interstitial Cystitis? (Etiology)

While there is currently no specific or well identified cause, the following might contribute to the cause of Interstitial Cystitis:

• Any predisposing factors that cause damage to the urinary bladder wall. Chronic nerve pain can develop, if the bladder is damaged further
• Individuals with Interstitial Cystitis do not have normal bladder lining repair function, when the bladder mucosa is damaged

What are the Signs and Symptoms of Interstitial Cystitis?

The severity of the signs and symptoms may be different in each individual. Generally, the affected individuals may experience the following:

• Frequent urination (that may be up to 60 times a day in some cases)
• Urgent urination
• Lower abdominal pain
• Pain in the urethral and/or vaginal area in women
• Testicular discomfort and pain from ejaculation in men
• Hunner’s ulcers, which are areas of bladder inflammation, can be detected during a cystoscopic examination

How is Interstitial Cystitis Diagnosed?

There is no test that specifically diagnoses Interstitial Cystitis. However, the following procedures may be used to aid in the diagnosis:

• A complete physical examination by a healthcare provider along with medical history assessment
• Other illnesses involving the urinary system, such as urinary tract infections and bladder cancer, are ruled out first
• Cystoscopic exam: During this exam, the healthcare provider inserts a special device with a camera into the urinary bladder and examines the bladder lining
• Bladder biopsy of the ulcers, to rule out infections, malignant/benign tumors, etc.
• A diagnosis is primarily arrived at by evaluating the symptoms such as bladder pain and frequent/urgent urination

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Interstitial Cystitis?

The complications of Interstitial Cystitis could include:

• Certain chronic conditions have been linked with Interstitial Cystitis. The most common associated conditions being:
  • Allergies
  • Irritable bowel syndrome
  • Skin sensitivity
• Individuals with Interstitial Cystitis are more likely to develop irritable bowel syndrome

Other complications that have been associated with Interstitial Cystitis include:

• Vulvodynia (pain in the vulvar area)
• Fibromyalgia (muscle pain)
• Chronic fatigue
• Systemic lupus erythematosus (a disorder in which the body’s immune system attacks its own healthy tissues)
• Panic attacks
• Pelvic floor dysfunction (lack of bladder and/or bowel control) 

How is Interstitial Cystitis Treated?

There is no cure for Interstitial Cystitis. The treatments provided are meant to relieve symptoms and may include:

• Bladder distention: It is a procedure that works to increase bladder capacity and disrupt pain signals being sent from the bladder nerves
• Bladder instillation is used by filling the bladder with a solution for around 10-15 minutes before it is drained
  • The solution used commonly is diemethyl sulfoxide
  • A catheter is inserted into the bladder from the urethra, in order to administer the solution
  • Bladder instillation is given every 1-2 weeks for a period of 6-8 weeks
• Medications can be prescribed to help repair defects in the bladder lining
• Electrical nerve stimulation can be used on bladder nerves through an implanted device multiple times throughout the day. The electrical pulses are thought to increase blood flow to the bladder and strengthen bladder muscles to reduce pain
• Continuous exercise can help relieve painful symptoms
• Surgery can be performed to eliminate ulcers, make the bladder bigger, or for bladder removal

How can Interstitial Cystitis be Prevented?

Interstitial Cystitis may not be preventable; however, the symptom severity may be reduced with certain lifestyle changes:

• Worsening symptoms of Interstitial Cystitis may be prevented through a diet that limits or eliminates alcohol, chocolate, caffeine, tomatoes, spices, and citrus foods
• Quitting smoking can also help prevent the worsening of symptoms; moreover, smoking can also lead to bladder cancer

What is the Prognosis of Interstitial Cystitis? (Outcomes/Resolutions)

• While there is no cure for Interstitial Cystitis, symptom relief is possible to a good extent
• Each case of Interstitial Cystitis is different and individuals should try to experiment and find a treatment that potentially provides maximum benefit to them

Additional and Relevant Useful Information for Interstitial Cystitis:

• The US National Institutes of Health (NIH) are working diligently in trying to find a cure for Interstitial Cystitis. Research is being done on gene therapy, pain medicines, and providing simple urine tests to even diagnose the condition
• An estimated 12 million individuals in the United States have Interstitial Cystitis. Also, approximately 2.7% of women and 1.3% of men have symptoms that are related to Interstitial Cystitis