Interstitial Cystitis

What Is Interstitial Cystitis – Bladder Pain Syndrome?

Interstitial cystitis / bladder pain syndrome (IC/BPS) is a condition with symptoms including burning, pressure, and pain in the bladder along with urinary urgency and frequency.

IC/BPS occurs in 3 to 7% of women, and can affect men as well. Though usually diagnosed among women in their 40s, younger and older women may have IC/BPS, too. Interstitial Cystitis is often reported as feeling like a bad bladder infection but cultures come back without any infection. Symptoms may become severe (called a “flare”) for hours, days or weeks, and then disappear. Or, they may linger at a very low level during other times.

The causes of IC/BPS are not fully understood. It is likely due to a combination of factors. IC/BPS runs in families and so may have a genetic factor. A deficiency in the protective coating of the bladder has been considered as a cause of IC/BPS. Without this protective layer, urine is irritating to the lining of the bladder. Other research found that nerves in and around the bladder of people with IC/BPS are hypersensitive or upregulated. This may also contribute to IC/BPS pain. 

Diagnosis

To diagnose IC/BPS, your urologist or urogynecologist will review your medical history and symptoms. Your doctor will ask about your pattern and level of pain, as well as urinary symptoms. To help rule out other conditions, you may need some lab tests. A special Cystoscopy with distension of the bladder with fluid (known as hydrodistension) may be used to confirm IC findings and may provide relief of symptoms. 

Treatments

Treatments depend on the severity of symptoms. Most women require more than one type of therapy to manage their pain and urinary symptoms. Right now, there is no cure for IC/BPS, but the symptoms can be treated and controlled. The good news is that IC is not dangerous. It does not decrease longevity and does not cause cancer. It does not affect fertility. Symptom control/management is the goal of treatment for IC.

Diet

Women with IC/BPS often find that certain foods and drinks irritate their symptoms. Identifying which items are troublesome to you and restricting or limiting them can help control symptoms. Food sensitivities can vary. However, there are foods and beverages that appear to trigger a flare among many women. In large scale dietary studies of IC patients, most participants found 4 major categories were irritating: caffeine, alcohol, spicy/tomato-based foods, and citrus/acidic foods. 

Stress Management

For most women, stress can worsen IC/BPS symptoms. Find an activity that relaxes you such as meditation, yoga, hypnosis, acupuncture, or taking a walk. Whatever it is, schedule time so you can help manage stress.

Pelvic Floor Physical Therapy/Myofascial Release Therapy

A specially trained women’s health physical therapist (PT) can manually maneuver your pelvic area to help relieve pelvic pain. This therapy may loosen tight pelvic floor muscles and tissues. Women with IC/BPS should NOT do pelvic floor strengthening exercises (called Kegel exercises) unless under the care of a PT. These exercises can worsen symptoms.

Other Treatments

Other treatments may be discussed with your physician. These include medicines, bladder instillations, cystoscopy under anesthesia, neurostimulation, Botox and surgery.

Contact Florida Urology Center at 386-673-5100 to learn more or schedule a consultation.

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