Interstitial Cystitis

What is Interstitial Cystitis?

Interstitial cystitis (IC) is a long-lasting bladder condition that causes frequent and urgent urination, as well as pelvic discomfort. It affects the tissue lining the bladder wall. People with IC have symptoms that come and go over time. IC is more common in women than men. About 3 to 8 million women in the United States live with this condition.

Understanding What Causes IC

Doctors are still researching the exact causes of IC. Here are some possible factors that may play a role:

• A defect in the bladder lining may allow urine and toxins to irritate the bladder wall.
• The immune system might mistake the bladder as harmful and attack it.
• Nerve signals in the bladder could trigger the muscles to contract too often.
• Chemicals in urine could damage the bladder over time.
• An infection could initially trigger the symptoms of IC.

Getting Diagnosed with IC

To diagnose interstitial cystitis, your urologist will start by asking about your urinary symptoms and medical history. This helps them understand when your symptoms started, how often they occur, and what seems to improve or worsen the symptoms. Your doctor will also perform a physical exam of your pelvis and abdomen to check for any tender spots or other abnormalities. They may order urine tests, which can help rule out whether an infection is causing your symptoms.

One common diagnostic test is cystoscopy, where your doctor uses a thin, flexible tube with a camera on the end to look inside your bladder. This allows them to visually inspect the bladder lining for any inflammation, ulcers, or other abnormalities. Your doctor may also perform a potassium sensitivity test, where a solution containing potassium is placed into the bladder through a catheter. If you have IC, the potassium solution will likely cause pain and urgency. Finally, your doctor may take a small tissue sample of your bladder wall, called a biopsy, which can be analyzed to help confirm an IC diagnosis and rule out other conditions.

Treatment Options for IC

There are several treatment options available for interstitial cystitis. Lifestyle changes like avoiding potential bladder irritants, practicing stress management, using heating pads, and making dietary changes can help manage IC symptoms. Your doctor may also prescribe oral medications, including antihistamines, tricyclic antidepressants, or immune-modulating drugs, which can help control pain and reduce urinary frequency.

Another treatment option is bladder instillations, where medication solutions are placed directly into the bladder through a catheter. The solutions coat the bladder wall and get absorbed into the tissues. Common solutions include dimethyl sulfoxide (DMSO), pentosan polysulfate, and hyaluronic acid. Your doctor may also recommend neuromodulation, which uses electrical nerve stimulation to alter pelvic nerve activity and reduce symptoms. If other treatments have not helped enough, surgery to enlarge the bladder may be an option in severe cases. This helps increase bladder capacity and reduce pain. Talk to your doctor to determine the best treatment approaches for your individual case.

Living with IC

Here are some tips for coping with IC:

• Modify your diet by avoiding foods and drinks that may irritate the bladder.
• Practice relaxation techniques to manage stress.
• Join a support group to connect with others who have IC.
• Keep a bladder diary to identify triggers and flare-ups.
• Have pelvic floor physical therapy.
• Work closely with your healthcare providers to customize your treatment plan.

While there is no cure for IC, various treatments can help reduce symptoms and improve quality of life. Being proactive and finding the right treatment approach for you can help manage this condition.