Interstitial cystitis, also known as painful bladder syndrome, is a condition causing pelvic and bladder pain, difficulty urinating, and decreased bladder capacity. It can be misdiagnosed as a bladder infection and is diagnosed through elimination. Treatments include medications, nerve stimulation, surgery, and dietary changes.
Interstitial cystitis (IC) is a condition associated with the bladder. People with interstitial cystitis experience pelvic pain, difficulty urinating, and bladder pain as their bladders fill or empty. The cause of this condition is not known and because people respond in very different ways to some of the treatments, some doctors have suggested that this condition should be known as ‘painful bladder syndrome’, reflecting the fact that it is a collection of symptoms that can be caused by different things, rather than by a single disease. Whether it’s called interstitial cystitis or painful bladder syndrome, this condition can be very debilitating for people who struggle with it.
In patients who develop interstitial cystitis, bladder capacity decreases, causing an increased need to urinate. The bladder also becomes inflamed, which means it can become painful when it empties or fills. Chronic inflammation can lead to scarring and lesions in the bladder, which cause additional pain for the patient.
This condition is often misdiagnosed as a bladder infection, and patients may be given several other diagnoses and treatments before their doctors realize the cause of the problem. Patients are typically diagnosed via the process of elimination, with the doctor first examining the patient’s urine for signs of infection, then performing a cytoscopy to examine the bladder for signs of cancer, and a biopsy to see how much it may be bladder inflamed.
These tests can be used to determine whether a patient’s IC is ulcerative or nonulcerative. In patients with ulcerative interstitial cystitis, ulcers known as Hunner’s patches are present in the bladder, and surgical removal of these patches can bring significant relief. In nonulcer IC, the patient does not have ulcers in the bladder, although small marks known as glomerulations are visible in the bladder.
Some patients can manage their interstitial cystitis with medications, including pain management medications, to reduce pain associated with the condition. Electrical nerve stimulation has also been shown to be helpful, by reworking nerve pathways to limit the number of pain signals sent to the brain. Distending the bladder or instilling medication also appears to help some patients, enlarging the bladder and soothing the irritation.
Sometimes, a doctor may recommend surgery for interstitial cystitis. Another option is dietary changes, as some substances seem to irritate the bladder more than others. A patient may need to go on an elimination diet to determine which substances trigger bouts of pain and irritation. Once a list of dangerous foods and drinks has been generated, the patient can avoid these dietary additions and reduce IC pain.
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