Interstitial Cystitis

Pronounced: In-tur-STI-shul sis-TY-tis

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Definition | Causes | Risk Factors | Symptoms | Diagnosis | Treatment | Prevention | Organizations

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Definition

Interstitial cystitis is chronic inflammation of the wall of the bladder. Inflammation can lead to scarring, pinpoint bleeding of the bladder wall, and a decreased bladder capacity. Although the symptoms are similar to those of a bladder infection, there is usually no clear cause.

Causes

Because bacteria, fungi or viruses are rarely found in the urine of people with interstitial cystitis, the cause is unclear. Possible causes include:

• An autoimmune response that occurs following a bacterial infection of the bladder
• Bacteria that cling too tightly to the wall of the bladder
• A "leaky" inner lining of the bladder that allows irritating substances in the urine to come into contact with the bladder wall

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

• Sex: female
• History of childhood bladder problems

Symptoms

The symptoms of interstitial cystitis vary from person to person. They can also occur in cycles. Some people experience periods of intense symptoms followed by periods of remission. Pain can be severe enough to keep people from working or even walking.

Symptoms can include:

• Discomfort, pain, or pressure in the bladder or pelvic area
• Frequent need to urinate (up to 60 times per day in severe cases)
• Urgent need to urinate
• Pain during intercourse
• Blood and pus in the urine
• Shrunken bladder

Diagnosis

Your doctor will ask about your symptoms and medical history, and perform a physical exam. In addition, your urine will be tested for pus and bacteria. If bacteria are present in the urine, you will likely be diagnosed with acute cystitis—a typical bladder infection. If no bacteria are present, your doctor will likely do other tests.

A diagnosis of interstitial cystitis will only be made after other conditions have been ruled out and a cystoscopy with bladder distention has been done. This consists of distending (stretching) the bladder to its full capacity by instilling gas or liquids through the cystoscope. A cystoscopy will help your doctor see if there is scarring, bleeding, or inflammation on the bladder wall.

Treatment

There is no treatment to cure interstitial cystitis. Treatment is aimed at relieving symptoms. Treatment depends on your symptoms. You may have to try several different treatments before you experience relief.

Treatments include:

Bladder Distention

Some people experience relief after the bladder distention—done during the cystoscopy—is done.

Bladder Instillation

During bladder instillation, a "wash" is put into the bladder through a tube in the urethra. It is held for anywhere from a few seconds to 15 minutes and then voided. There are several different types of solutions used. Some coat the bladder and are thought to decrease the inflammation.

Medication

Medications may include:

• Bladder coating - taken orally, they can coat and protect the bladder
• Antidepressants and pain relievers - for pain relief
• Antihistamines - may help stop the cycle of inflammation
• Antispasmodics - may alleviate frequency and urgency of urination

Diet

There is no research linking diet to interstitial cystitis. But many people find that changes in diet can help relieve pain. Different people have different "trigger" foods. Foods commonly reported to aggravate interstitial cystitis include:

• Coffee
• Chocolate
• Artificial sweeteners
• Alcohol
• Acidic foods
• Carbonated beverages

Transcutaneous Electrical Nerve Stimulation (TENS)

An external device that sends mild electrical impulses into the body. It has been helpful in relieving pain and decreasing frequency of urination in some people.

Bladder Training

Some people are able to train the bladder to have better control by setting a regular timed schedule for emptying their bladder. The amount of time between voidings is gradually increased. Bladder training should be attempted only after pain relief has been accomplished.

Surgery

Surgery is a treatment of last resort. It is used after all other treatment methods have been exhausted and if the pain is severe. Many people continue to have pain even after surgery.

Prevention

There are no guidelines for preventing interstitial cystitis because the cause is unknown.

Organizations

Interstitial Cystitis Association
http://www.ichelp.com/

Interstitial Cystitis Network
http://www.ic-network.com/

SOURCES:

National Institute of Diabetes and Digestive and Kidney Diseases

Interstitial Cystitis Network

Interstitial Cystitis Association

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Last reviewed June 2001 by Medical Review Board