Interstitial cystitis (IC) also known as Chronic Pelvic Pain Syndrome is a chronic, painful bladder condition that causes urinary urgency and frequency as well as pain, pressure and discomfort that are perceived to be coming from the bladder.
IC symptoms feel like those of a bladder infection (although no infection is present) and range from mild to severe and can go into remission or flare up.
If you have IC, you may have:
- Frequency: The need to urinate 8 or more times a day and more than once at night
- Urgency: Feeling the urgent need to urinate (even right after a trip to the bathroom) accompanied by pain, burning or bladder spasms
- Pelvic Pain: Pain and tenderness in the lower abdomen, genital area, during sex, or pain that gets better or worse as the bladder empties.
Testing & Evaluation
Most people live with symptoms of IC for several years before their condition is diagnosed and they begin treatment. Part of the challenge in diagnosing IC is that there is no definitive test to confirm its presence. Instead, IC is considered a “diagnosis of exclusion,” meaning that your health care provider must rule out other possible conditions that may be causing your symptoms.
Some of the tests your doctor may perform leading to the diagnosis of IC include urine cultures (to rule out infection), a physical exam, and a cystoscopy or an examination an examination of the bladder with a lighted scope that is passed through the urethra. Your doctor may also order additional tests to rule out other suspected causes of your symptoms.
- Lifestyle Modifications: With careful attention, most people can identify and avoid triggers that make their IC symptoms worse. Common triggers include acidic or tart foods, caffeine, carbonated beverages and alcohol. Drinking more water will dilute urine and can help minimize IC flare-ups. Managing your stress is another way to help your body cope.
Urology San Antonio’s IC Self Help Resources page offers additional information.
- Oral Medications: ELMIRON (pentosan polysulfate) is the only FDA-approved medication designed specifically to treat IC symptoms. It is believe to work by helping your body to form a protective coating on your bladder wall. This coating repairs defects in the lining and reduces bladder spasms.
Other oral medications, which are not specific to IC, can relieve pain and discomfort.
- Bladder Instillation: A combination of liquid medicines are inserted into your bladder through a catheter to reduce swelling and prevent muscle spasms.
- Pelvic Floor Therapy: Physical therapy that targets the pelvic floor muscles can help you learn to relax a tense pelvic floor that may be contributing to bladder pain and urinary symptoms. Physical therapy is commonly paired with biofeedback or digital monitoring of your body’s responses that you can use to train help you train and control your pelvic floor muscles.
- Neuromodulation / Sacral Nerve Stimulation Therapy: A small device is implanted in your lower back. The device sends mild electrical currents to the sacral nerves at the base of your spine that helps control your bladder, ease pain and reduce how often you need to urinate.
Paying close attention to your diet and avoiding foods that cause IC flares is one of the most effective things you can do to control your symptoms. Managing your stress is another way to help your body cope.
- IC-Smart Diet Guidelines – A printable chart showing, in general, the kinds of foods that are likely to cause flares. Provided by the makers of Elmiron.
- Potential Bladder Irritant Food List – Urology San Antonio’s custom list of foods are likely to aggravate urinary difficulties.
- Prelief – Over the counter acid reduction tablets you take before a meal.
- Food/Symptom Diary – A journal to track your diet and IC symptoms. Provided by the makers of Elmiron.
Some people find that wearing modified clothing helps them avoid the pelvic muscle tension that can trigger pelvic pain.
- Men’s Ballroom Jeans sold by Deluth Trading Co. have a modified crotch gusset designed to be more comfortable when you crouch or bend
- A seamstress or tailor can alter pants to include an elastomeric fabric in the crotch to achieve the same effect as the Ballroom Jeans. Expect to pay about $10-20 a pair for the alteration.
There are plenty of websites devoted to IC. Here are a few of our favorites. Remember, not all of the information you read online is accurate. Always seek your doctor or health care provider’s guidance before you act on any information that could affect your health.
- All About IC (www.allaboutIC.com) – A patient-friendly IC website, including real patient stories, explanations about symptoms and treatment, and online tools.
- American Physical Therapy Association: Women’s Health (www.moveforwardpt.com/womenshealth) – Information about how physical therapy can help ease pelvic pain and improve incontinence.
- Interstitial Cystitis Network (www.IC-network.com) – A detailed website about all facets of IC; includes a marketplace of IC products, a research library and chat forums.
- Interstitial Cystitis Association (www.ichelp.org) – A nonprofit dedicated to improving the health care and lives of people with IC. Has detailed information and resources. If you become a paid ICA member, you receive the quarterly ICA Update magazine, which is full of interesting and helpful articles.
- Journey To Relief (www.journeytorelief.com) – Basic IC information and self help tips designed to compliment medication (Elmiron) therapy.
- My Ortho Elmiron 360 (www.myorthoelmiron360.com) – IC and Elmiron information geared for health care providers treating IC. Much of the information is useful to patients.
How soon after starting treatment will I feel better?
It’s important to remember that none of the IC treatments works immediately and most have a more gradual effect on symptoms – sometimes taking up 3 to 6 months until significant improvement is seen.
Can IC be cured?
Interstitial cystitis is a chronic condition, but your symptoms can go into remission. This means that they might go away for a period of time or they are milder. The goal of treatment is to reduce symptoms so that you can function at your best despite having IC.