Health Encyclopedia

Interstitial cystitis (IC)

Definition

Interstitial cystitis is a long-term (chronic) inflammation of the bladder wall.

Alternative Names

Cystitis - interstitial; IC

Causes, incidence, and risk factors

Interstitial cystitis (IC) is a painful condition due to inflammation of the tissues of the bladder wall. The cause is unknown. The condition is usually diagnosed by ruling out other conditions (such as sexually transmitted disease, bladder cancer, and bladder infections).

IC is frequently misdiagnosed as a urinary tract infection. Patients often go years without a correct diagnosis. On average, there is about a 4-year delay between the time the first symptoms occur and the diagnosis is made.

The condition generally occurs around age 30 to 40, although it has been reported in younger people. Women are 10 times more likely to have IC than men.

Symptoms

Pain during intercourse
Pelvic pain
Urinary discomfort
Urinary frequency (up to 60 times a day in severe cases)
Urinary urgency

Signs and tests

Diagnosis is made by ruling out other causes. Tests include:

Bladder biopsy
Cystoscopy (endoscopy of bladder)
Urine analysis
Urine culture
Urine cytology
Video urodynamics (shows how much urine must be in the bladder before you feel the need to urinate)

Treatment

There is no cure for IC, and there are no standard or consistently effective treatments. Results vary from person to person. As long as the cause is unknown, treatment is based on trial and error until you find relief.

Elmiron is the only medication taken by mouth that is specifically approved for treating IC. This medicine coats the bladder like Pepto-Bismol coats the stomach.

Other medicines may include:

Opioid painkillers for severe pain
Tricyclic antidepressants such as Elavil (amitriptyline) to relieve pain and urinary frequency
Vistaril (hydroxyzine pamoate), an antihistamine that causes sedation helps reduce urinary frequency

Other therapies include:

Bladder hydrodistention (filling bladder with fluid)
Bladder training (using relaxation techniques to train the bladder to go only at specific times)
Instilled medications - medicines are placed directly into the bladder. Medicines that are given this way include dimethyl sulfoxide (DMS), heparin, Clorpactin, lidocaine, doxorubicin, or bacillus Calmette-Guerin (BCG) vaccine.
Physical therapy and biofeedback (may help relieve pelvic floor muscle spasms)
Surgery, ranging from cystoscopic manipulation to bladder removal (cystectomy)

Diet modification

Some patients find that changes in their diet can help control symptoms. The idea is to avoid foods and beverages that can cause bladder irritation. Below are some of the foods that the Interstitial Cystitis Association says may cause bladder irritation.

Aged cheeses
Alcohol
Artificial sweeteners
Chocolate
Citrus juices
Coffee
Cranberry juice (Note: Although cranberry juice is often recommended for urinary tract infections, it can make IC symptoms worse)
Fava and lima beans
Meats that are cured, processed, smoked, canned, aged, or that contain nitrites
Most fruits except blueberries, honeydew melon, and pears
Nuts except almonds, cashews, and pine nuts
Onions
Rye bread
Seasonings that contain MSG
Sour Cream
Sourdough bread
Soy
Tea
Tofu
Tomatoes
Yogurt

Experts suggest that you do not stop eating all of these foods at one time. Instead, try eliminating one at a time to see if that helps relieve your symptoms.

Support Groups

For additional information and support, see interstitial cystitis support groups.

Expectations (prognosis)

Treatment results vary. Some people respond well to simple treatments and dietary changes. Others may require extensive treatments or surgery.

Complications

Chronic depression
Chronic pain that may cause a change in lifestyle
Emotional trauma
High costs associated with frequent medical visits
Side effects of treatments (depending on the treatment)

Calling your health care provider

Call your health care provider if you have symptoms of interstitial cystitis. Be sure to mention that you suspect this disorder. It is not well-recognized or easily diagnosed.

References

Hanno PM. Painful Bladder Syndrome/Interstitial Cystitis and Related Disorders. In: Wein AJ. Wein: Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 74.

Moldwin RM. Rational approaches to the treatment of patients with interstitial cystitis. Urology. 2007;69:73-81.

Review Date:5/22/2008
Reviewed By:Scott M. Gilbert, MD, Department of Urology, Columbia-Presbyterian Medical Center, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

ADAM Quality A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is the first of its kind, requiring compliance with 53 standards of quality and accountability, verified by independent audit. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial process. A.D.A.M. is also a founding member of Hi-Ethics (www.hiethics.com) and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The Agency for Health Care Administration (Agency) and this website do not claim the information on, or referred to by, this site is error free. This site may include links to websites of other government agencies or private groups. Our Agency and this website do not control such sites and are not responsible for their content. Reference to or links to any other group, product, service, or information does not mean our Agency or this website approves of that group, product, service, or information.

Additionally, while health information provided through this website may be a valuable resource for the public, it is not designed to offer medical advice. Talk with your doctor about medical care questions you may have.