Interstitial Cystitis

Interstitial CystitisInterstitial cystitis (IC) is a painful condition due to inflammation of the tissues of the bladder wall. The cause is unknown, but some suspected causes include an allergic response, autoimmune disorder, or increased firing of nerve pain receptors. 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 or an overactive bladder. The symptoms may occur intermittently every few weeks or months and resolve after a few days. Often symptoms are aggravated by sexual intercourse, certain foods, or stress. IC is often associated with endometriosis, vulvodynia (vulvar burning) and irritable bowel syndrome.

Symptoms include:

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

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

  • Urine cytology
  • Urodynamics
  • Potassium Sensitivity test


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.

Treatment:

We usually recommend a combination regimen to treat all potential causes of IC, including:

  • 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.
  • Antidepressants to address the nerve component of the pain
  • An antihistamine that causes sedation and decreases histamine release, one of the possible factors affecting IC flares
  • A bladder antispasmodic/analgesic such as Uribel or Pyridium

Other medications sometimes used:

  • Anticholinergic medications (usually used for an overactive bladder) to decrease the urgency/frequency symptoms
  • Prelief: an acid blocker
  • CystoProtek: a nutritional supplement with a combination of ingredients to heal the bladder wall

Other therapies include:

  • Bladder hydrodistention: over-filling the bladder with fluid while under general anesthesia
  • Bladder training: emptying by the clock rather than with the need to go
  • Bladder instillations: placing a solution of lidocaine, heparin and sodium bicarbonate into the bladder to relieve the symptoms
  • Physical therapy and biofeedback (may help relieve pelvic floor muscle spasms)
  • Diet modification

Most 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*
  • 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

*(Note: Although cranberry juice is often recommended for urinary tract infections, it can make IC symptoms worse.)

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