Interstitial cystitis

Overview

Interstitial cystitis, also known as bladder pain syndrome (IC/BPS), is a condition that causes persistent pain, pressure, or discomfort in the bladder. The bladder pain may range from minor to severe. Interstitial cystitis leads to a persistent requirement for frequent urination (frequency) and abrupt, compelling urges to urinate (urgency) that last for a minimum of six weeks.

The urinary system of the body is made up of the bladder, kidneys, ureters, and urethra. Urine is stored in the bladder, which is a hollow, muscular structure. The bladder enlarges until it is full, at which point it sends a signal to the brain via the pelvic nerves that it is time to urinate. 

In the case of interstitial cystitis, the signals become confused, resulting in a sensation of needing to urinate more frequently and with smaller amounts of urine. Unlike a healthy bladder, the walls of the bladder become irritated and inflamed. 

Predominantly afflicting women, interstitial cystitis can exert a prolonged influence on one’s quality of life. While a definitive cure remains elusive, medications and alternative therapies might provide alleviation. 

Symptoms

The symptoms of interstitial cystitis or bladder pain syndrome can vary significantly from person to person. Symptoms can range from mild to severe, exhibiting either a consistent presence or sporadic occurrence. These symptoms can also fluctuate over time, occasionally intensifying in response to typical triggers, such as menstruation, extended periods of sitting, stress, physical exertion, and sexual activity. It’s possible for some individuals to also experience symptom–free periods. 

Although the signs and symptoms of interstitial cystitis may match those of a chronic urinary tract infection, an infection is rarely present. However, if a person with interstitial cystitis has a urinary tract infection, their symptoms may intensify.

The common signs and symptoms of interstitial cystitis include:

• Frequency of urination, typically in little amounts, up to 60 times per day 
• Urgency of urination
• Discomfort or pain while the bladder fills, followed by relief after peeing 
• Pelvic pain or pain between the vagina and anus in women 
• Persistent bladder or pelvic pain 
• Sexual discomfort

If any of the signs and symptoms persist, consult a healthcare provider for proper diagnosis and treatment. Tests may be necessary to rule out infections or other diseases that could be causing similar symptoms. 

Causes

Interstitial cystitis has no known cause. Medical experts assume that it is related to certain medical disorders, such as autoimmune disease, allergies, mast cell abnormalities, unidentified infection, or genetics. Proteinuria, the presence of abnormal substances in the urine, such as regularly high protein levels can also be related to interstitial cystitis. 

Some may have a defect in the bladder’s protective lining or epithelium. A breach in the epithelium could potentially enable harmful substances within urine to provoke irritation of the bladder wall.  

Risk factors

Several risk factors may contribute to an increased risk of interstitial cystitis:

• Age: People at least 30 years old are more vulnerable to acquiring interstitial cystitis.
• Sex: Interstitial cystitis is more common among women than men. While men may experience symptoms resembling interstitial cystitis, these are often associated with prostatitis or inflammation of the prostate gland.
• Chronic pain disorder: One may be more vulnerable to acquiring IC/BPS if he or she has another chronic pain disorder, such as irritable bowel syndrome or fibromyalgia.