Interstitial Cystitis

Interstitial cystitis (IC), also called bladder pain syndrome, affects the bladder and surrounding pelvic region. It causes discomfort that may feel like:

• Pressure
• Burning
• Pain

Along with these symptoms is the frequent urge to urinate, even when the bladder isn’t full.

Although symptoms can be similar to those of a urinary tract infection, no infection is involved. Therefore, antibiotics are unlikely to be effective.

Normally, when your bladder fills, nerves signal your brain that it’s time to urinate. With IC, this signaling system may not work properly. You may feel an urgent need to go to the bathroom frequently, sometimes dozens of times a day, and experience pain either during or after urination.

It often affects women, but men can also develop IC. And, the severity of symptoms can vary from person to person. Some may only notice occasional irritation, while others live with constant pain and pressure in the pelvic area. IC can disrupt sleep and make days seem overwhelming.

Doctors still don’t fully understand the exact cause of IC. It’s likely that more than one factor contributes, including:

• A damaged bladder lining that allows irritating substances in urine to leak into surrounding tissues
• Nerve hypersensitivity, where pain signals are amplified
• Inflammatory or immune responses, where the body may mistakenly target the bladder
• Genetic or hereditary links, since IC may run in families
• History of pelvic surgery, trauma, or infections, which may alter bladder function over time

It’s also worth noting that IC often overlaps with other chronic conditions like irritable bowel syndrome (IBS), fibromyalgia, or endometriosis.

The signs aren’t always constant. They can come and go in cycles, flaring up under certain triggers. Common symptoms include:

• Bladder or pelvic pain that may get better temporarily after urinating
• Urinary frequency
• Pain during sex or discomfort after intercourse
• A burning or sharp sensation in the lower abdomen or urethra
• Frequent nighttime trips to the bathroom
• Pressure or fullness in the bladder, even when it’s not full

Over time, nerves involved in bladder function may become oversensitive, and surrounding areas, like the hips, thighs, or abdomen, can also start to hurt.

An IC flare is a sudden worsening of symptoms. For some, flares are brief and manageable, but for others, they can be intense and long-lasting. Triggers may include:

• Foods and beverages, especially those high in acid, caffeine, or alcohol
• Stress or emotional strain
• Hormonal changes, especially during menstruation
• Physical pressure on the pelvic area, including from tight clothing or prolonged sitting
• Sexual activity

Because IC mimics other conditions, it can take time to get a clear diagnosis. No single test can confirm IC, but your doctor may use a combination of methods, such as:

• A detailed medical history and symptom review
• Urine tests to rule out infection or blood
• Cystoscopy, a thin camera used to examine the bladder lining
• Biopsy of bladder tissue to exclude other causes, like cancer or inflammation
• For men, evaluating prostate health or pelvic nerve function

There’s no universal treatment for IC. Keeping a journal to track symptoms and flare patterns can help you identify and avoid your triggers. Management often involves trying different strategies over time until you find a combination that works best.

1. Lifestyle and dietary changes

Avoiding acidic, spicy, or caffeinated foods may reduce symptom flare-ups. Common triggers include:

• Coffee and tea
• Citrus fruits
• Alcohol
• Carbonated drinks
• Artificial sweeteners

2. Bladder training

Using a timed voiding schedule and gradually increasing the time between trips to the bathroom may reduce frequency and urgency.

3. Pelvic floor physical therapy

Tension or dysfunction in the pelvic floor muscles can worsen bladder pain. A pelvic floor therapist can teach you exercises to relax and strengthen these muscles.

4. Medications

A variety of drugs may help reduce pain, urgency, or inflammation:

• Pentosan polysulfate sodium, Elmiron, may help repair the bladder’s protective lining. Long-term eye safety warnings necessitate regular eye exams and ongoing monitoring.
• Amitriptyline is a low-dose antidepressant used to reduce pain signaling.
• Antihistamines, like hydroxyzine, may help calm inflammation triggered by allergens.
• NSAIDs, such as ibuprofen and naproxen, are taken for general pain and inflammation relief during flares.

5. Intravesical therapy

Medications may be administered directly into the bladder via a catheter to alleviate irritation.

6. Neuromodulation

Sacral nerve stimulation involves placing a small device under the skin to deliver electrical signals that help regulate bladder activity.

7. Stress management

Because stress can exacerbate IC symptoms, relaxation strategies such as deep breathing, yoga, or counseling can play a role in managing flares.

When symptoms flare, the following strategies can be tried:

• Use a heating pad or cold pack on your lower abdomen
• Take a warm bath or sitz bath for pelvic muscle relaxation
• Drink plenty of water to dilute urine
• Rest in a position that relieves pressure from your bladder
• Avoid tight clothing and physical strain

1. Can IC be confused with other conditions?

Yes. IC often resembles UTIs, overactive bladder, or even gynecologic or prostate issues. Careful evaluation and testing are needed to rule out other causes before confirming a diagnosis of IC.

2. Does IC ever go away completely?

Some people experience long periods of remission, while others continue to experience persistent symptoms. With proper management, many people find relief, even if the condition doesn’t fully resolve.

All of our providers perform Interstitial Cystitis.