Interstitial cystitis
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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.
References
Hanno PM. Painful bladder syndrome/interstitial cystitis and related disorders. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 10.
French L, Phelps K, Pothula NR, Mushkbar S. Urinary problems in women. Prim Care. 2009 Mar;36(1):53-71, viii.
Marinkovic SP, Moldwin R, Gillen LM, Stanton SL. The management of interstitial cystitis or painful bladder syndrome in women. BMJ. 2009 Jul 31;339.
Review Date: 6/17/2010
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; Scott Miller, MD, Urologist in private practice in Atlanta, Georgia. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Cystitis - interstitial; IC
Symptoms
Signs and tests
Diagnosis is made by ruling out other causes. Tests include:
References
Hanno PM. Painful bladder syndrome/interstitial cystitis and related disorders. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 10.
French L, Phelps K, Pothula NR, Mushkbar S. Urinary problems in women. Prim Care. 2009 Mar;36(1):53-71, viii.
Marinkovic SP, Moldwin R, Gillen LM, Stanton SL. The management of interstitial cystitis or painful bladder syndrome in women. BMJ. 2009 Jul 31;339.
Review Date: 6/17/2010
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; Scott Miller, MD, Urologist in private practice in Atlanta, Georgia. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Cystitis - interstitial; IC
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 (over-filling the bladder with fluid while under general anesthesia)
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
Seasonings that contain MSG
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, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 10.
French L, Phelps K, Pothula NR, Mushkbar S. Urinary problems in women. Prim Care. 2009 Mar;36(1):53-71, viii.
Marinkovic SP, Moldwin R, Gillen LM, Stanton SL. The management of interstitial cystitis or painful bladder syndrome in women. BMJ. 2009 Jul 31;339.
Review Date: 6/17/2010
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; Scott Miller, MD, Urologist in private practice in Atlanta, Georgia. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Cystitis - interstitial; IC
References
Hanno PM. Painful bladder syndrome/interstitial cystitis and related disorders. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 10.
French L, Phelps K, Pothula NR, Mushkbar S. Urinary problems in women. Prim Care. 2009 Mar;36(1):53-71, viii.
Marinkovic SP, Moldwin R, Gillen LM, Stanton SL. The management of interstitial cystitis or painful bladder syndrome in women. BMJ. 2009 Jul 31;339.
Review Date: 6/17/2010
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; Scott Miller, MD, Urologist in private practice in Atlanta, Georgia. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Review Date: 6/17/2010
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; Scott Miller, MD, Urologist in private practice in Atlanta, Georgia. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.