Interstitial cystitis (IC) is a chronic inflammatory condition of the bladder wall that leads to bladder pain, increased urinary frequency, and urgency. This condition occurs when the bladder lining is damaged or inflamed, allowing harmful substances in the urine to irritate the bladder wall. IC is more common in women and can greatly affect daily life, causing discomfort, emotional distress, and disruptions to both work and social life.

The causes of IC are not fully understood, but potential factors include bladder lining defects, immune system responses, and nerve dysfunction​.

IC symptoms vary from person to person but commonly include:

• Bladder pressure and discomfort, particularly in the pelvic area.
• Frequent and urgent need to urinate, often in small amounts.
• Painful urination or a feeling of burning during urination.
• Pelvic pain that may increase during menstruation.
• Painful sexual intercourse (dyspareunia) in women.
• Pain or discomfort in the scrotum or penis in men.

These symptoms can often mimic other conditions such as urinary tract infections (UTIs), so it’s essential to consult a urologist for proper diagnosis.

While the exact cause of IC remains unknown, several factors may contribute to its development:

• Bladder lining defects: A compromised bladder lining may allow harmful substances in the urine to irritate the bladder wall.
• Histamine and mast cells: Overproduction of histamine by mast cells can cause inflammation and discomfort.
• Nerve changes: Abnormal nerve signaling in the bladder can cause pain and urgency.
• Autoimmune responses: Some believe IC may be an autoimmune disorder, where the body’s immune system mistakenly attacks healthy tissue.
• Physical trauma: Events such as sexual assault or car accidents can trigger or exacerbate IC in some individuals.

There is no single test for diagnosing IC, and it is often diagnosed after ruling out other conditions with similar symptoms. Diagnostic procedures may include:

• Urine analysis and culture: To rule out infections.
• Cystoscopy: A thin tube with a camera inserted into the bladder allows the doctor to inspect the bladder lining and check for ulcers or other abnormalities.
• Bladder distention: This involves stretching the bladder during cystoscopy to assess bladder capacity and any abnormal changes in the bladder lining.
• Biopsy: A tissue sample may be taken during cystoscopy to rule out bladder cancer.

While there is no cure for IC, a variety of treatments are available to manage symptoms and improve quality of life:

Bladder Installations

Bladder installations involve a minimally invasive procedure where medication is directly instilled into the bladder via a catheter. This medication helps soothe the bladder lining, offering immediate symptom relief. Multiple treatments may be needed for optimal results.

Anti-Inflammatory Diet

A key aspect of managing IC is following an anti-inflammatory diet. Avoiding irritants like caffeine, alcohol, acidic foods (e.g., tomatoes), dairy, and spicy foods can help reduce symptoms. Drinking plenty of water also helps to dilute urine and reduce irritation​.

Pain Management

Pain relief can be achieved through various medications, including anti-inflammatories and histamine blockers. If pain persists, stronger pain management strategies may be explored.

Pelvic Floor Physical Therapy

For many IC patients, pelvic floor dysfunction is common. Specialized pelvic floor physical therapy can help relax and strengthen pelvic muscles, improving overall bladder control and alleviating pelvic pain.

Medications

Medications to help thicken the bladder wall and reduce irritation can be prescribed. These may not work for all patients, but for some, they provide significant symptom relief.

Surgical Options

In severe cases of IC, when other treatments are ineffective, surgical interventions may be considered. This could involve bladder augmentation or removal for patients with extensive damage to the bladder.