Interstitial cystitis (IC) is a chronic painful condition of the bladder. Also known as painful bladder syndrome (PBS) and bladder pain syndrome (BPS), IC symptoms are similar to a bladder infection, but IC is unresponsive to antibiotics.

About four million Americans – of all ages, genders, races, and ethnicities – suffer from IC. IC can be a debilitating condition that negatively impacts nearly every aspect of a person’s life. Because of the complexity of the disease and lack of clear understanding, it may take up to five years to obtain a diagnosis of IC, which is based on:

  • Pain and/or pressure in the bladder or pelvic region
  • Unexplained urinary urgency and frequency, as often as every ten minutes
  • Absence of infection and negative urine cultures
  • Ruling out other diseases that can cause similar symptoms

In severe cases, IC patients suffer from unrelenting pain in the pelvic region that necessitates trips to the bathroom as often as every 10 to 15 minutes – both during the day and at night – for relief. Some people with IC have symptoms that prevent them from leaving their homes or even riding in a car, greatly limiting or preventing their ability to work full time (if at all), travel, or participate in leisure activities. In addition, some people with IC are unable to share sexual intimacy with their partners because sex can exacerbate the condition.

Many different treatments are available to relieve IC symptoms. Usually a combination of treatments is needed to provide symptom relief and because symptoms can vary from person to person, treatments also vary from individual to individual. It sometimes takes a period of “trial and error” before the most effective treatment or combination of treatments results in improvement.

  • Diet changes (avoiding citrus, spicy, and other potentially problematic foods, as well as limiting caffeine, carbonated drinks, and alcohol) and relaxation exercises and biofeedback can help control symptoms.
  • Physical therapy to relax pelvic muscles and treat overlapping conditions such as pelvic floor dysfunction is often part of the treatment plan.
  • Oral medications to treat IC symptoms include Elmiron (pentosan polysulfate sodium, the only oral medication approved for specific use in IC), antihistamines, muscle relaxants, and tricyclic antidepressants to alleviate pain, as well as other pain medications.
  • Bladder instillations may be added to the IC treatment protocol and include DMSO (dimethyl sulfoxide), heparin, Marcaine and combinations of medicines called “bladder cocktails.”

More research is needed to understand all aspects of IC, including variations in treatment response. There are a number of promising clinical trials testing potential new IC treatments underway.

Revised Wednesday, June 24th, 2015