What is Interstitial Cystitis?

Interstitial cystitis (IC) is also known as Painful Bladder Syndrome (PBS), Irritable Bladder Syndrome or Bladder Pain Syndrome (BPS).

Interstitial cystitis is a conditions affecting the space between the bladder lining and the bladder muscle (interstitial meaning ‘between the layers’ and cystitis, in this sense, meaning ‘of the bladder’).

In general terms, it is a chronic inflammation of the bladder wall. It can resemble a bacterial bladder infection (cystitis) but typically symptoms are always present and don’t respond to antibiotics.

There is an estimated 400.000 people living with this condition in the UK alone, of which 90% are females and 10% are males [1, 2, 3].

The main symptoms of interstitial cystitis include:

• Chronic frequency of urination
• Chronic urgency that can be accompanied by pain, pressure or spasms
• Chronic pain located in the abdominal, urethral or vaginal area, frequently also during intercourse
• Ulceration and scarring of the bladder
• ‘Electric shocks’ of the bladder
• Blood in the urine

How is interstitial cystitis diagnosed?

In Europe, interstitial cystitis is defined as ‘the presence of chronic pelvic pain lasting more than 6 months, pressure/discomfort perceived to be related to the urinary bladder, and one or more urinary symptoms such as urinary urgency or frequency’ [4].

A diagnosis is usually made via exclusion of other conditions and using diagnostic tests such as biopsy or cystoscopy and based on the aforementioned symptoms [3].

The causes of interstitial cystitis

Officially, the cause of interstitial cystitis is not yet known and research continues to find the cause. Interstitial cystitis seems to be a multi-factoral condition and therefore may have different causes rather than a single one. Some suggested causes include:

• A defective bladder lining [5]
• Autoimmunity [4]
• Environmental causes [2]
• Back problems [2]
• Mycobacteria [6]

Common treatments for interstitial cystitis [7]

Treatments are mainly focused on managing symptoms of interstitial cystitis.

1. Oral medication to relieve pain, spasm, inflammation and soothe the bladder lining:

• Painkillers
• Anticholinergics/Antimuscarinics
• Antihistamines
• Cimetidine Tagamet
• Elmiron (Pentosan Polysulfate Sodium)

2. Intravesical Medications (placed directly into the bladder via a small catheter) to coat and soothe the bladder lining:

• Cystistat
• Gepan
• Uracyst
• iAluRil
• Hyacyst
• DMSO (Dimethyl Sulfoxide)
• Cystilieve
• Parsons Solutions

3. Bladder training
4. Surgery
5. Nerve Stimulation
6. Bladder stretch
7. Cystoscopy
8. Complementary therapies to relieve pain (acupuncture, psychotherapy etc)

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Sources

• Kilmartin, Angela The Patient’s Encyclopaedia of Cystitis, Sexual Cystitis, Interstitial Cystitis (London: Angela Kilmartin, 2002)
• Gillespie, Larrian You Don’t Have to Live with Cystitis (New York: Avon Books, 1996)
• COB Foundation Bladder Conditions http://www.cobfoundation.org/bladder-conditions (July 2016)
• International Neurology Journal http://einj.org/

1. Kilmartin, Angela The Patient’s Encyclopaedia of Cystitis, Sexual Cystitis, Interstitial Cystitis (London: Angela Kilmartin, 2002), Book 3, p. 1-4
2. Gillespie, Larrian You Don’t Have to Live with Cystitis (New York: Avon Books, 1996), p.56-72
3. COB Foundation Interstitial Cystitis http://www.cobfoundation.org/bladder-conditions/interstitial-cystitispainful-bladder-syndrome (July 2016)
4. Hyun-Jung, KimUpdate on the Pathology and Diagnosis of Interstitial Cystitis/Bladder Pain Syndrome: A Review Int Neurourol J 2016 [20(1): 13-17.] available at: http://einj.org/journal/view.php?doi=10.5213/inj.1632522.261
5. Parsons, CL. The role of the urinary epithelium in the pathogenesis of interstitial cystitis/prostatitis/urethritis. Urology 2007 [69(4 Suppl):9-16.] available at: http://www.ncbi.nlm.nih.gov/pubmed/18082196
6. Kilmartin, Angela So called, interstitial cystitis Nov 2015 http://www.angelakilmartin.com/so-called-interstitial-cystitis/
7. COB IC/PBS Treatments July 2016 http://www.cobfoundation.org/bladder-conditions/interstitial-cystitispainful-bladder-syndrome/icpbs-treatments