Interstitial Cystitis (IC)

Interstitial Cystitis, or IC, can be a frightening diagnosis for many patients. It’s too often considered an umbrella diagnosis, meaning we’ve ruled out simple infection, we’ve ruled out anatomic abnormalities or tumors, and we’ve ruled out coexisting medical problems. However, the term IC, in the past, has been overused and, in large part, has now been substituted with the diagnoses of chronic pelvic pain syndrome and overactive bladder (OAB). It is a real and severe disease, and we tend to be very judicious in who we assign this diagnosis to. It’s estimated in the US that, up to eight million women and four million men are affected by IC.

Symptoms & Diagnosis of IC

IC can present very similarly to a urinary tract infection (UTI); however, there will be no evidence of bacteria. The hallmark symptom of IC is pain with a full bladder, and patients thus will complain of frequent urgent urination, bladder pain, urethral issues, pelvic pain, and even painful intercourse. The severe case of interstitial cystitis will often be confused with cancer on a CT scan, with the lining of the bladder looking like a bloodshot eye with the potential presence of ulcerations. There are lesser gradations of this disease, but IC should not be diagnosed merely in the presence of frequent urination. When one sees an IC bladder, it is not hard to understand why patients will frequently urinate in an attempt to keep their bladder empty.

Causes of IC

We don’t know what exactly causes IC. Theories suggest a disruption in the bladder lining, which allows substances within the urine to cause irritation. This irritation leads to inflammation. However, in patients with IC, the inflammation doesn’t end. We also see a higher prevalence of IC in patients with autoimmune disorders – fibromyalgia, IBS, etc. – conditions that are associated with whole-body inflammation. Of course, these are all unexplained chronic pain syndromes.

Next Steps

If you’re having symptoms of frequent, urgent urination or pelvic pain, it’s important to schedule a consultation with your urologist for a better understanding of what may be available to you. Unlike when IC was first understood, various forms of treatment are available for patients. These include dietary and behavior modifications, pelvic floor physical therapy, oral medication, bladder neuromodulation, and even outpatient surgical procedures.