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Interstitial cystitis (IC) is a chronic inflammation of the bladder that causes pain and discomfort. Symptoms can include a sense of urgency and increased frequency of urination.
Inflammation associated with IC causes the lining of the bladder to scar and the bladder to stiffen, affecting the way the bladder expands when it fills with urine.
In about 90% of cases, there is bleeding visible in the lining. In about 10% of cases, there are ulcers or sores called Hunner’s ulcers.
IC can causes mild to severe pain in the bladder, as well as the pelvic area. In women, the pain tends to worsen during menstruation and they may also experience painful intercourse. Men may have painful ejaculations and even erectile dysfunction.
The symptoms go away spontaneously in about 50% of cases, but in nearly all return after an average of 8 months.
In the UK, it is thought that over 400,000 people suffer from interstitial cystitis. Generally, a healthy adult does not urinate more than 7 times a day and will rarely need to get up to go to the toilet in the middle of the night. However, some suffering from severe IC, may need to urinate as often as 60 times in 24hrs, including in the night. Although IC has no cure, there are several treatment options available to ease symptoms and help patients manage their lives better.
IC can develop at any age, but it is more likely to develop in middle age and is more common in women. Many people with IC also have conditions such as fibromyalgia or IBS. Other than being female, there aren’t any known factors that increase the risk of developing IC and there is no known way to prevent it or the symptoms from recurring after it goes into remission.
No one really knows what causes IC and because it varies from person to person, specialists believe there may be multiple causes such as:
The urine of people with IC contains a substance known as antiproliferative factor (APF), which appears to block the development of cells in the bladder lining. Therefore it could be that some people are predisposed to get interstitial cystitis after an infection or injury to the bladder
Symptoms of interstitial cystitis vary from individual to individual. Some people may have only a mild sense of urgency while others have multiple symptoms. Any of the following symptoms could indicate the presence of IC:
There is no one test that is specific for interstitial cystitis. Because other conditions can cause the same symptoms, a diagnosis is made only after other possible causes are ruled out. Other conditions that can cause the same symptoms include:
The doctor will start by asking you about your symptoms. Then the doctor will give you a physical examination and arrange a series of tests to rule out other possible causes. Those tests include:
Because there is no cure for interstitial cystitis, the goal of treatment is to relieve symptoms. Not everyone with IC responds the same way to the same treatment. What works for one person may not work for another. In addition, IC treatments generally take several weeks to several months to provide relief. When you discuss your treatment options, your doctor will help you decide which one might work best for you. Treatment options include:
None of the IC treatments work immediately, and it can take weeks or months before the symptoms improve. Because interstitial cystitis is a chronic condition, most patients need to continue treatment indefinitely to keep the symptoms from returning. It’s also important to note that not all patients will become symptom-free. Many still have an issue with frequency or with some level of persistent discomfort.
There are several things you can do on your own or with the help of a physiotherapist that can improve your symptoms.