Interstitial Cystitis: Signs, causes & treatment!

Interstitial cystitis (IC) which is also known as Bladder pain syndrome is a type of chronic pain that affects the bladder.

Women are five times more prone to have this condition than men.


  • Suprapubic pain
  • Urgent need to urinate
  • Increased frequency of urination
  • Painful sexual intercourse
  • Waking up from sleep to urinate
  • Painful urination
  • Burning sensation in the urethra
  • Pelvic pain
  • Urinary retention
  • Difficulty & discomfort during driving, walking or traveling.


  • Pelvic floor dysfunction
  • Hunner’s ulcer
  • Bleeding
  • Chronic fatigue syndrome
  • Sjogren Syndrome
  • Chronic bacterial prostatitis
  • Low quality of life
  • Depression.


No specific causes are known that lead to interstitial cystitis, some theories are based on:

  • Damaged urothelium/bladder lining;
  • Due to infection of the bladder, excess consumption of soda or coffee & trauma.
  • Due to a deficiency in the glycosaminoglycan (GAG) layer, which leads to impaired protection & allows the irritating substances in urine to breakdown the bladder lining.
  • Interstitial cystitis is also linked with stress, anxiety & panic.
  • Another theory proposes it as an autoimmune disorder, as mast cells present on the bladder lining produce chemicals which attack the bladder lining and damage it.
  • Genetic factors: An antiproliferative agent is secreted by bladders of people with IC  which inhibits bladder cell proliferation.


Some disease/disorders that are found along with IC are:

  • Irritable bowel syndrome
  • Fibromyalgia
  • Allergy
  • Gluten sensitivity
  • Overactive bladder
  • Endometriosis


  1. The diagnosis of IC done primarily by the exclusion of other conditions/diseases that show similar symptoms.
  2. All the physical symptoms, medical history, diet & lifestyle factors of the patients are noted.
  3. Urine analysis for detection of foreign antigens, infectious agents, abnormal chemicals, etc.
  4. Serum Prostate specific antigen test in men.
  5. Ultrasound
  6. Cytoscopy: The endoscopy of the bladder seen by inserting of a scope through the urethra under local anesthesia.


Drugs used:

  • Antihistamine drugs, cimetidine, hydroxyzine
  • Antidepressant drugs, amitryptyline, duloxetine
  • Immunosuppressant drug, cyclosporin  A
  • Oral pentosan polysulfate has shown to repair the lining of the bladder
  • Bladder instillation with heparin & lidocaine
  • Treatment of Hunner’s ulcer by triamcinolone injection
  • Botulinum toxin (Botox)

Invasive procedures:

  • Bladder distension while under general anesthesia, also known as hydrodistention (a procedure which stretches the bladder capacity), provides pain relief & reduces urinary frequency.
  • Bladder instillation in people with Interstitial cystitis with medications like dimethyl sulfoxide (DMSO), heparin, hyaluronic acid, chondroitin sulfate, etc which are efficient in management of symptoms.


  • Bladder augmentation, the surgical alteration of the bladder
  • Urinary diversion, rerouting of the urine flow
  • Transurethral fulguration
  • Resection of ulcer
  • Cystectomy, surgical removal of the urinary bladder
  • Neuromodulation of the affected region by electrical stimulation through TENS, PTNS, percutaneous sacral nerve stimulation.


  • Pelvic floor exercises by physiotherapy & kegel exercise to strengthen the pelvic muscles.
  • Elimination of potential trigger foods like;
  • Coffee
  • Tea
  • Soda
  • Alcohol
  • Chocolate
  • Citrus fruits
  • Hot pepper
  • Artificial sweetners
  • Stopping smoking
  • Lifestyle changes by reducing stress & anxiety management.