What is Interstitial Cystitis?

Interstitial cystitis (IC) is a chronic, clinical syndrome characterized by the urgent and frequent need to urinate in combination with the sensation of pelvic pain in the absence of any identifiable infection or other cause. Many women also have painful intercourse, or pain immediately following sexual intercourse. Women can be affected by this condition at any age, but the average age of onset is 40. Twenty-five percent of patients with IC, however, are under the age of 30.

Estimates have been that it may affect up to 700,000 Americans, 90% of whom are women. However, many more women may be affected than previously identified.  A recent study in the Women's Health Care: A Practical Journal for Nurse Practitioners (July 2005) surveyed over 1,600 women nurse practitioners to identify the prevalence of IC in this group. Their results were based upon the self-reported scores of the PUF questionnaire, a validated questionnaire for IC which assesses pelvic pain and urinary urgency/frequency. According to this study, 6% of the respondents were likely to have IC and up to 23% of the nurse practitioners themselves were "possible" IC patients. 

The cause is IC unknown and it is difficult to identify. This contributes to significant psychological, social and hygienic problems for patients with IC. The good news is that there is are ways to diagnose, manage and treat IC. While there is no cure for IC, the majority of patients who are properly diagnosed and treated may obtain relief.

Proper diagnosis is the challenge. IC is frequently misdiagnosed as an acute urinary tract infection (cystitis), a disorder that can be successfully treated with antibiotics. While many patients describe IC as "the worst bladder infection of my life" or as "the bladder infection that wouldn't go away", IC characteristically does not respond to antibiotics. While IC is the most common cause of chronic pelvic pain, it is frequently confused with other causes of chronic pelvic pain, including endometriosis and irritable bowel syndrome. Of course, the diagnosis is further complicated by the fact that many patients may have IC in addition to one of these other conditions.

Several treatment options that may help relieve symptoms of IC include:

• The IC Diet: Keep diet low in acidic foods, and avoid caffeine (coffee, tea, carbonated colas) and alcohol.
• Prelief®, a dietary supplement, may help to reduce the symptoms of IC by reducing the acids in foods and beverages.
• Stress reduction techniques, such as biofeedback and pelvic floor relaxation exercises
• Bladder retraining, once pain is under control
• Bladder hydrodistention
• Elmiron® (pentosan polysulfate sodium):  the only FDA approved oral medication specifically to treat IC
• Other oral medications such as tricyclic antidepressants, antispasmodics, anti-inflammatories and antihistamines
• Opioid analgesics - for severe IC pain
• DMSO (dimethyl sulfoxide) - medication instilled into the bladder

Created: 8/8/2005  -  Donnica Moore, M.D.