Interstitial Cystitis (Painful Bladder Syndrome, Bladder Pain Syndrome)

What is Interstitial Cystitis?

Interstitial cystitis is a chronic inflammation of the bladder wall. It is also called painful bladder syndrome (PBS) or bladder pain syndrome (BPS). The RAND Interstitial Cystitis Epidemiology (RICE) study, published in 2011, found that from 3 – 7% of American women have symptoms that may be interstitial cystitis. The condition occurs about eight times more often in women than in men. (1)

What Are the Symptoms of Interstitial Cystitis?

Patients experience some of all of the following symptoms:

• Frequency – urinating often throughout the day and/or night
• Urgency – feeling the need to urinate immediately, which can occur with a sense of pain, pressure, or spasms
• Pain – the abdomen, urethra or vaginal area can be tender or have sharp or stabbing pains. Pain may be frequently associated with sexual intercourse or menstrual periods (1, 2)

How is Interstitial Cystitis Diagnosed?

Diagnosis is generally made through a process of elimination, since symptoms may be similar to other conditions, such as bacterial cystitis or overactive bladder. Diagnostic tests can include urodynamics, to assess the bladder’s function and efficiency, or cystoscopy, a procedure to examine the lining of the bladder.

The exact cause is unknown although it could be due to a defective bladder lining, changes in nerves that carry bladder sensations, or an autoimmune disorder. (3)

How is Interstitial Cystitis Treated?

There are no cures but over time, most patients can find a treatment plan that helps them feel better.

The most conservative measures include bladder retraining, stress reduction, dietary changes, and wearing loose clothing. Over-the-counter painkillers may help relieve mild pain. A prescription medication, pentosan polysulfate sodium (Elmiron) can help ease symptoms in about one-third of patients although it may take up to six months before improvement is noted. Sometimes amitriptyline is also prescribed (an antidepressant that can help increase bladder capacity and block pain). (3)

Procedures that may be used include bladder instillation (a bath or wash of the lining), in which the bladder is filled with medicine and then emptied for about 6 – 16 times over the course of 6 – 8 weeks. Sacral nerve stimulation is sometimes also considered. Finally, if other treatments have failed and the pain is disabling, surgery may be an option although it may not ease symptoms. (3)

References:

1. Sandra H. Berry, Marc N. Elliott, Marika Suttorp, Laura M. Bogart, Michael A. Stoto, Paul Eggers, Leroy Nyberg, J. Quentin Clemens. Prevalence of Symptoms of Bladder Pain Syndrome/Interstitial Cystitis Among Adult Females in the United States. The Journal of Urology - August 2011 (Vol. 186, Issue 2). Pages 540-544.
   
   
2. National Institute of Diabetes and Digestive and Kidney Diseases. Interstitial Cystitis/Painful Bladder Syndrome. Accessed Jan. 13, 2013.
   
   
3. U.S. Department of Health and Human Services Office on Women’s Health. Interstitial cystitis/bladder pain fact sheet. Accessed Jan. 13, 2013.

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