What is Interstitial Cystitis?

All You Need to Know About Interstitial Cystitis

Interstitial cystitis is also known as bladder pain syndrome. The bladder is an organ that is connected to the urinary tract system, which includes the kidneys, ureters, bladder, and urethra. Interstitial cystitis can cause people to experience pain in the bladder and forces them to urinate often. 

Continue reading to learn more about interstitial cystitis, as well as as its causes, symptoms, cystitis treatment options, and medications.

Interstitial Cystitis Causes

Interstitial cystitis is more common in females but can occur in both men and women. The cause of interstitial cystitis is unknown, but doctors have linked the illness to the following conditions:

• A urinary tract infection

• An infection in the vagina 

• An infection in the prostate

• An injury to the pelvic area or buttocks

• Surgery on the bladder, pelvis or back

If you suspect you have an infection, timely consultation with a healthcare professional is crucial. Usually, interstitial cystitis starts after a patient has experienced one of those conditions. Some doctors suspect that symptoms are caused by abnormal changes in the lining of the bladder. In such cases, a UTI prescription may be recommended.

Interstitial Cystitis Symptoms: What to Look For 

All people with interstitial cystitis have bladder pain that gets better after urinating. Symptoms of interstitial cystitis can vary from mild to severe. Bladder pain may be felt in the lower belly area or around the area where urine leaves the body (the urethra). 

Other common symptoms include:

• Feeling the urge to urinate during the day or night even if you do not actually urinate

• Urinating often during the day

• Urinating often during the night

People might not have symptoms every day. But they can have "flares," which are times when their symptoms get worse. Flare ups can be caused by certain food or drinks. 

Some people find that their symptoms get worse at certain times, such as:

• During menstrual cycles (in women)

• After having sexual intercourse

• After sitting for a prolonged period of time

• During times of stress

It is advised to avoid certain exercises, recreational activities, sexual activities, or body positions that seem to worsen bladder symptoms. A symptom diary may be useful for some patients to self-identify such factors so that they can be avoided.

Interstitial Cystitis Diet: Foods to Avoid

Bladder pain syndrome can be exacerbated by certain food and drinks. Certain foods and drinks are known to aggravate interstitial cystitis. 

Food to avoid due to exacerbation risks include:

• Caffeine

• Alcohol

• Artificial sweeteners

• Hot peppers

• Foods containing Vitamin C 

The Interstitial Cystitis Association (ICA) provides online diet advice for patients as a resource. Overall, the ICA suggests: 

• Having a variety of foods in your diet

• Eating in moderation 

• Drinking adequate fluids

• Monitoring your sugar intake

• Staying away from saturated and trans fats

Interstitial Cystitis Diagnosis

There is not a specific test to diagnose interstitial cystitis. Your doctor may perform certain other  tests and gather information from you to determine if you have bladder pain syndrome. You will most likely have to provide a urine sample.

A cystoscope is a diagnostic study that may be performed. This test examines the bladder for any abnormalities, especially in the lining. During a cystoscopy, a doctor puts a thin tube with a tiny camera on the end into the opening in the body where urine comes out (called the urethra). 

Then, the doctor advances the camera until the bladder is reached. This allows the doctor to look at the inside of the bladder to see if there is anything abnormal. 

Interstitial Cystitis Treatment

There are different treatments for interstitial cystitis, including pharmacological and non-pharmacological practices. Most people need more than one treatment. Different treatments can include:

• Bladder training

• Physical therapy 

• Medicines 

• Surgery 

You can train your bladder to urinate less often by holding your urine for longer periods of time. For example, if you feel the need to urinate every 45 minutes, try to wait and urinate every 60 minutes.

Many people with interstitial cystitis have tight and painful muscles in the lower belly, groin, and buttocks. A physical therapist can teach you exercises to help relax these muscles.

The last resort is surgery if a person still has symptoms after trying all other treatments. During surgery, a doctor puts a small device in the lower back that connects to the nerve that goes to the bladder. The device sends electrical signals to the nerve that can stop it from feeling pain.

Interstitial Cystitis Medications

Doctors can use different medicines to treat interstitial cystitis. Some medicines help heal the bladder lining, and others can reduce pain.

A medication called amitriptyline is the first-line therapy for interstitial cystitis. It is considered a tricyclic antidepressant medication. Amitriptyline helps treat interstitial cystitis as well as depression associated with chronic pain.

You can meet with a doctor at PlushCare to get a amitriptyline prescribed. The typical dose for amitriptyline therapy is 10 mg at bedtime and can be prescribed up to 75mg. 

Side effects of amitriptyline include:

• Dry mouth

• Urinary retention

• Constipation

• Sedation

• Weight gain

• Orthostatic hypotension

• Heart arrhythmias

It takes about 4 weeks of pharmacologic therapy before you see results. This is because the medication has to build up in your system.

For people who do not respond well to amitriptyline, there are other oral medications to take. These medications include:

• Pentosan polysulfate sodium (PPS)

• Hydroxyzine

• Ibuprofen

• Acetaminophen

• Tramadol

• Phenazopyridine

• Methenamine

• Cimetidine

• Sildenafil

Can Interstitial Cystitis Flare-ups Be Prevented? 

Yes, interstitial cystitis flare-ups can be prevented by:

• Avoiding food and drinks that worsen symptoms

• Avoiding activities that exacerbate symptoms

• Getting treated quickly for bladder infections

Talk to a Doctor About Interstitial Cystitis Online

Talk to your PlushCare online doctor if you have symptoms of interstitial cystitis. Your PlushCare provider can help you come up with a treatment plan.

Your PlushCare doctor will work with you to determine the best medication for you to take and will check on you to ensure the care plan is working. Do not wait for your symptoms to get better on their own.

You can book an appointment or download the free PlushCare mobile app. The average appointment lasts just 15 minutes and 97% of conditions are successfully treated on the first visit.

Sources

• Mayo Clinic. Interstitial Cystitis Management. Accessed on December 10, 2020. https://www.mayoclinic.org/diseases-conditions/interstitial-cystitis/diagnosis-treatment/drc-20354362

• Interstitial Cystitis Association. Living with IC. Accessed on December 10, 2020 https://www.ichelp.org/living-with-ic/interstitial-cystitis-and-diet/