Interstitial Cystitis, also referred to as IC or BPS (Bladder Pain Syndrome), is a fairly common bladder condition that affects millions of men and women from all over the world. The average age of IC onset is 40, with only 25% of patients being under the age of 30.

The hallmark symptom of Interstitial Cystitis is pain, which can be felt in the abdominal and pelvic regions as well as in other areas, such as the urethra, vagina, vulva, testicles, penis, or even rectum. Individuals with IC also often say that their pain will increase as their bladder fills with urine. While pain during urination is rare with this diagnosis, Interstitial Cystitis can cause things like urination urgency or frequency, which affects anywhere from 84% to 92% of patients. Some patients may also develop something called nocturia. This is when the urgency to urinate is more prevalent in the evenings — as often as every 15 minutes — which can then lead to sleep deprivation. Intimacy can also be an issue when Interstitial Cystitis is involved. For women, pain can occur during sexual intercourse or occur 24 to 48 hours following it, while men with Interstitial Cystitis can experience pain during ejaculation. These symptoms of IC can range from mild to severe. In some cases they may persist, while in others the symptoms may go into remission for anywhere from 1 month to a few years before flaring up again.

There are different subtypes and phenotypes related to Interstitial Cystitis. For example, IC: Hunner’s Lesions and BPS: Non-ulcer. Hunner’s lesions, which is considered “classic” IC, is also the most severe form and results in lesions, bleeding and damage to the bladder wall. When biopsied, these lesions will usually show signs of inflammation. With BPS: Non-ulcer, patients will usually have a normal bladder but still struggle with pelvic pain as well as tight muscles or an injured bladder wall. Because the pain can vary, it can be harder to treat patients that fall under this category. Other subtypes include bladder wall injuries (with symptoms starting after a patient has had a urinary tract infection, been exposed to certain chemicals, chemotherapy, or from an unhealthy diet) and pelvic floor injuries (due to childbirth or other pelvic trauma), pudendal neuralgia (tight muscles which can make sitting painful.) Patients with Interstitial Cystitis can also develop something known as Functional Somatic Syndrome. Someone with this condition will not only struggle with the symptoms of IC, but may also have a wide range of other health issues such as irritable bowel syndrome, fibromyalgia, and neurosensitivity.

Because Interstitial Cystitis can be so debilitating and cause a decline in one’s quality of life, it’s not uncommon for those with a diagnosis to develop anxiety and other mental health related issues, like depression. Your mental health matters as much as every other aspect of your health, so if this happens to you then it’s important that you tackle it sooner than later.

As for how Interstitial Cystitis is treated, pain management is a key factor. Non-steroidal anti-inflammatory drugs (NSAIDs) can be helpful in treating mild to moderate symptoms, as well as urinary analgesics which are specifically designed for treating pain associated with the urinary tract, such as burning, as well as the increased need to urinate. In cases where the pain from Interstitial Cystitis is severe, narcotic medications may be prescribed. However, it’s important to note that these are not recommended for long-term use as they can be habit forming; therefore, patients who do take these medications need to be closely monitored by their prescribing physician. Furthermore, when dealing with Interstitial Cystitis, it is also not recommended that narcotics be used as a standalone treatment. Instead, other therapies should also be explored. There are many medications on the market that were not originally designed with Interstitial Cystitis in mind, but have shown to have a significant impact on treating the symptoms associated with IC. These medications include certain tricyclic anti-depressants, medications used to inhibit acid production, and even certain antihistamines.

Diet can also play a major role. Certain foods and beverage, such as those that are acidic (i.e. citrus fruits and vinegar), foods high in potassium (such as bananas and yams), artificial sweeteners, chocolate, gluten, foods containing MSG, nitrites and nitrates, carbonated beverages, alcohol and caffeine have all been known to be foods that can potentially irritate the bladder. Instead, swap them for things that are less bothersome, such as water, low-fat milk, blueberries, watermelon, carrots, zucchini, salmon, beef, pork, chicken, and oats.

For more information on how Interstitial Cystitis is treated, self-help tips, and other resources, visit www.ic-network.com.

Dr. Ali Ghahary is a Family Physician in Vancouver, British Columbia, Canada. http://www.alighahary.ca