Abdominal Pain: Interstitial cystitis

Overview

Interstitial cystitis — also called painful bladder syndrome — is a chronic condition causing bladder pressure, bladder pain and sometimes pelvic pain. The pain ranges from mild discomfort to severe.

Your bladder is a hollow, muscular organ that stores urine. The bladder expands until it’s full and then signals your brain that it’s time to urinate, communicating through the pelvic nerves. This creates the urge to urinate for most people.

With interstitial cystitis, these signals get mixed up — you feel the need to urinate more often and with smaller volumes of urine than most people.

Interstitial cystitis most often affects women and can have a long-lasting impact on quality of life. Although there’s no cure, medications and other therapies may offer relief.

Symptoms

The signs and symptoms of interstitial cystitis vary from person to person. If you have interstitial cystitis, your symptoms may also vary over time, periodically flaring in response to common triggers, such as menstruation, sitting for a long time, stress, exercise, and sexual activity.

Interstitial cystitis signs and symptoms include:

• Pain in your pelvis or between the vagina and anus in women
• Pain between the scrotum and anus in men (perineum)
• Chronic pelvic pain
• A persistent, urgent need to urinate
• Frequent urination, often of small amounts, throughout the day and night (up to 60 times a day)
• Pain or discomfort while the bladder fills and relief after urinating.
• Pain during sexual intercourse.

Symptoms severity is different for everyone, and some people may experience symptom-free periods.

Although signs and symptoms of interstitial cystitis may resemble those of a chronic urinary tract infection, there’s usually no infection. However, symptoms may worsen if a person with interstitial cystitis gets a urinary tract infection.

When to see a doctor

If you’re experiencing chronic bladder pain or urinary urgency and frequency, contact your doctor.

Causes

The exact cause of interstitial cystitis isn’t known, but it’s likely that many factors contribute. For instance, people with interstitial cystitis may also have a defect in the protective lining (epithelium) of the bladder. A leak in the epithelium may allow toxic substances in urine to irritate your bladder wall.

Other possible but unproven contributing factors include an autoimmune reaction, heredity, infection or allergy.

Risk factors

These factors are associated with a higher risk of interstitial cystitis:

• Your sex. Women are diagnosed with interstitial cystitis more often than men. Symptoms in men may mimic interstitial cystitis, but they’re more often associated with an inflammation of the prostate gland (prostatitis).
• Your skin and hair color. Having fair skin and red hair has been associated with a greater risk of interstitial cystitis.
• Your age. Most people with interstitial cystitis are diagnosed during their 30s or older.
• Having a chronic pain disorder. Interstitial cystitis may be associated with other chronic pain disorder, such as irritable bowel syndrome or fibromyalgia.