Do you have pressure in your bladder that just won’t go away? This type of chronic bladder pain is different from the spasms you may get with a condition such as overactive bladder or a urinary tract infection (UTI).
Bladder pressure feels more like constant ache rather than a muscle contraction. Doctors typically attribute bladder pressure to interstitial cystitis (IC). IC is also known as bladder pain syndrome.
Here’s more about this syndrome, its causes, and how to get relief from the pressure.
The most noticeable symptom of IC is pain and pressure in the bladder. The pain you experience may range from mild to severe. For some, the pressure can come and go. For others, the feeling doesn’t let up.
These symptoms may lead you to think that you have a bladder infection, but IC isn’t an infection at all. It’s a chronic condition, which means that there isn’t cure.
Other symptoms of IC include:
- pelvic pain
- urination in small amounts, frequently throughout the day
- constant need to urinate
- pain while bladder is full and relief when it’s emptied
- pain during sex
Signs and symptoms vary. Some people may need to urinate up to 60 times each day. You may also experience periods of time when you have no symptoms.
Although IC isn’t a UTI, getting an infection can make your symptoms worse.
Doctors aren’t sure what exactly causes IC. What they do know is that the bladder normally fills and then tells your brain to use the bathroom. It communicates this through the nerves in your body.
With IC, these signals get mixed up. You may feel like you need to urinate more frequently but without a lot of urine at each bathroom trip.
Bladder pressure may also be caused by:
- a defect in the lining of the bladder
- an autoimmune reaction
IC is more common in women than in men. Some people who have IC, also have other health issues such as irritable bowel syndrome (IBS) and fibromyalgia. Other pain syndromes are also possible.
People who have both fair skin and red hair also have a greater risk of IC.
IC is primarily diagnosed in people in their 30s or older.
If you have bladder pressure and feel like you need to urinate frequently, it’s a good idea to make an appointment with your doctor. In some cases, these symptoms may be signs of a UTI. If you truly have IC, your doctor should still be able to help.
Your doctor may ask you to start keeping a log of your symptoms to bring to your appointment. You should write down how much you drink, how much you urinate, and any pain or pressure you experience.
At your appointment, you will first assess your medical history. They’ll also perform a pelvic exam and test a urine sample to rule out infection.
Other tests include:
Cystoscopy: Your doctor will insert a thin tube into your urethra to look at the inside of your bladder. You’ll be numbed beforehand, so this procedure shouldn’t hurt.
Biopsy: Your doctor will put you under anesthesia. Then, they’ll take some tissue from your bladder and urethra for examination. Your doctor will check the tissue for symptoms of bladder cancer and other causes of pain.
Urine cytology: This urine sample test allows your doctor to examine the cells for cancer.
Potassium sensitivity test: After placing water and potassium chloride into your bladder, your doctor will ask you to rate your pain and need to urinate on a scale from 0 to 5. People with “normal” bladders usually can’t tell a difference between the two solutions. If you’re more sensitive to the potassium chloride, it may indicate IC.
There are a variety of treatment options that you may try alone or in combination:
Physical therapy: Working on muscle tenderness and connective tissue issues in your pelvic floor may help relieve pain.
Prescription medications: Your doctor may prescribe a tricyclic antidepressant to help relax your bladder or an antihistamine to help with urgency.
Nerve stimulation: This includes options for transcutaneous electrical nerve stimulation (TENS) and sacral nerve stimulation. These procedures can help with anything from pain to urgency to frequency of urination.
Bladder distention: This is a fancy way of saying that your doctor may stretch your bladder with water. Similarly, some people notice that their symptoms improve after having a cystoscopy test, which fills the bladder with liquid.
Instilled medications: These medications are put directly into your bladder through a tube inserted into your urethra. The medication is usually left inside your bladder for around 15 minutes. You repeat this process weekly for six to eight weeks.
Acupuncture and guided imagery are alternative medicine routes that show promise. They haven’t been tested enough to show their true effectiveness, but your doctor may have more information if they interest you.
There isn’t a cure for IC, but medications and other treatments can help improve your quality of life. If your pain, pressure, and urgency are starting to affect your everyday activities and relationships, visit your doctor.
It’s important to rule out infection because a UTI can make IC symptoms worse.
Without treatment, IC can lead to complications:
- The walls of your bladder may stiffen and lead to reduced bladder capacity. This means it will be able to hold less and less urine over time.
- Urination may become so painful that it affects your quality of life and your daily activities.
- Pelvic pain can affect your sex life and personal relationships.
- Disrupted sleep from pain and frequent urination may cause emotional issues. You may feel stressed and depressed.
Some people manage their symptoms by changing parts of their lifestyle. For example, avoiding irritating foods and beverages can improve your symptoms.
- artificial sweeteners
- pickled foods
You may find it beneficial to eliminate the “four Cs” from your diet. This includes carbonated beverages, caffeine, citrus fruits and foods, and high concentrations of vitamin C.
Keeping a food diary may help you discover your own unique triggers. To do this, record what you eat, and in what quantity, throughout the day. Be sure to note any symptoms you may feel afterward.
Other steps that may help include:
Tips and tricks
- Train your bladder by timing your urination. Going to the bathroom on a schedule may help train your bladder fill up more regularly, increasing the time between trips. You can also work on techniques that help you control urgency, such as breathing exercises and distracting yourself.
- Wear loose clothing. Belts and tight clothes may put pressure on your stomach and increase your symptoms.
- Stop smoking. It may make your body more prone to bladder cancer and can increase your pain.
- Exercise regularly. Stretching, may help reduce your IC symptoms.