What is interstitial cystitis?

Interstitial cystitis (IC) is a chronic bladder problem caused by inflammation or irritation of the bladder wall. In IC, scarring of the bladder causes the bladder to stiffen, decreasing the amount of urine it can comfortably hold. IC is sometimes called bladder pain syndrome, or frequency-urgency-dysuria syndrome.

Symptoms vary greatly from person to person, ranging from mild to very severe. Symptoms may appear intermittently or become chronic.

Urgent and frequent urination

The most prominent symptom of IC is the need to urinate frequently. While most people urinate up to seven times per day, people with IC tend to urinate as many as 30 to 40 times per day. Often, the urge to urinate is prompted by only a few drops of urine. Unfortunately, that distracting sense of urgency doesn’t always subside after you go. This symptom can occur all day and throughout the night (nocturia), interrupting your sleep pattern.

Pain and pressure of the bladder and pelvis

If you have IC, you may feel generalized tenderness or pressure in the area of your bladder or throughout your pelvis. You may also experience pain. Sometimes, people with IC also feel discomfort in the lower abdomen, lower back, or urethra. These symptoms may grow more intense when your bladder is full. For some, pelvic pain and discomfort will become chronic.

Pain and pressure in the genital area

A common symptom of IC is tenderness, pressure, or pain in the perineum — the area between the anus and genitals. This is true for both men and women. Women may also have pain in the vagina or vulva.

In men, there may be pain in the scrotum, testicles, or penis. Some people feel constant pain, but for others, the pain comes and goes.

Sexual problems

IC can interfere with your sex life. In women, the bladder is located close to the vagina. This proximity means that IC can result in painful intercourse. Symptoms may intensify during menstruation.

Men may experience discomfort or pain in the penis or scrotum. There may be pain during ejaculation or even the day after ejaculation. Over time, the emotional toll of painful sex can have serious effects on romantic relationships.

Bleeding and ulcers

If you have some of the symptoms of IC, your doctor may refer you to a specialist, called a urologist, for further examination. Using an instrument called a cystoscope, a urologist can get a good view of the inside of your bladder and pinpoint areas of inflammation and scarring that may cause intermittent bleeding. This examination may also uncover a rare type of ulcer called Hunner’s ulcer. This type of ulcer is associated with IC.

You may notice that particular foods or drinks aggravate your symptoms. Many people with IC report an increase in symptoms when they feel physically or emotionally stressed out. According to the Mayo Clinic, although symptoms can worsen with stress, symptoms are not actually caused by stress.

Other triggers include exercise, sexual activity, and sitting for too long. Many women find that symptoms fluctuate with their menstrual cycle.

Some people with IC have fairly minor symptoms, but others experience drastic symptoms that directly impact quality of life. Over time, the persistent urge to use the bathroom can cause some people to shy away from social activities, opting instead for the comfort of home. In the extreme, it can interfere with your ability to attend school or work. Sexual and emotional relationships may suffer. According to the U.S. Department of Health and Human Services, life with a chronic condition like IC may increase your likelihood of developing depression.

Signs and symptoms of IC resemble those of several other conditions. If you have ongoing urinary urgency or pelvic pain, make an appointment to see your doctor. There is no single test to diagnose IC. However, your doctor can rule out or treat urinary tract infection, vaginal infection, sexually transmitted diseases, bladder cancer, and chronic prostatitis.

Medications and lifestyle changes can help to ease symptoms and make it easier to manage life with IC.