It is a chronic inflammatory condition of the bladder with unclear etiology. The mucous layer inside bladder is believed to be damaged, which may allow irritating substances in the urine to aggravate and inflame the bladder wall, resulting in pain.

Symptoms

  • Unpleasant sensation (pain, pressure, discomfort) perceived to be related to the urinary bladder, associated with lower urinary tract symptoms of more than 6 weeks duration, in the absence of infection or other identifiable causes;
  • Pressure or pain occurs in the urethra, vagina, pubis, inner thighs, lower abdomen, lower back, groin, or combinations of the above;
  • Sexual dysfunction due to pain;
  • feeling the urge to urinate, sometimes even if there’s nothing left in the bladder;
  • urinary frequency;
  • urinary tract infection (UTI) or being diagnosed with more than 2 UTIs per year;
  • symptoms that come and go
  • flare-ups associated with menstruation, certain foods, allergies or stress

Diagnosis

  • Urinalysis and urine culture: to rule out genuine bacterial infection which may mimic symptoms of IC
  • Potassium sensitivity test: Most patients with IC respond positively to the PST; however, a small percentage of patients with IC have a negative result, and the reason for this is not known.
  • Cystoscopy: Many patients with IC have changes seen in the bladder but some have not.
  • Urodynamics
  • Symptom questionnaires
  • Voiding diary

Treatment
Comfort measures

  • Some people find that a warm compress or heating pad on the lower abdomen helps. Others find that a cold pack may help. For pain in the external genitalia, a bath in warm water with baking soda or Epsom salts may be soothing. The patients should speak to the doctors to see if these comfort measures are right for them.
  • Changing the diet may help, so the patients should review what they are eating by recording in a food diary. Some patients will experience flare-ups of their IC for as long as 3 days after they have eaten certain foods, which include:
  • Foods and drinks that contain caffeine, such as chocolate, coffee, tea and soft drinks
  • Fermented foods and drinks, including cheeses and alcohol
  • Aged, canned, cured, processed, and smoked meats and fish; anchovies; caviar; animal livers; corned beef; and meats that contain nitrates or nitrates.
  • Fava beans, lima beans, onions, rhubarb and tofu
  • Rye and sourdough breads
  • Most nuts except for almonds, cashews and pine nuts
  • Spicy foods (especially Chinese, Mexican, Indian and Thai foods).
  • Acidic items, such as oranges, tomatoes and cranberry juice.
  • Foods and drinks containing some artificial sweeteners, such as aspartame or saccharin.
  • Preservatives, such as citric acid and monosodium glutamate (MSG)

Medical therapy

  • Pentosan Polysulfate Sodium (Elmiron) is one of oral medication. The most common side effects would be blood in stool, diarrhea, nausea, hair loss, headache, rash, upset stomach, abdominal pain, liver function abnormalities and dizziness.
  • Antihistamines
  • Antidepressant
  • Intravesical therapy
    • With intravesical therapy, normal saline or medication is instilled directly into the bladder. In intravesical therapy for IC, the bladder is filled with a solution that is held for varying periods of time, averaging 30 minutes, before it is then emptied.

Surgical treatment: e.g. hydrodistension