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Interstitial Cystitis/Painful Bladder Syndrome

Woman with painful bladder syndrome

Overview of painful bladder syndrome

Painful bladder syndrome is chronic bladder pain with a cause that cannot be determined. The goal of treatment is to relieve symptoms. Patients with painful bladder syndrome often have other pain syndromes as well, such as fibromyalgia. This condition is relatively uncommon, affecting between 1-6% of women and even fewer men.

The cause of painful bladder syndrome is largely unknown, by definition. The best evidence tells us that there is some unusual gene expression and cellular structures in the bladder and surrounding tissue. Because of this abnormal structure, irritating substances in the urine that the body is getting rid of are thought to penetrate the bladder wall, leading to tissue damage and pain. The nerves may also be overactivated so the body senses pain in the absence of actual damage. Painful bladder syndrome may occur following an injury to the area, and there appears to be a pattern of genetic susceptibility.

What is Painful Bladder Syndrome – Interstitial Cystitis?

Chronic bladder pain and/or urinary symptoms with an unknown cause is descriptively named painful bladder syndrome or interstitial cystitis. Pain of this type feels dull, achy, or like there is constant pressure in the area of your bladder. Many patients also have to urinate frequently or wake up more than once a night to go to the bathroom, even without consuming large amounts of water.

Most Common Signs and Symptoms
  • Pain or pressure in the lower abdomen
  • Frequent urge to urinate
  • Waking up to urinate during the night
  • Painful urination
  • Sensation of bladder spasms
  • Increased discomfort with a full bladder
  • Improved discomfort following urination
  • Painful sexual intercourse


Woman with painful bladder

Why does Painful Bladder Syndrome/Interstitial Cystitis happen?

Bladder infections are a common problem that many people have experienced at one time or another in their lives. However, chronic bladder pain may be a different problem called interstitial cystitis. This condition is more often found in women over the age of 30 and can significant reduction in quality of life. A number of treatment options are available to provide relief from discomfort.

Interstitial cystitis is believed to be caused by irritation of the epithelium, the protective lining inside the urinary bladder. This lining may develop small cracks that allow urine and substances within the urine to cause irritation. The irritation then causes symptoms of pain, frequent urge to urinate, general pelvic pain, discomfort when the bladder is full, urgency, and pain during intercourse. The severity of symptoms may come and go or may be chronic. Physicians recognize a number of risk factors for this condition:

  1. Gender – Women are twice as likely to develop the condition than men. 
  2. Age – The condition generally strikes people who are over the age of 30.
  3. Presence of Other Chronic Pain Conditions – Patients who have other pain conditions such as fibromyalgia or irritable bowel syndrome may also have interstitial cystitis.

Diagnosing the Problem

Making an accurate diagnosis of interstitial cystitis can be difficult. Cystoscopy is a test that views the interior of the bladder to determine if there are any irregular growths that are causing the urinary symptoms. Sometimes, lesions are found on the lining of the bladder that can contribute to bladder discomfort. Another test to determine the capacity of the bladder to hold urine may also be done. However, physicians generally diagnose interstitial cystitis by the patient’s reporting of symptoms and by eliminating other possible causes of urinary discomfort.

Treatment Options

Relieving the discomfort associated with interstitial cystitis involves utilizing a number of different therapies. Physicians may recommend taking over-the-counter, non-steroidal anti-inflammatory medications such as ibuprofen or naproxyn. A medication called pentosan polysulfate sodium is used to help rebuild the lining of the bladder to relieve pain. However, this medication can cause gastrointestinal upsets and reversible hair loss. Hydroxyzine, an antihistamine, can also be helpful for these patients. A variety of different antidepressant categories can also be used to relieve bladder discomfort. For some patients, instilling medications directly into the bladder can be helpful. These medications include heparin, sodium hyaluronate, and dimethyl sulfoxide.

Woman without a painful bladder

Complementary Remedies

Many patients with interstitial cystitis report that certain foods seem to increase the discomfort. Acidic foods such as citrus products and tomatoes are among these irritants, as well as chocolate and caffeine-containing foods. Many patients also find that voiding the bladder regularly throughout the day can help to relieve symptoms. Stress reduction techniques such as meditation and biofeedback can also help patients to deal with chronic discomfort. Acupuncture and massage therapy is used to help patients deal with chronic urinary discomfort. A number of supplements are also available that contain ingredients that help to soothe bladder irritation, such as cranberry, aloe vera, quercetin, and other compounds.

Communicating with your practitioner

You are encouraged to make an appointment with your Primary Care Provider or OBGYN if you are bothered by any of the common symptoms of above. You know your own body. Together with their medical knowledge, you can get the correct diagnosis and advice for the most effective management of your unique circumstances. The right doctor will be a partner in decision making and will make you feel heard, respected, and in control of your health.

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