Interstitial cystitis or IC is an inflammatory condition of the bladder wall. The etiology is unknown and the condition may present with multiple and varied symptoms making the diagnosis ofiC are often one of exclusion. Most IC patients complain of persistent bladder pain, pressure or discomfort, urinary frequency (need to go) and urgency (the strong desire to go). Other overlapping conditions include Painful Bladder Syndrome (PBS), Bladder Pain Syndrome (CPS) and chronic pelvic pain, overactive bladder, and Pelvic floor dysfunction.
There are two subtypes ofiC recognized by the National Institute of Health (NIDDK) Ulcerative IC 5% and nonUlcerative IC 90%. The ulcerative IC is identified by the presence of Hunner’s ulcers (red, bleeding, irritative areas seen on the bladder wall on cystoscopy. NonUlcerative IC does not have identifying ulcers but may have pinpoint petechia (glomerulations) These findings are not specific for IC making the diagnosis difficult for clinicians.
End Stage IC refers to persistent symptoms for more than 2 years with a decreased bladder capacity and terrible pain. An interview with internationally known IC expert Kristene Whitmore, MD of the Pelvic and Sexual Health Institute of Philadelphia may be seen on ICHelp YouTube.
Diagnosis of IC
There is no definitive test to diagnosis interstitial cystitis. Doctors will rule out other bladder conditions such as infection, chronic pelvic pain/pelvic floor dysfunction, bladder cancer or chronic prostatitis in men. The diagnosis ofiC is based on the presence of pain related to the bladder, usually accompanied by frequency and urgency and the
absence of other diseases that could cause the symptoms.
- History and Physical Exam including pelvic and rectal exam.
- Cystoscopy with Hydrodistention
- Urodynamic Testing (Bladder pressures measurements with bladder filling)
Interstitial cystitis flare-ups are related to a handful of foods and beverages.
- Coffee, tea, soda, alcohol, citrus juices and cranberry juice ( acidic foods)
- Foods and beverages containing artificial sweeteners
- Hot peppers and spicy foods
Studies have consistently found that there are great variations among IC patients. The Foods, combinations, and amounts are unique for the individual patient. Milk allergies, Lactose intolerant, gluten intolerance may play a role.
For further information see:
- AUA and ACOG Clinical Guidelines
- Long Island IC Diet Study
- USF IC and Diet Study
- ICA complementary and Alternative Medicine (CAM) Survey 2009
- IC Interstitial Cystitis and Diet Survey 2004