Interstitial cystitis (IC) is a chronic bladder condition that results in recurring discomfort or pain in the bladder or pelvic area.

IC can cause a lot of stress and greatly affect the patient’s mental health as well as their ability to maintain a healthy social life.

Unfortunately, this condition is often overlooked or misdiagnosed. Patients may experience symptoms for years, unaware of what’s really causing their pain and discomfort.

Patients often confuse their condition with urinary tract infection (UTI). But there is a huge difference between a UTI and IC.

As pelvic floor physical therapists, we see a lot of patients with interstitial cystitis and we have treatment options available.

In this article, we’re going to break down the most common symptoms of this condition and the treatment methods we use at FemFirstHealth to treat our patients.

What is interstitial cystitis?

Interstitial cystitis (IC), sometimes called painful bladder syndrome (PBS), is a chronic bladder condition that results in recurring discomfort or pain in the bladder or pelvic area.

It’s not unusual for people who have IC/PBS to urinate as often as 50 times in a single day — almost 7 times the normal frequency.

This frequency and urgency to urinate happens not only during the day but also at night during sleep (known as nocturia).

Having IC/PBS can ruin quality of life as a lot of time is wasted on trips to the bathroom. This makes it almost impossible to hold a full-time job, especially while commuting somewhere like New York City.

And because of IC’s similarities to UTI, the two are often confused, despite the latter being a milder condition.

This confusion leads people with IC/PBS to underestimate the severity of their condition, taking them longer to seek medical help.

Urinary Tract Infection (UTI) vs. Interstitial Cystitis (IC)

A telltale sign that you have UTI instead of IC/PBS is that you have bacteria in your urine. To know for sure, take a clinical urine test. If the results of the urine culture test are negative, then you might have IC and not UTI.

Consult a medical professional if you think you might have interstitial cystitis.

Dyspareunia (or painful sex) is also a symptom not commonly associated with UTI but it is a common symptom of IC.

What are the causes of interstitial cystitis?

It isn’t clear yet why IC/PBS occurs, but there are several theories:

• The immune system mistakenly attacks the bladder (an autoimmune response)

• The presence of mast cells, which release histamine and other chemicals, leading to IC/PBS

• Bladder injuries, such as infection may increase the risk of IC/PBS

IC could also be caused by heredity. If you have a family member with IC/PBS, there is a chance that you could inherit it.

What are symptoms of interstitial cystitis?

Below are some of the most common symptoms of IC/PBS:

• Urinary frequency: This is perhaps the most burdensome symptom of all and is one of the hallmark symptoms of IC/PBS. For people with IC/PBS, it is not unusual to urinate as much as 50 times per day, both day and night. This tends to interfere with patients’ ability to work well throughout the day.

• Dysuria: People with IC/PBS will often experience a burning sensation while urinating. This phenomenon is called dysuria and is commonly caused by bacteria infections in the urinary tract.

• Urgency: Bladder conditions like interstitial cystitis also cause involuntary contractions of the bladder muscle. These contractions are often sudden and will cause an urgent need to release urine.

• Suprapubic pain: The suprapubic area (or hypogastrium) is the region of the abdomen below the stomach but above the pubic bone. Pain in the suprapubic area can happen for many reasons, but it is one of most common symptoms of IC/PBS.

• Nocturia: Someone might have nocturia if they have to get up 2 or more times each night just to urinate. Something like this is not normal and could be a sign of IC/PBS.

• Dyspareunia: Patients with IC/PBS also report having painful sex. This phenomenon is called dyspareunia, which is never normal and should be reported to your pelvic floor physical therapist.

• Incomplete voiding: If you find it hard to empty your bladder (e.g., weak stream of urine, urinary hesitancy, etc.), you may have voiding dysfunction or incomplete voiding. Although this only occurs in 11% of patients, it can still be a sign of IC/PBS.

The most common symptoms of IC/PBS are urinary frequency, dysuria, urgency, and suprapubic pain, but the other symptoms can occur as well.

IC/PBS symptoms can manifest in other ways as well, including pain as the bladder fills, bladder spasms, intermittency, and urge urinary incontinence.

Who is at risk of interstitial cystitis?

IC/PBS affects men and women of all racial and ethnic backgrounds and ages, but women are much more prone. Up to 90% of all cases of IC/PBS are women.

In the US, about 3% to 6% of women have IC/PBS. That’s about 3 to 8 million women in the US alone. 

In New York, the number of IC cases amounts to about every 1 in 11 women.

Most IC patients are diagnosed at midlife (40 to 65 years old) but patients’ history may extend back to childhood.

Children as young as 11 can be diagnosed with IC/PBS.

Are there any medications, treatments, or home remedies for interstitial cystitis?

Currently, there is no known cure for IC/PBS, but there are treatment options that can help alleviate the symptoms. 

Half of the time, IC/PBS goes away by itself and the patient’s life resumes as normal. But for patients where interstitial cystitis does not go away, they can try making changes to their lifestyle.

Treating IC/PBS:

• Retraining the bladder: If the patient has the urge to pee every 20 minutes, they can try to hold it in and stretch it out to 30 minutes, 45, and so on.

• Loose clothing: Patients can relieve some of the pressure on their bladder by wearing looser clothing. Tight clothing tends to put pressure on the bladder, which can trigger the urge to pee.

• Diet: Some foods can trigger IC symptoms. Eating fewer citrus fruits, tomatoes, chocolate, caffeinated drinks, carbonated drinks, alcohol, spicy foods, and artificial sweeteners can help.

• Quit smoking: Smoking can lead to damage of the lining of the urinary tract, which can worsen IC/PBS.

Studies have found that the number of people searching for IC/PBS has doubled in the last 2 decades. This means that more and more people are looking for ways to alleviate this unpleasant condition.

Some IC cases are mild, which makes home remedies more practical for some patients. But in severe cases, we recommend consulting a urologist.

Natural treatments for Interstitial Cystitis

We consulted with Dr. Ivy Branin, a Naturopathic Doctor in NYC, regarding natural treatments for interstitial cystitis. Here’s what Dr. Ivy has to say:

“As a naturopathic doctor who treats patients with interstitial cystitis, I don’t believe in a one-fits-all approach, and IC is no exception. IC, in most cases, is related to an autoimmune and/or allergic destruction of the glycosaminoglycan (GAG) component of the protective layer of the bladder. The biggest contributors to inflammation for patients with IC are stress, hormonal imbalances, poor sleep quality, and food allergies/intolerances. While the underlying root cause(s) are addressed, nutrient and herbal support is given to reduce histamine release, build up a healthy bladder lining, and provide symptomatic relief. My top choices in my IC naturopathic medicine kit include quercetin, glucosamine, and kava kava.”