Do you often find yourself rushing to the bathroom with the urgent need to empty your bladder—even if you haven’t had much to drink? And when you do finally go, it's just a dribble or a few drops, which feel fiery or like you're peeing glass?
It could be a garden-variety urinary tract infection (UTI), the kind that's treated with antibiotics and typically goes away within a week. But it might also be an indicator of interstitial cystitis.
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What is interstitial cystitis? Also known as painful bladder syndrome, it's a condition characterized by a feeling of pressure in the bladder area. For some people with interstitial cystitis, that feeling of pressure comes and goes. For others, it's constant. The pressure in turn leads to bladder pain, a frequent need to urinate day and night, and pain and irritation during urination and even during sex.
Basically, it’s not fun. Interstitial cystitis is often confused with a recurrent UTI, as symptoms can overlap. That confusion leads to misdiagnosis and improper treatment, which in turn cuts into your quality of life and affects how well you sleep, your stress levels, and your sex life. Here's what urologists want you to know.
Interstitial cystitis symptoms
“Interstitial cystitis symptoms can resemble a urinary tract infection presenting with burning with urination, bladder pain, urethral pain, and pelvic pain, and the pain can also radiate to the abdomen and back,” Andrea Staack, MD, PhD, associate professor of female pelvic medicine and reconstructive surgery in the department of urology at Loma Linda University in Southern California, tells Health.
if you have interstitial cystitis, you'll only void small amounts and often feel like you didn't—or couldn't—get rid of all the urine in your bladder. Beyond complications in the bathroom, it can also lead to pain during sex, too. The current estimate is that 3 to 8 million women have symptoms of interstitial cystitis, according to the American Urological Association (AUA).
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Interstitial cystitis causes
The exact cause of interstitial cystitis is not well established. One theory, however, has to do with a person's immune system. “[It could be] a response of the immune system to certain specific stressors or infections, constant stress, or severe trauma or a malfunction of the lower urinary tract,” Dr. Staack explains. It could also be triggered by problems with the nerves that normal signal the brain that it's time to empty the bladder, states the AUA.
Urologists do agree that people with interstitial cystitis have certain factors in common. Being female is one of them. “Interstitial cystitis occurs mostly in women, with a ratio of 5 women suffering from this symptom complex versus 1 man," says Dr. Staack. "Per year, an estimate of 21 women and 4 men per 100,000 people in the U.S. are diagnosed with interstitial cystitis,” she says.
Interstitial cystitis is also more prevalent in those with fair skin and red hair, who are at least 30 years old (the likelihood of a diagnosis increases with age), and have already been diagnosed with another chronic pain disorder, such as irritable bowel syndrome or fibromyalgia.
Interstitial cystitis diagnosis
If you have symptoms, it’s a good idea to keep a bladder diary for a few weeks to track how often you’re rushing to pee and how it feels when you do urinate. Talk to your doctor about what you're experiencing, and use the bladder diary to accurately relay how frequent you feel the urge and what happens when you do.
Your doctor may want to do a pelvic exam and test your urine, which can rule out a UTI or other type of infection. You might also undergo a cystoscopy (when your doctor inserts a small tube into your urethra to visualize the bladder), a biopsy, a urine cytology test (which examines urine cells), and a potassium sensitivity test. This test involves placing water and a potassium solution in your bladder at different times and asking you to rate how each feels, which can be a clue to diagnosing interstitial cystitis.
You should also look at other factors that may be causing your symptoms. “The key in interstitial cystitis treatment or chronic pelvic pain syndrome is to understand the source of the problem and to rule out any secondary problems, like a urinary tract infection, bladder lesions, a stone disease of the urinary tract, and a voiding dysfunction," Dr. Staack explains. "In some patients, chronic stress, severe infections, and a previous trauma or abuse can manifest as bladder pain."
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Interstitial cystitis treatment
Unlike with most UTIs, there is no simple cure for interstitial cystitis. But if you are diagnosed with it, your doctor may prescribe medication to ease symptoms. Some types of medications that can help include anti-inflammatory drugs, tricyclic antidepressants, and antihistamines. Electric nerve stimulation techniques might also be options.
Some strategies that can help reduce symptoms are things you've already heard of. “Dysfunctional voiding can be addressed with relaxation techniques, breathing techniques, yoga, swimming, and stretching exercises,” Christina Palmer, MD, urologist at Comprehensive Urology in Los Angeles and at the University of California, Irvine Health Chao Family Comprehensive Cancer Center, tells Health.
Physical therapy can help, too. “Pelvic floor physical therapy has been known to provide much-needed relief by stretching and strengthening the muscles that cramp around the bladder,” says Dr. Palmer. Weak or tight pelvic muscles often trigger pain, so strengthening them will provide relief.
Certain lifestyle or behavioral factors, such as your exercise routine, "may contribute to the painful symptoms of interstitial cystitis, and therefore, making adjustments to your habits can help relieve discomfort or pelvic pain,” says Dr. Palmer.
Interstitial cystitis diet
What you eat can also play a role in easing symptoms as well. Dr. Palmer advocates eliminating the ”four Cs” from your diet: carbonated beverages, caffeine, citrus products, and food containing high concentrations of vitamin C, like tomatoes and some leafy greens like spinach. These "can worsen the irritation in the bladder and lead to frequent urination and exacerbated IC symptoms,” she says. Spicy meals can also have the same effect.
It's also important to consume foods that brighten your mood and can help fight stress, such as oatmeal, salmon, seeds, and avocado, which contain nutrients that have been shown to influence stress hormones. “Stress often exacerbates symptoms, therefore, stress management practices are highly recommended,” suggests Dr. Palmer.
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