What is interstitial cystitis?
Interstitial cystitis, also called bladder pain syndrome, is a condition that causes chronic pelvic pain and pressure, along with a frequent need to urinate. To be diagnosed with the condition, your symptoms must last for more than six weeks and have no clear cause, such as an infection.
Interstitial cystitis can be mild or severe, and your symptoms may come and go over time. It can also occur with other conditions that can cause discomfort, such as irritable bowel syndrome and fibromyalgia.
Interstitial cystitis can greatly affect the quality of your life, but there are treatment options available for you to find the relief you need.
Interstitial cystitis symptoms
Interstitial cystitis can cause a range of symptoms that may go away for a while and return. Symptoms include:
- A frequent need to urinate (up to 60 times a day when the condition is severe)
- Pain in the lower abdomen, urethra (the tube that empties urine from the bladder out the body) or vagina
- Painful sex (dyspareunia)
- Pressure in the pelvic area
- An urgent need to urinate
These symptoms can get worse after doing certain exercises or eating certain foods.
When to see a doctor
Make an appointment with your provider if you experience pelvic pain that doesn’t go away or goes away and comes back. Changes in your urination habits, especially those that affect your daily life, are also cause for visiting your provider.
What causes interstitial cystitis?
The exact cause of interstitial cystitis is unknown but may involve multiple factors, such as a defect in the bladder's protective lining, which allows irritants to affect the bladder wall. Other possible but unproven factors include autoimmune reactions, genetics, infections or allergies.
Painful bladder syndrome risk factors
The following factors may contribute to the development of the condition.
- Sex: Women are diagnosed with interstitial cystitis more often than men. Men’s symptoms may mimic interstitial cystitis but are often related to prostatitis.
- Age: Most diagnoses occur in people aged 30 or older.
- Allergic reaction: Mast cells in the bladder may trigger allergic reactions, causing symptoms.
- Autoimmune diseases: Interstitial cystitis may result from the immune system attacking the bladder, mistaking it for a harmful invader.
- Bladder wall damage: Damage to bladder tissue can lead to irritation from substances in urine, weakening the wall and causing ulcers.
- Other conditions: Interstitial cystitis may be linked to other chronic pain disorders, such as irritable bowel syndrome or fibromyalgia.
How is interstitial cystitis diagnosed?
Interstitial cystitis can cause symptoms that resemble those of other conditions, such as urinary tract infections, bladder cancer, diabetes and nerve problems. Your provider will perform an exam and order tests to rule out other conditions.
Medical history and physical exam
Your healthcare provider may ask you to describe your symptoms and keep a bladder diary, noting fluid intake and urine output. During a pelvic exam, they will check your pelvic organs and floor muscles for signs of dysfunction and muscle spasms that might contribute to bladder pain.
Urinalysis
Your provider may order a urinalysis, in which a sample of your urine is tested for bacteria and white or red blood cells. If the test shows no signs of these substances, they can rule out a bladder infection as the cause of your symptoms.
Biopsy
Your provider may also recommend a biopsy. For this procedure, they’ll start by administering anesthesia. Your provider will then use a thin needle to collect a tissue sample from your bladder wall and urethra to rule out other conditions, including bladder cancer.
Cystoscopy
Your provider will use a cystoscope, a thin, lighted tube with an eyepiece, to examine the inside of your bladder and rule out bladder cancer. The cystoscope is gently inserted through your urethra into your bladder. You'll be awake during the procedure, but anesthesia may be needed if a bladder biopsy is also performed.
Cystoscopy with hydrodistention
Your provider may perform a cystoscopy with bladder hydrodistention, which involves stretching your bladder to its maximum capacity by filling it with water. This procedure can reveal ulcers or cracks in the bladder and requires anesthesia. Many people experience temporary relief of interstitial cystitis or bladder pain syndrome symptoms afterward.
Urodynamic testing
With urodynamic testing, your bladder is filled with water and emptied through two small catheters. The goal is to measure bladder pressure and capacity so your provider can determine how much urine your bladder holds (people with interstitial cystitis can’t hold much urine) and whether filling your bladder causes pain.
Interstitial cystitis treatment
There is no cure for interstitial cystitis, but lifestyle changes and medications can help manage symptoms and improve your quality of life. Your provider may need to try a few different treatments before finding the one that works best for you.
Lifestyle changes
Management of interstitial cystitis may also include:
- Diet changes: Dietary changes can help people with interstitial cystitis manage symptoms, as certain foods and beverages could trigger symptoms. Avoid trigger foods like alcohol, caffeine, chocolate, citrus fruits, soda, spicy foods and tomatoes.
- Quit smoking: Smoking can worsen symptoms of interstitial cystitis.
- Exercise: Regular physical activity may help alleviate symptoms.
- Reducing stress: Stress can worsen symptoms of interstitial cystitis. Practicing relaxation and coping techniques or talking to a counselor can help you manage stress and reduce pain and other symptoms.
Physical therapy
Pelvic floor physical therapy relaxes the pelvic floor muscles through stretching, helping to manage symptoms. A physical therapist can show you specific exercises that can heal damaged tissue and provide relief.
Oral medications
Interstitial cystitis medications include:
- Antidepressants: These can help relax the bladder and address pain and inflammation caused by neurochemicals.
- Antihistamines: If your provider suspects your symptoms are caused by inflammation, antihistamines may help.
- Narcotic pain medicines: Codeine and hydrocodone can manage severe discomfort.
- Over-the-counter medications: Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or aspirin can help with mild to moderate pain.
Nerve stimulation
Nerve stimulation techniques include:
- Transcutaneous electrical nerve stimulation (TENS): Mild electrical pulses relieve pelvic pain and may reduce urinary frequency. Wires are placed on your lower back or pubic area to deliver pulses to increase blood flow, strengthen bladder muscles or trigger pain-blocking substances.
- Sacral nerve stimulation: A wire near the sacral nerves sends electrical impulses to reduce urinary urgency. If effective, a permanent device may be implanted. This technique primarily addresses urinary symptoms, not pain.
Bladder instillations
Bladder instillations are liquid medications injected directly into the bladder through a catheter. The installations may include a single medication or a combination and are intended to reduce inflammation in your bladder walls. Bladder installation treatments span up to two months, and you may need to receive treatment weekly or every other week.
Surgery and procedures
Procedures that your provider may recommend include:
- Bladder distention: Some people experience temporary symptom relief after a cystoscopy with bladder distention, in which the bladder is stretched with water. If symptoms improve long-term, the procedure may be repeated.
- Botulinum toxin injections: Small doses of botulinum toxin injected directly into the bladder can paralyze bladder muscles, relieving any pain. This treatment may need to be repeated after six to nine months.
Surgery is rarely used to treat interstitial cystitis, as removing the bladder often doesn’t relieve pain and can cause complications. However, for those with severe pain or very limited bladder capacity, surgical options may be considered after other treatments fail:
- Fulguration: Minimally invasive procedure that uses heat to destroy ulcers through the urethra
- Resection: Minimally invasive removal of ulcers through the urethra
- Bladder augmentation: Rarely, a surgeon increases bladder capacity with an intestinal patch, though it doesn’t eliminate pain and may require catheter use
Find specialized care for interstitial cystitis
You can find relief from interstitial cystitis and bladder pain with help from a Baylor Scott & White women’s health provider. We help you get care at a location that fits your needs and offer several locations, including specialized women’s health centers in North and Central Texas.
AccentCare - Fort Worth
3880 Hulen St , Fort Worth, TX, 76107
AccentCare Home Health of Brenham
526 W Main St , Brenham, TX, 77833
AccentCare Home Health of College Station
119 Medical Park Lane Ste C, Huntsville, TX, 77340
AccentCare Home Health of College Station
1605 Rock Prairie Rd Ste 206, College Station, TX, 77845
AccentCare Home Health Of Denton
225 W. Mulberry St. Ste A, Denton, TX, 76201
AccentCare Home Health Of Desoto
911 York Drive Ste 203, DeSoto, TX, 75115
AccentCare Home Health Of Fort Worth (Arlington)
700 Highlander Blvd Ste 205, Arlington, TX, 76015
AccentCare Home Health of Huntsville
122 Medical Park Lane B , Huntsville, TX, 77340
AccentCare Home Health of Marble Falls
1100 Mission Hills Dr Ste 100, Marble Falls, TX, 78654
AccentCare Home Health Of McKinney
6800 Weiskopf Ave Ste 100, McKinney, TX, 75070
AccentCare Home Health Of Taylor (Hutto)
567 Chris Kelley Blvd Ste 201, Hutto, TX, 78634
AccentCare Home Health Of Temple
3809 S General Bruce Dr Ste 105B, Temple, TX, 76502
AccentCare Home Health Of Waco
8300 Central Park Dr Ste A, Waco, TX, 76712
AdventHealth Central Texas
2201 S Clear Creek Rd , Killeen, TX, 76549
Andrews Women's Hospital at Baylor Scott & White - Fort Worth
1400 8th Ave , Fort Worth, TX, 76104
Baylor Scott & White - Hillcrest Infectious Disease Clinic
50 Hillcrest Medical Blvd MOB1, Ste 104, Waco, TX, 76712
Baylor Scott & White - Plano Brain and Spine Center
4708 Alliance Blvd Pavilion I, Ste 810, Plano, TX, 75093
Baylor Scott & White - Texas Brain and Spine Institute
900 Scott and White Dr , College Station, TX, 77845
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White - Texas Brain and Spine Institute - Huntsville
122 Medical Park Ln Ste A, Huntsville, TX, 77340
Baylor Scott & White - The Brenham Clinic
600 N Park St , Brenham, TX, 77833
- Monday: 7:30 am - 5:00 pm
- Tuesday: 7:30 am - 5:00 pm
- Wednesday: 7:30 am - 5:00 pm
- Thursday: 7:30 am - 5:00 pm
- Friday: 7:30 am - 5:00 pm
Baylor Scott & White 65+ Clinic
4716 Alliance Blvd Ste 500, Plano, TX, 75093
- Monday: 8:00 am - 4:30 pm
- Tuesday: 8:00 am - 4:30 pm
- Wednesday: 8:00 am - 4:30 pm
- Thursday: 8:00 am - 4:30 pm
- Friday: 8:00 am - 4:30 pm
Baylor Scott & White Advanced Cardiac Imaging Specialists
1100 Allied Dr , Plano, TX, 75093
Baylor Scott & White Advanced Cardiovascular and Imaging Consultants
4708 Alliance Blvd Ste 450, Plano, TX, 75093
Baylor Scott & White Advanced Digestive Care
3434 Swiss Ave Ste 200, Dallas, TX, 75204
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White Advanced Heart and Lung Disease Center - Fort Worth
1420 8th Ave Ste 103, Fort Worth, TX, 76104
Baylor Scott & White Advanced Heart Care - Anna
450 N Standridge Blvd , Anna, TX, 75409
Baylor Scott & White Advanced Heart Care - Decatur
2401 S FM 51 Ste 200, Decatur, TX, 76234
Baylor Scott & White Advanced Heart Care - Denton
3333 Colorado Blvd , Denton, TX, 76210
Baylor Scott & White Advanced Heart Care - Idabel, OK
4 SE Avenue A , Idabel, OK, 74745
Baylor Scott & White Advanced Heart Care - Keller (Satellite)
3124 N Tarrant Pkwy Ste 204, Keller, TX, 76177
Baylor Scott & White Advanced Heart Care - McKinney (Satellite)
5236 W University Dr Ste 4450, McKinney, TX, 75482
Baylor Scott & White Advanced Heart Care - Mt Pleasant (Satellite)
1011 N Jefferson Ave , Mt Pleasant, TX, 75455
Baylor Scott & White Advanced Heart Care - Paris
875 S Collegiate Dr , Paris, TX, 75462
Baylor Scott & White Advanced Heart Care - Plano
4716 Dexter Dr Ste 100, Plano, TX, 75093
Baylor Scott & White Advanced Heart Care - Sherman Sycamore (Satellite)
203 E Sycamore St , Sherman, TX, 75090
Baylor Scott & White Advanced Heart Care - Sulphur Springs
601 Airport Rd Ste 110, Sulphur Springs, TX, 75482
Baylor Scott & White Advanced Heart Care – Sherman Highland (Satellite)
300 N Highland Ave , Sherman, TX, 75092
Baylor Scott & White Advanced Heart Failure Clinic - Irving
2001 N MacArthur Blvd Bldg 1, Ste 360, Irving, TX, 75061
Baylor Scott & White Advanced Heart Failure Clinic - Abilene
1219 E South 11th St Ste B2, Abilene, TX, 79602
Baylor Scott & White Advanced Heart Failure Clinic - Amarillo
1901 Medi Park Dr Ste 2051, Amarillo, TX, 79106
Baylor Scott & White Advanced Heart Failure Clinic - Dallas
3410 Worth St Ste 250, Dallas, TX, 75246
- Monday: 8:00 am - 4:30 pm
- Tuesday: 8:00 am - 4:30 pm
- Wednesday: 8:00 am - 4:30 pm
- Thursday: 8:00 am - 4:30 pm
- Friday: 8:00 am - 4:30 pm
Baylor Scott & White Advanced Heart Failure Clinic - Longview
906 Judson Rd , Longview, TX, 75601
Baylor Scott & White Advanced Heart Failure Clinic - Lubbock
3711 22nd St Ste B, Lubbock, TX, 79410
Baylor Scott & White Advanced Heart Failure Clinic - Midland/Odessa
420 E 6th St Ste 102, Odessa, TX, 79761
Baylor Scott & White Advanced Heart Failure Clinic - Tyler
1321 S Beckham Ave , Tyler, TX, 75701
Baylor Scott & White Advanced Heart Failure Clinic - Waxahachie
2360 N Interstate 35E MOB 2, Ste 310, Waxahachie, TX, 75165
Baylor Scott & White Advanced Heart Failure Specialists - Fort Worth
1250 8th Ave Ste 200, Fort Worth, TX, 76104
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White Advanced Lung Disease Specialists - Dallas
3410 Worth St Ste 250, Dallas, TX, 75246
- Monday: 8:30 am - 5:00 pm
- Tuesday: 8:30 am - 5:00 pm
- Wednesday: 8:30 am - 5:00 pm
- Thursday: 8:30 am - 5:00 pm
- Friday: 8:30 am - 4:30 pm
Baylor Scott & White All Saints Medical Center - Fort Worth
1400 8th Ave , Fort Worth, TX, 76104
Baylor Scott & White Ambulatory Endoscopy Center
4708 Alliance Blvd Pavilion I, Ste 210, Plano, TX, 75093
- Monday: 7:00 am - 3:00 pm
- Tuesday: 7:00 am - 3:00 pm
- Wednesday: 7:00 am - 3:00 pm
- Thursday: 7:00 am - 3:00 pm
- Friday: 7:00 am - 3:00 pm
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February 11, 2025