Dr. Stacy McBroom
Dr. John Upshaw
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Interstitial Cystitis

Overview

Interstitial cystitis (IC) is a chronic inflammatory condition of the bladder that causes frequent, urgent, and painful urination and pelvic discomfort. The natural lining of the bladder (epithelium) is protected from toxins in the urine by a layer of protein called glycoaminoglycan (GAG). In IC this protective layer has broken down, allowing toxins to irritate the bladder wall. The bladder then becomes inflamed and tender and does not store urine well.

Unlike common cystitis (inflammation of the bladder caused by bacterial infection), which is associated with urinary tract infections (UTI) and usually treated with antibiotics, no infectious agent has been found in IC. Though not curable, IC is treatable and most patients find some relief with treatment and lifestyle changes.

Incidence and Prevalence

According to the National Institutes of Health, IC affects about 700,000 people in the United States, 90% of which are women. The average age of onset is 40 years. Although only 25% of cases involve people under age 30, the number of children affected by IC may be greater than commonly believed. IC is often misdiagnosed, and sufferers may see several doctors over the course of years before a diagnosis is made. Increasing awareness of the disease is helping to speed diagnosis and treatment.

Causes and Risk Factors

IC is a poorly understood disease with unknown causes. Although no bacteria or viruses (pathogens) have been found in the urine of IC sufferers, an unidentified infectious agent may be the cause. Others believe that IC occurs with ischemia (tissue death) or a deficiency of GAG in the epithelium. It may be an autoimmune disease, in which the immune system attacks healthy cells, perhaps following a bladder infection. Spasms of the pelvic floor muscles may also contribute to the IC symptoms. It is likely that several factors cause the condition.

Other conditions associated with IC include the following:

  • Asthma
  • Endometriosis
  • Food allergies
  • Hay fever (pollen allergy)
  • Incontinence
  • Irritable bowel syndrome
  • Lupus
  • Migraine
  • Rheumatoid arthritis
  • Sinusitis

The connection between IC and these conditions is not understood.

IC may occur following gynecological surgery. Some evidence suggests an increased risk for IC in Jewish people, and studies of mothers, daughters, and twins who suffer from it suggest a hereditary risk factor.