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
Baylor Scott & White Advanced Heart Care - Idabel, OK
4 SE Avenue A , Idabel, OK, 74745
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 Cardiac Surgery - Longview
906 Judson Rd , Longview, TX, 75601
Baylor Scott & White Liver Consultants of Texas - Longview
906 Judson Rd , Longview, TX, 75601
- Monday: 8:30 am - 4:30 pm
- Tuesday: 8:30 am - 4:30 pm
- Wednesday: 8:30 am - 4:30 pm
- Thursday: 8:30 am - 4:30 pm
- Friday: 8:30 am - 4:30 pm
Baylor Scott & White Advanced Heart Failure Clinic - Longview
906 Judson Rd , Longview, TX, 75601
Baylor Scott & White Advanced Heart Care - Sulphur Springs
601 Airport Rd Ste 110, Sulphur Springs, TX, 75482
Baylor Scott & White North Texas Colon and Rectal Associates - Sulphur Springs
601 Airport Rd Ste 110, Sulphur Springs, TX, 75482
Baylor Scott & White Advanced Heart Failure Clinic - Tyler
1321 S Beckham Ave , Tyler, TX, 75701
Baylor Scott & White Center for Advanced Surgery - Tyler
1321 S Beckham Ave , Tyler, TX, 75701
Baylor Scott & White Liver Consultants of Texas - Tyler
1321 S Beckham Ave , Tyler, TX, 75701
Baylor Scott & White North Texas Colon and Rectal Associates - Tyler
1321 S Beckham Ave , Tyler, TX, 75701
Baylor Scott & White Center for Thoracic Surgery - Tyler
1321 S Beckham Ave , Tyler, TX, 75702
Baylor Scott & White Cardiac Surgery - Tyler
1321 S Beckham Ave , Tyler, TX, 75701
Touchstone Imaging Tyler
2019 Old Troup Hwy , Tyler, TX, 75701
Baylor Scott & White Texas Spine & Joint Hospital
1814 Roseland Blvd Ste 100, Tyler, TX, 75701
Glen Oaks Hospital
301 Division St , Greenville, TX, 75401
Baylor Scott & White Surgical Hospital - Sherman
3601 N Calais St , Sherman, TX, 75090
Baylor Scott & White Urgent Care+ Sherman
4028 N Hwy 75 , Sherman, TX, 75090
- Monday: 8:00 am - 8:00 pm
- Tuesday: 8:00 am - 8:00 pm
- Wednesday: 8:00 am - 8:00 pm
- Thursday: 8:00 am - 8:00 pm
- Friday: 8:00 am - 8:00 pm
- Saturday: 8:00 am - 5:00 pm
- Sunday: 8:00 am - 5:00 pm
Baylor Scott & White Texas Spine & Joint Hospital Urgent Care - Tyler
8101 S Broadway Ave , Tyler, TX, 75703
- Monday: 8:00 am - 8:00 pm
- Tuesday: 8:00 am - 8:00 pm
- Wednesday: 8:00 am - 8:00 pm
- Thursday: 8:00 am - 8:00 pm
- Friday: 8:00 am - 8:00 pm
- Saturday: 8:00 am - 6:00 pm
Texas Vascular Associates - Greenville
4400 Interstate 30 Ste 300, Greenville, TX, 75402
Baylor Scott & White Primary Care Associates Pediatrics - Greenville
4400 Interstate 30 W Ste 110, Greenville, TX, 75402
- 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 Cardiology Consultants of Texas - Greenville
4400 Interstate 30 W Ste 300, Greenville, TX, 75402
- 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 - 5:00 pm
Baylor Scott & White Imaging Center - Greenville
4400 Interstate 30 W Ste 200, Greenville, TX, 75402
- 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 Outpatient Rehabilitation - Greenville
4400 Interstate 30 W Ste 120, Greenville, TX, 75402
- 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 Orthopedic Associates of Dallas - Greenville
4400 Interstate 30 W Ste 300, Greenville, TX, 75402
Baylor Scott & White Primary Care Associates - Greenville
4400 Interstate 30 W Ste 100, Greenville, TX, 75402
- 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 Gastroenterology - Greenville
4400 Interstate 30 W Ste 300, Greenville, TX, 75402
Baylor Scott & White Endoscopy Center - Sherman
1615 US-75 Ste B, Sherman, TX, 75090
Sherman Endoscopy Center
1615 N Hwy 75 , Sherman, TX, 75090
Baylor Scott & White Women's Care & Continence Center - Sherman
260 E Evergreen St , Sherman, TX, 75090
- 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 - 5:00 pm
Baylor Scott & White Advanced Heart Care - Sherman Sycamore (Satellite)
203 E Sycamore St , Sherman, TX, 75090
Texas Vascular Associates - Sherman
230 E Sycamore St Ste 105, Sherman, TX, 75090
Baylor Scott & White The Heart Group - Sherman
230 E Sycamore St Ste 205, Sherman, TX, 75090
Baylor Scott & White Arrhythmia Management - Sherman
230 E Sycamore St Ste 205, Sherman, TX, 75090
Baylor Scott & White Advanced Heart Care – Sherman Highland (Satellite)
300 N Highland Ave , Sherman, TX, 75092
Baylor Scott & White Digestive Diseases Group - Sherman
204 Medical Dr Ste 240, Sherman, TX, 75092
Baylor Scott & White Primary Care - Van Alstyne
250 N Collin McKinney Pkwy , Van Alstyne, TX, 75495
- 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 - 4:00 pm
Baylor Scott & White Institute for Rehabilitation - Anna
601 S. Ferguson Pkwy Ste 100, Anna, TX, 75409
Baylor Scott & White Institute for Rehabilitation - Royse City
594 W Interstate 30 , Royse City, TX, 75189
- Monday: 7:00 am - 7:00 pm
- Tuesday: 7:00 am - 7:00 pm
- Wednesday: 7:00 am - 7:00 pm
- Thursday: 7:00 am - 7:00 pm
- Friday: 7:00 am - 7:00 pm
Baylor Scott & White Advanced Heart Care - Anna
450 N Standridge Blvd , Anna, TX, 75409
Baylor Scott & White Digestive Diseases Group - Anna
450 N Standridge Blvd Ste 104, Anna, TX, 75409
Baylor Scott & White Texas Cardiac Associates - Royse City
6257 FM 2642 Blvd Ste 100, Royse City, TX, 75189
Baylor Scott & White Primary Care Associates - Royse City
6257 FM 2642 Blvd Ste 100, Royse City, TX, 75189
- 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 Surgical Institute - Royse City
6257 FM 2642 Blvd Ste 100, Royse City, TX, 75189
- Monday: 9:00 am - 5:00 pm
- Tuesday: 9:00 am - 5:00 pm
- Wednesday: 9:00 am - 5:00 pm
- Thursday: 9:00 am - 5:00 pm
- Friday: 9:00 am - 5:00 pm
Baylor Scott & White Institute for Rehabilitation - McKinney Red Bud
1705 W University Dr Ste 119, McKinney, TX, 75069
Baylor Scott & White Institute For Rehabilitation - McKinney Lake Forest
1705 W University Dr Ste 119, McKinney, TX, 75069
Baylor Scott & White Institute For Rehabilitation - McKinney University
1705 W University Dr Ste 119, McKinney, TX, 75069
Heritage Eye Center
1501 Redbud Blvd , McKinney, TX, 75069
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February 11, 2025