Bladder Pain Syndrome (Interstitial Cystitis)

Topic Overview

Bladder pain syndrome (interstitial cystitis) is a problem that causes pain in the bladder or pelvis. It also causes an urgent, frequent need to urinate. The problem is much more common in women than in men.

To diagnose bladder pain syndrome (BPS), your doctor may do a test called cystoscopy that uses a thin, lighted tube to see the inside of your bladder. He or she may also do a urine test to rule out other problems, such as a urinary tract infection.

What causes BPS?

Some doctors think BPS may be caused by abnormal changes in the lining of the bladder. But the cause isn't clear. Because of this, treatment focuses on helping to relieve symptoms. Your doctor may have you use a bladder diary (What is a PDF document?) to record how often you urinate and about how much urine is released.

What are the symptoms?

The pain from BPS can be mild to severe but almost always goes away right after you urinate. Other symptoms of BPS include:

• Urinating often during the day and night.
• Feeling pressure, discomfort, and a persistent urge to urinate.
• Having pain in your lower belly or pelvis.

People with BPS may go days or weeks with no symptoms.

How is it treated?

Treatment may include:

• Bladder training. To help your bladder get used to comfortably holding more urine, you can slowly increase the time between when you urinate during the day (not while sleeping).
  • If you find you are urinating every 30 minutes, for example, you can set a schedule of going every 45 minutes during the day.
  • If that works for a week, you may be able to increase your time to every 60 minutes.
  • Slowly work your way up to 2½ hours.
• Physical therapy. A physical therapist can teach you exercises to relax the muscles in your lower belly, groin, and buttocks. You may want to look for a physical therapist who is specially trained in pelvic floor therapy.
• Medicines for pain and other symptoms.
  • Oral medicines (such as pills) include amitriptyline, pentosan polysulfate, antihistamines, anti-inflammatory medicines, and pain medicines.
  • Medicines that are put into the bladder (bladder instillations) include dimethyl sulfoxide (DMSO) or a combination of medicines, such as lidocaine, heparin, and sodium bicarbonate.
• Electrical stimulation. This treatment uses a mild electrical pulse to stop nerve pain.
• Other treatments. These include biofeedback, transcutaneous electrical nerve stimulation (TENS), or acupuncture. These have been helpful for some people.
• Surgery. If no other treatments help, surgery might be done to repair a bladder problem. Or surgery may be done to stop nerve pain.

How can you manage your pain?

Your doctor will help you manage your pain, but there are also things you can do. Here are some ideas:

• Stay active in ways that don't trigger pain, such as walking, yoga, or pilates.
• If sitting for a long time causes pain, find out about using a standing desk.
• Eat foods that are good for you. It will help you feel better. If spicy foods, coffee, or alcohol are a problem, avoid them.

What else can you do?

Other things you can do to manage the symptoms of BPS include:

• Find ways to relax and lower your stress, such as taking warm tub baths, listening to restful music, or meditating.
• Join a support group for people who have chronic pain. Contact the American Chronic Pain Association at www.theacpa.org for more information about groups near you.
• Talk to a counselor. Look for one who has had training in managing chronic pain.