What is interstitial cystitis (IC)?
It's a chronic disease of the bladder that is caused by deficiencies in the lining of the bladder, which allow irritants in the urine to leak through the coating of the bladder into the interstitium where all the nerves and nerve endings are located. These irritants in the urine irritate these nerve endings and basically initiate a cascade of events that is responsible for the symptoms that people with interstitial cystitis have. Part of this cascade is the release of substances that act on mast cells, which then release histamines. We believe that it is histamine that causes the bladder to sense frequency and urgency. The irritation also leads to the development of scar tissue in the bladder, which is less elastic than normal bladder tissue.
What causes these deficiencies in the lining?
We don't really know for sure. I believe that in a majority of people with interstitial cystitis the cause of the damage to the lining of the bladder is a chronic exposure to low grade urinary tract infection (UTI) for many years, at some time in the past.
What are the symptoms of IC?
Interstitial cystitis is like the worst urinary tract infection that you've ever had that never goes away. It's a triad of symptoms that includes urinary frequency, urgency and pain. Severe urinary frequency may mean going to the bathroom at least every hour. The sense of constant urgency is present even when you've already gone to the bathroom. And at least 90 percent of patients have some manifestation of pelvic pain. Different people have different interpretations of pain, so for some people, the pain is a deep pelvic pain. Others say it's a severe urgency that's very uncomfortable. And many women have pain with intercourse.
