Bladder pain syndrome (interstitial cystitis)

What is bladder pain syndrome?

With bladder pain syndrome, you have bladder pain and a frequent and urgent need to wee.

Painful bladder syndrome is often associated with other chronic pain syndromes such as persistent pelvic pain, fibromyalgia, vulvodynia, rheumatoid arthritis and irritable bowel syndrome.

Symptoms

With bladder pain syndrome, you may have symptoms ranging from a slight urgency to wee through to strong pain.

Symptoms can include:

• an urgent need to wee, during the day and at night
• needing to wee frequently
• pressure, pain and tenderness around the bladder, pelvis and the area between your vagina and anus (perineum), which may increase as the bladder fills
• pain when doing a wee
• not being able to hold as much wee as you used to
• pain during sex.

Causes

We don’t know exactly what causes painful bladder syndrome and more research is needed in this area. It’s thought the condition may be associated with factors such as inflammation, bladder lining problems, infections, pain response and autoimmune response.

Diagnosis

Your doctor will ask you about your medical history and symptoms. They will also ask to do a physical examination, including an abdominal and vaginal examination.

You will need to do other tests, including:

• urine tests to check for infection
• vaginal swabs to look for infections such as sexually transmitted infections (STIs) and thrush
• an ultrasound of your pelvis and kidneys to look for stones and structural problems.

If your doctor can’t find the cause, you may be referred to a specialist. The specialist will do a cystoscopy to see the inside of your bladder. If you have bladder pain syndrome, the cystoscopy might show features of the condition.

Treatment and management

You can try different therapies to treat bladder pain syndrome. A combination of therapies may give the best results. Lifestyle changes and changing what you drink will also help. For example:

• avoid alcohol, fizzy drinks and caffeine
• avoid spicy and acidic foods, chocolate, tomatoes and artificial sweeteners
• quit smoking
• work with a continence nurse or pelvic floor physiotherapist to learn bladder training and pelvic floor exercises
• do relaxation therapy
• join support groups and online forums
• have counselling with a psychologist.

Your specialist may recommend certain medicines (e.g. Elmiron). They will talk to you about the benefits and risks of any medicines before you start taking them.