Happy Interstitial Cystitis Awareness Month!

By Dr. Brooke Meinema, DPT, FAFS

What Is Interstitial Cystitis?

Interstitial cystitis (IC), also known as bladder pain syndrome (BPS), is a chronic bladder condition resulting from irritation within the bladder wall. This can lead to scarring or stiffening of the tissue lining the bladder resulting in symptoms. There is currently debate amongst professionals about whether the presence of lesions is required for a diagnosis, so for the purposes of this blog, we will focus more on symptoms and ways to manage them.

Potential causes:

The exact cause of IC/PBS is currently unknown. That being said, there are theories about potential triggers including:

• Bladder wall trauma or injury
  • UTI
  • Chemotherapy
  • Chemical exposure
• Pelvic floor injury or dysfunction
  • Can be caused by various traumas or childbirth
• Genetics
• Neurosensitivities

There may be links between IC/PBS and other autoimmune diseases such as fibromyalgia.

Symptoms of this may include:

• pelvic pain or pressure
• urinary frequency
• urinary urgency
• excessive need to urinate at night (nocturia)
• painful intercourse
• having symptoms of a UTI with negative cultures

What can I do if I have IC/BPS?

There are different avenues to try and manage the symptoms associated with IC/BPS. One important step is to maintain good hydration. A dehydrated bladder is an unhappy bladder. Dehydration can cause the pH of urine to become more acidic leading to increased irritation of tissue and urge/frequency of urination.

Another thing to be sure to monitor is your diet. While this is something that may seem very frustrating at first, it can be very helpful to figure out your specific triggers (common triggers can be acidic foods/drinks, spices, and caffeine). Modification diets can seem very daunting, but when you are able to get rid of your specific triggers, it is definitely worth it! It may be helpful to speak with a dietician or other professional to sort through how to address these changes.

Since pelvic tension and trigger points can be very common with IC/BPS, working with a pelvic floor physical therapist can also be helpful to address this tension as well as provide you with ways to better manage these symptoms on your own. Pelvic floor PTs can also help you manage some of the other symptoms with painful intercourse and urinary frequency and urgency. It can also be beneficial to work on the mobilization of the bladder. The bladder needs the flexibility to shift and move to allow it to fill with urine. Helping keep the tissue flexible and prevent further scarring can ease some of the symptoms that commonly come with IC/PBS.

Another important thing to keep in mind is your mental health when dealing with this. IC is a lifelong condition that can cause great distress, so getting a support group, seeing a therapist/counselor, and checking in on your current state improves outcomes and quality of life.

There are also other forms of medical treatments, such as bladder installations, supplements, and medications, that can be helpful for some women. If you are unsure what medications or treatments may be helpful for your specific needs, be sure to discuss this with your doctor.

What should I not do?

Kegels! Kegels, or pelvic floor contraction exercises, are not encouraged for IC/BPS as they can lead to increased tension in an already tight and agitated pelvic floor.

Don’t give up! It can take so long to get this diagnosis, and once diagnosed, it may feel like an uphill battle. Don’t let this get you down! There are so many options for you to help with this.

While it can be very frustrating to deal with interstitial cystitis/bladder pain syndrome, we want you to know there are things you can do to help! At the end of the day, our goal is to put you in the driver’s seat; we want you to understand possible symptoms and ways to address them and give you control over your bladder. Discuss your options for moving forward with a trusted provider!

Questions? Ask a pelvic health physical therapist!