What is painful bladder syndrome?

Painful bladder syndrome, also known as Interstitial cystitis, is an inflamed or irritated bladder wall. It can lead to scarring and stiffening of the bladder. The bladder can’t hold as much urine as it did in the past. It is a chronic disorder.

What causes painful bladder syndrome?

Experts don’t know what causes painful bladder syndrome. Researchers are looking at many theories to understand the causes and find the best treatments.

Most people find that certain foods make their symptoms worse. These include:

• Citrus fruits
• Tomatoes
• Chocolate
• Coffee
• Potassium-rich foods
• Alcohol
• Caffeinated drinks
• Spicy foods
• Some carbonated drinks

What are the symptoms of painful bladder syndrome?

These are the most common symptoms:

• Frequent urination
• Urgency with urination
• Feelings of pressure, pain, and soreness around the bladder, pelvis, and the area between the anus and vagina or anus and scrotum (perineum)
• Pain during sex
• In men, discomfort or pain in the penis and scrotum
• In women, symptoms may get worse around their period

Stress may also make symptoms worse, but stress does not cause symptoms.

The symptoms may look like other conditions or health problems. Always talk with a healthcare provider for a diagnosis.

How is painful bladder syndrome diagnosed?

No single test can diagnose painful bladder syndrome. The symptoms are a lot like those of other urinary disorders. For these reasons, a variety of tests may be needed to rule out other problems. Your healthcare provider will start by reviewing your health history and doing a physical exam. Other tests may include:

• Urinalysis. Lab testing of urine to look for certain cells and chemicals. This includes red and white blood cells, germs, or too much protein.
• Urine culture and cytology. Collecting and checking urine for white blood cells and bacteria. Also, if present, what kind of bacteria there are in the urine.
• Cystoscopy. A thin, flexible tube and viewing device is put in through the urethra. It examines the bladder and other parts of the urinary tract. This test checks for structural changes or blockages.
• Bladder wall biopsy. Tissue samples are removed from the bladder (with a needle or during surgery). They are checked under a microscope to see if cancer or other abnormal cells are present.
• Lab exam of prostate secretions (in men). This is done to look for prostate inflammation or infection.

How is painful bladder syndrome treated?

There is no cure and it can be hard to treat. Treatments are aimed at easing symptoms, and may include:

• Bladder enlargement. This method increases bladder capacity. It also interferes with pain signals being sent by the nerve cells in the bladder.
• Bladder wash. The bladder is filled with a solution that is held for varying times, from a few seconds to 15 minutes. Then it is drained out through a catheter.
• Medicine. Medicine may be taken by mouth or put right into the bladder. There are many different medicines that may be used.
• Transcutaneous electrical nerve stimulation (TENS). Mild electric pulses enter the body for minutes to hours. This is done 2 or more times a day. The pulses are sent through wires placed on the lower back. Or through special devices put into the vagina in women or into the rectum in men. For some people, TENS eases bladder pain and urinary frequency and urgency.
• Bladder training.  You urinate at certain times and use relaxation methods and distractions to help keep to the schedule. Over time, you try to lengthen the time between the scheduled urinations.
• Surgery. Surgery to remove all or part of the bladder may be done in severe cases, if other treatments don’t work.

Management of the condition may also include:

• Diet changes. No proof links diet , but some believe that alcohol, tomatoes, spices, chocolate, caffeinated and citrus drinks, and high-acid foods may contribute to bladder inflammation. Removing these from the diet may help to decrease some symptoms.
• Not smoking. Many people find that smoking makes their symptoms worse.
• Exercise. Exercise may help ease symptoms or make them stop for a while.
• Reducing stress. There is no proof that stress is a cause, but stress can make the symptoms worse.

Talk with a healthcare provider about any questions of concerns you may have.

Key points about painful bladder syndrome

• Painful bladder syndrome is an inflamed or irritated bladder wall.
• Experts don’t know what causes it. It does not get better with antibiotics.
• Symptoms include pain during sex and frequent and urgent urination. There may also be pressure, pain, and soreness around the bladder, pelvis, and the area between the anus and vagina (women) or the anus and scrotum (men).
• There is no best way to diagnose it. A variety of tests may be needed. These include urine tests, imaging tests, and biopsy.
• Treatments are aimed at easing symptoms. A variety of procedures, medicines, and lifestyle changes may be advised.