Interstitial cystitis is a chronic bladder condition that causes pelvic pain and increased urgency and frequency to urinate. A “normal,” or healthy bladder is typically free from infection or disease, and functions as it should.

People with interstitial cystitis (IC) may feel pain and pressure in the bladder, and will need to urinate more frequently and urgently than people with a normal bladder.

This article looks at the differences between IC and a healthy bladder, IC symptoms, treatment for IC, and a person’s outlook.

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A recent 2022 article notes that the current definitions of a “normal” bladder are based on how the bladder functions, and how well it stores and empties urine.

Authors of a 2011 article point out that there are a variety of challenges when defining what a “normal” or healthy bladder means.

However, the authors state that a healthy bladder is typically free from bacterial infection or tumors. It is able to store urine without causing discomfort.

A healthy bladder is also able to empty urine with a strong, continuous flow, without pain or blood in the urine. People should also be able to hold onto the urine without leakage.

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) notes that IC is a chronic, long lasting condition that results in painful urinary symptoms.

IC causes inflammation or irritation of the wall of the bladder, which may lead to stiffening of the bladder wall or scarring. The bladder is not able to hold as much urine as a healthy bladder.

Although there is no clear cause for IC, bladder differences may cause IC, including:

  • an irregularity in bladder tissue, which allows substances to pass through and weaken the bladder
  • damage to the bladder from a substance in urine or an infection
  • an inflammatory cell in the bladder causes an allergic reaction
  • changes to the nerves that signal to the bladder
  • the immune system mistakenly attacks the bladder

People with IC may have increased frequency and urgency of urination compared with people who do not have IC.

How many times a day does a person urinate with a healthy bladder?

On average, people with a healthy bladder will pass urine seven times a day. This amount may also depend on how much fluid people consume.

People with a healthy bladder will also not need to get up to use the toilet more than once in the night.

How many times a day does a person urinate with IC?

People with IC will need to urinate far more frequently than the average person, during both day and night. A person with IC may need to urinate up to 60 times a day.

IC may feel similar to a bladder infection, but they are different conditions. IC is a chronic condition, which causes symptoms to last for over 6 weeks. Bladder inflammation causes IC.

Bacteria entering the bladder and causing an infection leads to a bladder infection. People may feel a burning sensation when they urinate, along with a frequent and urgent need to urinate.

In some cases, people with IC may have other health conditions, such as irritable bowel syndrome or fibromyalgia.

Symptoms of IC include:

  • feeling of pressure and pain in the bladder and pelvic area
  • frequent urination
  • urgent need to urinate
  • pain during sex

The Urology Care Foundation states that although pain is a common symptom, is it possible to have IC without pain. People may only experience intense pressure in the bladder.

IC treatments focus on relieving symptoms and may include a combination of methods.

Treatments may include:

  • Medications: Various medications may help manage IC symptoms. These may include pain relievers, anti-inflammatory drugs, antihistamines, or immunosuppressants.
  • Bladder training: People follow a set schedule for when to urinate and gradually increase the time between urinating to retrain the bladder.
  • Bladder enlargement: A doctor fills the bladder with a solution of water and certain medications to increase bladder size.
  • Transcutaneous electrical nerve stimulation (TENS): TENS delivers mild electrical pulses via an implant in the body to help relieve IC symptoms.
  • Botox injection: Botox injections into the bladder may help relieve pain and ease symptoms.
  • Surgery: In severe cases, people may require bladder surgery to remove part or all of the bladder.

Lifestyle changes may help manage IC and can include:

  • taking part in regular exercise
  • avoiding smoking if a person smokes
  • managing stress

People may find eliminating certain foods and drinks that may aggravate the bladder may help improve symptoms. People may wish to limit or avoid:

  • citrus fruits
  • chocolate
  • tomatoes
  • alcohol
  • spicy foods
  • coffee or other caffeinated drinks

IC treatment aims to effectively manage symptoms. Although treatment may not cure IC, it can lead to remission.

Treatment may vary for each person. People may have to experiment with different options to find what works best for them.

In most cases, treatment will help improve symptoms, but it may take weeks to see symptom improvement. A combination of medical treatments and lifestyle changes may be an effective option.

IC is not a life threatening condition and does not cause cancer.

To diagnose IC, doctors may need to order a variety of tests and perform examinations, which will help rule out other possible conditions.

A doctor will request a full medical history and conduct a pelvic examination. Diagnostic tests may include:

  • Urine tests: A doctor will order a urine sample for laboratory testing to check for bacteria, excess protein, and white and red blood cell counts.
  • Cystoscopy: A doctor inserts a flexible, thin tube with a camera at one end through the urethra to look inside the bladder and urinary tract to check for any abnormal changes or blockages.
  • Biopsy: A doctor may request a tissue sample (biopsy) from the bladder wall for examination under a microscope to check for any unusual cell changes.

In males, a doctor may also request prostate secretions for laboratory review to check for inflammation or infection.

IC causes an inflamed, irritated bladder, and can lead to scarring or stiffening of the bladder wall.

IC increases the urgency and frequency of urination compared with people who do not have IC. People with IC may also experience bladder pressure or pain.

IC is a chronic condition, but treatments may help manage symptoms. Treatment may include medications, bladder training, and electrical nerve stimulation. Lifestyle changes including an elimination diet, regular exercise, and managing stress may also help.