Interstitial Cystitis: The Mysterious Pelvic Pain You’ve Never Heard Of

Interstitial Cystitis (IC for short) has gone by many names, and most commonly known as Painful Bladder Syndrome. Unfortunately, it has been a poorly understood condition and can take years to be diagnosed properly.

If you have a chronic pelvic pain that doesn’t seem to be getting better despite treatments and evaluations, consider these symptoms:

  1. Pelvic pain that can be dull or sharp, mild or moderate or severe, and can be intermittent or constant.
  2. A personal history of frequent urinary tract infections and/or vaginal infections that have been treated with minimal or no improvement in symptoms
  3. A personal history of being told you had urinary tract infections and/or vaginal infections in childhood
  4. All other testing to evaluate pelvic pain has been negative.

IC is a condition that can be associated with chronic bladder inflammation, and this can be so chronic that it may be present as early as childhood. It is often mistaken as a urinary tract infection (UTI), vaginal yeast infection, endometriosis, or irritable bowel syndrome. In fact, the average time for diagnosis is 8 years. It is more common in women than men and most often diagnosed in patients most often in their 40’s or later. The cause of it is unknown, however it behaves similar to an allergy, where the release of histamines from the bloodstream can result in inflammation of the inner bladder mucosa. The bladder has many nerves and when it is inflamed it can result in a crampy pelvic pain, burning with urination, and sometimes a discolored urine. Due to its proximity to the vaginal cavity, it may also cause the sensation of vulvar pain and vaginal irritation.

Pain is most commonly triggered due to problematic foods and beverages. The kidneys filter the blood and all that excess waste is collected in the bladder. Foods or drinks that are high in acid or potassium tend to cause an inflamed bladder to become more painful, and thus trigger a cascade of nerve stimulation that can cause the bladder to spasm. This will result in urinary frequency, painful urination, lower pelvic pain, vulvar pain or vaginal irritation. I compare this to pouring lemon juice on a paper cut: when the bladder is inflamed, adding irritating foods is like “pouring the lemon juice”.

The condition is one that does not have a specific test to identify and diagnose it as such. When a patient presents with the above symptoms, a series of testing and exams must be done to rule out other causes of the pain. Primarily, urinary testing must be done to eliminate an infection as the cause. Vaginal exams will be performed to diagnose any possible vaginal infection as the cause. This will also help your provider to evaluate the uterus and ovaries as well as examine the bladder for any other abnormalities such as masses or lesions.

The primary treatment for IC is dietary modification. A diet low in acid and potassium will aid in eliminating the symptoms. As this is a chronic condition, symptoms may flare periodically over a lifetime, but being aware of what foods or beverages may trigger the condition is the most important thing in controlling the symptoms. The most common foods that can trigger bladder pain are: citrus foods (oranges, lemons, etc.) and their juices, tomatoes (or any tomato-based product), carbonated beverages, artificial sweeteners, and vinegar. This is by no means an exhaustive list of foods to eliminate, and you can find a more complete diet at In addition, I will also recommend use of certain essential oils to aid in pain modulation. Lavender essential oil helps reduce inflammation and pain. Adding this to a warm bath of epsom salts can often help to reduce pain during times of IC flares. Simple dietary modification and use of occasional oils is often enough to treat the condition. Medication therapy is not often recommended but can be in more severe cases. The use of narcotic pain medication is not recommended and can often make the pain worse.

If you have experienced these symptoms and have not been able to find the relief you need, please call for an evaluation for this condition.

Carrie L. Merrill D.O.