​Interstitial Cystitis

A chronic inflammation of the bladder (muscular organ that stores urine) wall which compromises its ability to stretch as it fills with urine is known as interstitial cystitis. Alternatively, you may also hear it being labelled as ‘Painful Bladder Syndrome’. Although it can affect all adults and children, most of the cases are diagnosed in women. ​

Inflammation is a chemical response to injury or irritation. In the case of interstitial cystitis, no specific cause has been identified for leading to inflammation of the bladder lining. It is possible that a defect in the protective inner lining of your bladder may allow toxic substances in urine to irritate the wall. Normally, the bladder waits to fill itself with urine before signalling your brain to create the urge for urination. But it becomes more sensitive in interstitial cystitis and attempts to empty itself even with small amounts of urine. Long term inflammation results in scarring of the bladder wall, rendering it stiff and unable to expand. This further restricts the volume of urine that can be accumulated, leading to a frequent urge to pass urine. It can be distressing to deal with this disorder and negative consequences include:

  • Interference in daily activities of life

  • Disturbance in social life

  • Interrupted sleep

  • Problems with intimacy leading to a strain on personal relationships

  • Depression

Other medical disorders such as autoimmune disease, allergies, undetected infections and blood vessel diseases are thought to be related. Interstitial cystitis may be associated with chronic pain disorders, so having irritable bowel syndrome or fibromyalgia​ can be a risk factor. ​

In the attempts to identify interstitial cystitis, you need to take notice of the following symptoms:

  • Discomfort, pressure or pain in lower belly when bladder fills up (often relieved after urination) 

  • Urgency, a strong urge to pass urine immediately

  • Frequent urination, often only small amounts at a time

  • Pelvic pain which is usually long term

  • Pain in the lower private area (where urine outlet is located between opening of vagina and anus)

  • Pain during intercourse​

Some of the symptoms of interstitial cystitis can mimic those experienced during a urinary infection or bladder stone. In case you experience any of the above mentioned complaints, get a consult at the ​Kidney and Bladder Service Line at the Aga Khan University Hospital, Karachi.​
Your time with your doctor maybe limited, so make sure to prepare for your visit beforehand. Here​ are some tips to help get you started.​

Your doctor will begin your diagnosis with a few questions regarding your complaints and then proceed to a physical examination of your abdomen and pelvis. It is possible that you may be asked to maintain a bladder diary, to record the amounts of fluid intake and outflow in urine. After initial assessment your physician may order one or more of the following tests if needed:

  • Urine test: for microscopic evaluation and culture to rule out infection

  • Cystoscopy: a thin tube with a camera will be inserted into the bladder 

  • Biopsy, from bladder wall

  • Bladder hydrodistention: under anaesthesia, water will be injected into bladder to allow it to stretch to its maximum capacity and check for cracks in wall​​

The severity of symptoms of the disorder and its effect on daily life varies from person to person. A number of treatment options are available and your health care provider will be able to suggest which of these will work best for you:

  • If certain foods make your symptoms worse, you may be asked to avoid them 

  • If stress aggravates your complaints, stress reduction and relaxation techniques might help 

  • Oral Medications including painkillers, anti-allergies, anti-depressants and/or pentosan may be prescribed to ease the pain

  • Injection of a medicinal solution into bladder 

  • Physiotherapy  and exercise, to help with the pelvic pain

  • Bladder hydrodistention may help relieve symptoms

  • Nerve stimulation may help control urinary urgency and block pain signals

  • Surgery, though not done routinely. Only sought as a last resort if above methods fail​​

The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.

The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the ‘Important Numbers’ section on the website homepage.

The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments’ costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the ‘Important Numbers’ section on the website homepage.​

Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the ‘Important Numbers’ section on the website homepage

The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider.