Chronic pelvic pain [3] may be a symptom of a number of different conditions [4]. That's why it may be hard for your doctor to diagnose the cause of your pain and to determine an effective treatment. However, by helping your doctor identify the cause of your pelvic pain, you can help him or her make an accurate IC diagnosis [5]. Be sure to tell your doctor if you feel the urge to urinate frequently, if you have pain that is decreased by urinating, or if you often wake up in the middle of the night to urinate. These symptoms may be signs of interstitial cystitis (IC) [6] — a long-term medical condition where the bladder [7] wall can become irritated and inflamed. Your symptoms may come and go, and may occur all at once or each at different times.

While the exact cause, or causes, is unknown, many experts believe that, in IC patients, the mucous layer that lines and protects the inside of the bladder [7] is too thin — or missing altogether. This condition allows chemicals in the urine to irritate the bladder wall.Some evidence points to irritating substances in the urine or the release of inflammatory substances. Other evidence suggests that IC is caused by the body's own natural defense system turning on itself. IC associated with chronic pelvic pain [3] may also be made worse by allergies.In some people, symptoms may get worse when certain foods are eaten.

Although the majority of people diagnosed with IC are women, men can also develop IC. Recent studies show that IC occurs more often in men than was previously recognized. Approximately 25% of patients are under 30 years old when they first develop symptoms, and the mean age at diagnosis is 44 years.

Both men and women get IC. The exact number of people with IC is unknown, but current estimates suggest that there may be as many as 9 million women in the US who suffer from chronic pelvic pain. [3]

One of the reasons IC is so hard to diagnose [4] is because the pain associated with IC can be felt in various locations throughout your pelvis, so it can be easily confused with gynecologic or urologic conditions.

In women, IC pain may be felt in the urethra [12], the vagina, the area above the pubic bone, the inside of the thighs, the lower abdomen, the lower back, the groin area, or any combination of these areas. Other conditions that can produce the same or similar symptoms include endometriosis [13], urinary tract infection [12] (though most people with IC have negative urine cultures) or vaginal infection.

In men, IC pain may be felt in the penis, testes and/or scrotum, the area above the pubic bone, the lower abdomen, the lower back and the groin area or any combination of these areas. As with women, these different pain locations can complicate the diagnosis. IC may be labeled recurrent urinary tract infection, “urgency-frequency” syndrome or “urethral syndrome [12],” though most people with IC have negative urine cultures. Men who may have IC are sometimes diagnosed as having chronic nonbacterial prostatitis, benign prostatic hypertrophy (BPH) [7] or epididymitis [13].

The IC Self-Screener [15] may help your doctor screen for IC. This tool measures symptoms associated with IC — such as the urge to urinate, frequent trips to the bathroom to urinate, pain, and pain associated with sexual intercourse — and the extent to which you may be affected by these symptoms. The questionnaire is designed to encourage a frank and comprehensive conversation between you and your doctor. A thorough discussion is a valuable part of making an early diagnosis.

Although there is no specific test for IC, some doctors may perform a cystoscopy. Many doctors will screen for IC using the IC Self-Screener [15] before having a cystoscopy performed.

A cystoscopy (sis-TO-skoh-pee) is a procedure performed by a urologist to see the interior lining of the bladder [7]. To perform a cystoscopy, your urologist may fill your bladder with water, to expand it like a balloon. Next, your urologist will insert a cystoscope (a thin, lighted tube that has a tiny camera attached to the end) into your urethra [12] — the canal that carries urine from the bladder to the outside of the body. Once the tube is inserted, your urologist can view your bladder lining to see if there are any signs of irritation.

While a cystoscopy may be a helpful screening method for your urologist, it does not always find bladder irritation. For some patients, the sores on the bladder lining may not be visible and it can be very difficult to definitively diagnose IC. The IC Self-Screener [15] is a simple, noninvasive screening tool that doctors and patients can feel comfortable using. The questions are very specific, and pinpoint what the patient may be feeling.

You may suspect you have IC if:

• You feel unexplained pain or pressure in the urethra [12], the vagina, the area above the pubic bone, the inside of the thighs, the lower abdomen, the lower back, the groin area, or any combination of these areas.
• You feel pain during or after sexual intercourse.
• You have frequent, sometimes painful, urination. (Normally, people urinate an average of 6 to 7 times per day. Patients with IC urinate an average of 16 times per day, and some urinate as often as 60 times per day.)
• You wake up one or more times at night to urinate.
• You feel the urge to urinate, sometimes even after you've emptied your bladder [7].
• You have unresolved symptoms of a urinary tract infection (UTI) [12] that have not responded to antibiotic therapy.
• Your symptoms come and go — flare-ups may be associated with menstruation, certain foods, allergies and stress.

Yes, IC can be treated. There are a few interstitial cystitis treatments [21] available — including ELMIRON [22]^®. It's important to note that ELMIRON^® is the only oral medication approved by the US Food and Drug Administration (FDA) for the relief of bladder pain or discomfort associated with IC. Other therapies may include bladder analgesics, and solutions to fill the bladder [7], such as dimethyl sulfoxide (DMSO) [23] or heparin [24].

The most common side effects in patients taking ELMIRON^® were blood in stool, diarrhea, nausea, hair loss, headache, rash, upset stomach, abdominal pain, liver function abnormalities and dizziness. When side effects did occur, they were generally mild and usually did not interfere with continuing treatment.

Please read the ELMIRON^® Important Safety Information [25].

With the help of your doctor you can find symptom improvement. Success may vary from patient to patient. Some people eventually become symptom-free. Others may feel varying degrees of improvement. Only a small number of patients have little or no response to available treatments. Without treatment, many people experience flare-ups and remissions. In women, these often occur during hormonal fluctuations.

Since IC may cause you to wake up often throughout the night to urinate, getting a good night's sleep may be rare. It's also common for people to feel depressed.

No. IC is not contagious. No one passed IC on to you, and you can't pass it on to anyone else.

There is no evidence that IC is related to cancer.

When sex hurts, relationships may suffer. Even an understanding partner may become frustrated. Therefore, you may wish to speak with your doctor about the pain you experience during sex. Here are some measures to discuss with your doctor to see if they are right for you:

• Washing with a warm rinse after sex.
• Using plenty of lubrication (such as K-Y^® brand lubricating liquid or jelly).
• Using a soothing gel or ice pack on the external genitalia.

Follow the link for interstitial cystitis organizations [32] that have more information regarding IC. Newsletters, support groups, telephone support groups and other resources are all available. Take time to contact some of these associations to learn more about IC.