Interstitial cystitis (IC) initially presents with a subacute onset followed by
a rapid peak in severity of symptoms. The plateau phase which follows the rapid
peak is characterised by exacerbations and remissions of symptoms.
The symptoms of IC are listed below:
Urinary sensory urgency with or without pain, pressure or spasm
Urinary frequency
Vague sense of incomplete bladder emptying
Increase in nocturnal frequency with progression of the disease
Suprapubic pain radiating to low back and thighs; aggravated by full bladder and
relieved after bladder emptying
An average rate of voiding of 16 times per day
Associated medical conditions such as allergies, irritable bowel syndrome and fibromyalgia
Emotional and psychological overlap in the complaints
Complaint of incontinence is rare
Dyspareunia and decreased libido1-3
Flares in IC
The progression of disease in IC undergoes episodes of exacerbations and remissions.
Around 50% of the patients show a spontaneous remission after a few months. The
patients may be completely asymptomatic intermittently with acute episodes of flares.
In some, the disease may have a progressive course with gradual increase in symptoms
over several years. Some of the precipitating factors responsible for intermittent
flares are as follows: 2
Emotional or physical stress
Muscle and joint pain, migraines, allergic reactions, and gastrointestinal problems
Premenstrual period
Consumption of specific foods such as coffee, alcohol, carbonated drinks, citrus,
tomatoes and chocolates 3
Symptoms of IC in Women
The symptoms of IC in women overlap with symptoms of urinary tract infection, chronic
urethral syndrome, vulvodynia, overactive bladder and endometriosis. The common
symptoms seen in women with IC are as follows:
Urinary frequency, urgency and nocturia
Dyspareunia (common in 50% of patients)
Fluctuations in symptoms relative to ovulatory cycle
Remission of symptoms during second and third trimester of the disease 1,2,4,5
Symptoms of IC in Men
The symptoms of IC in men overlap with the symptoms of prostatitis which is characterised
by similar symptoms and single pathophysiological process in the lower urinary tract.
The symptoms seen in male patients with IC are as listed below:
Urinary urgency and frequency
Nocturia
Perineal, groin, penile or scrotal pain
Pain at locations throughout the pelvis during sexual intercourse 1,2