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How do you know if you have IC?

Although IC is not an infection, the symptoms of IC mimic that of a bladder infection. The symptoms may even vary in the same individual.

You may experience IC symptoms such as the following:

  • An urgent need to urinate
  • Frequent need to urinate even at night
  • Pain/pressure in the bladder1

The most common symptom is urgency to urinate, which exists even after urinating. On an average, a person would urinate not more than seven times a day, without the need to wake up at night for using the bathroom. Frequency is the need to urinate more than normal. In IC, the frequency of urination can be increased as often as 60 times per day, including nighttime urination.


Patients with IC complain of pain as the bladder gets distended during filling, and the pain is relieved on emptying. This intermittent or constant pain can extend to the lower abdomen, lower back, vulva or vagina in women, and testicles or penis in men. Women may also have pain during sexual intercourse, and men may have painful ejaculation.

The symptoms of IC can vary from person to person. Majority of the women observe exacerbation of symptoms just before or during the menstrual cycles and on intake of oral contraceptive pills. It can flare up in times of physical or mental stress, and can be triggered by certain foods and drinks.

How will your Doctor Diagnose IC?

Patients seek medical help only after years of suffering from the disease. Numerous physicians and specialists are consulted before the right diagnosis is made. It is important for the physician to be aware of IC so as to refer to a urologist in time. IC is also treated by gynaecologists.

To diagnose IC, the physician needs to

  • Take a thorough medical history,
  • Carry out a physical examination and
  • Carry out tests such as urine analysis, urine culture and cytology.

Medical History

Your doctor will take a detailed medical history by asking you many questions, such as:

  • How often do you urinate?
  • Do you have an urgent need to urinate day and night?
  • What is your fluid intake per day?
  • How much urine do you pass in a day?
  • What makes your symptoms worse - menstruation (in women)?
  • Do you have pain during sexual intercourse/ejaculation (in men)?
  • Does any food make you feel worse?

Physical Examination

Your doctor will examine you for any pain in the lower abdomen. In women a vaginal examination and in men digital rectal examination are performed.

What Are the Investigations Done for IC?

Urinalysis, urine culture and cytology

These tests are carried out using samples from the patient's urine, to rule out any bacterial infections in the bladder. In men, sometimes prostatic fluid may be examined for infection.

Ultrasound scan

This may be performed to investigate the amount of urine left in the bladder after urination.


Your doctor will look inside your bladder by using a cystoscope. Direct bladder wall viewing is done by inserting a narrow tube into the bladder. This is recommended as a standard investigation procedure to rule out bladder cancer and stones, and also to visualise any pinpoint bleeding or ulcers [Figure 5]


There are two ways to conduct this examination:

  • Under local anaesthesia - to detect scarring and ulcers.
  • Under general/spinal anaesthesia - here the bladder is assessed for bladder capacity. Bladder is filled with fluid to examine bladder capacity and bladder wall for injury.

Optional Investigations

Urodynamic investigations

This investigation will help in assessing the bladder capacity, pain and when the patient first feels the desire to urinate. This procedure involves filling up of the bladder and measuring its pressure as it fills up.1

Bladder biopsy

Samples of the bladder tissue are taken from different levels of the bladder wall and muscle. These samples are checked microscopically for any abnormality such as cancer and presence of inflammatory cells that hamper the growth of the protective GAG layer. Cost is a limiting factor for bladder biopsy.

IC questionnaires/voiding chart

IC questionnaires and voiding charts are used to assess the quality of life in IC patients. Patients may be asked to record their pain, fluid intake and frequency of urination. However, these do no play any significant role in the diagnosis of IC.1,2

  1. Homma Y, Ueda T, Ito T, Takei M, Tomoe H. Japanese guideline for diagnosis and treatment of interstitial cystitis. Int J Urol. 2008; 16(1):4-16.
  2. Meijlik JM. Interstitial cystitis, diagnosis and treatment - an overview. International Painful Bladder Foundation. Available at: