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.
Cystoscopy
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
