Patient education: Bladder pain syndrome (interstitial cystitis) (The Basics)

What is bladder pain syndrome? — Bladder pain syndrome ("BPS") is a condition that causes people to have bladder pain and urinate often (figure 1). It is also sometimes called "painful bladder syndrome" or "interstitial cystitis."

BPS is more common in females. Doctors do not know what causes BPS, but some doctors suspect that it might be caused by abnormal changes in the lining of the bladder. Sometimes, BPS happens on its own. Other times, it starts after a person has:

●An infection of the urinary tract, vagina, or prostate

●Surgery on the bladder, pelvis, or back

●An injury to the pelvic area or buttocks

What are the symptoms of BPS? — All people with BPS have bladder pain that gets better after urinating. Other common symptoms include:

●Feeling like you need to urinate often during the day and night (even if you don't actually urinate)

●Urinating often during the day and night

●Having pain in the lower belly or around the area where urine leaves the body

Symptoms of BPS are different from person to person and can be mild or severe. People might not have symptoms every day. But they can have "flares," which are times when their symptoms get worse. Some people find that their symptoms get worse at certain times, such as:

●After they have certain foods or drinks

●During certain times of their monthly cycle (in females)

●After having sex

●After sitting for a long time

●During times of stress

Is there a test for BPS? — There is no specific test to check for BPS. But if you have BPS symptoms, your doctor or nurse will talk with you, might do an exam, and will probably do a urine test. Depending on the results, your doctor might do other tests, too.

For example, some people have a test called "cystoscopy." During cystoscopy, a doctor puts a thin tube with a tiny camera on the end into the opening in the body where urine comes out (called the urethra) (figure 2). Then, they advance the tube until it reaches the bladder. That way, the doctor can look at the inside of the bladder to see if it is abnormal.

How is BPS treated? — There are different treatments for BPS. Most people need more than 1 treatment. Different treatments can include:

●Bladder training – You can train your bladder to urinate less often by holding your urine for longer periods of time. For example, if you feel the need to urinate every 30 minutes, try to wait and urinate every 45 minutes.

●Physical therapy – Many people with BPS have tight and painful muscles in the lower belly, groin, and buttocks. A physical therapist can teach you exercises to help relax these muscles.

●Medicines – Doctors can use different medicines to treat BPS. Some medicines help heal the bladder lining, and others can reduce pain.

●Surgery – A person might have surgery if they still have symptoms after trying all other treatments. During surgery, a doctor puts a small device in the lower back that connects to the nerve that goes to the bladder. The device sends electrical signals to the nerve that can stop it from feeling pain.

How can I help prevent BPS flares? — To help prevent flares, you should:

●Avoid the foods and drinks that make your symptoms worse.

●Avoid activities that make your symptoms worse.

●Get treated quickly for bladder infections, which can make BPS symptoms worse.

What if I have long-term pain? — If you have long-term pain, talk with your doctor or nurse about what you can do. Some people find it helpful to work with a mental health expert or join a support group for people with BPS.

More on this topic

Patient education: Chronic pelvic pain in females (The Basics)
Patient education: Urinary tract infections in adults (The Basics)
Patient education: Cystoscopy (The Basics)
Patient education: Bladder training (The Basics)
Patient education: Pelvic ultrasound (The Basics)
Patient education: Bladder instillation (The Basics)

Patient education: Diagnosis of interstitial cystitis/bladder pain syndrome (Beyond the Basics)
Patient education: Treatment of interstitial cystitis/bladder pain syndrome (Beyond the Basics)