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Interstitial cystitis (bladder pain syndrome)

Cystitis interstitialis · Intersticiální cystitida (syndrom bolestivého měchýře)

What it is

A painful bladder with no infection — pressure and pain that ease on emptying, and the need to go again and again; mostly women.

Symptoms & signs

  • Pelvic or bladder pain, better after passing urine
  • urgency and frequency day and night
  • pain during sex
  • flares with some foods or stress

🚩 Get help if…

  • call 112 / 911 now Unable to pass urine with a painful, full bladder
  • see a doctor soon Blood in the urine
  • see a doctor soon Fever, shivers or pain in the loin
  • see a doctor soon Burning with cloudy, smelly urine

Where it strikes

Medical treatment

  • Rule out infection and cancer
  • amitriptyline or hydroxyzine
  • pentosan polysulfate
  • bladder instillations (DMSO, heparin, lidocaine)
  • botulinum toxin or hydrodistension

Natural & lifestyle

  • Diet diary: less coffee, citrus, tomato, spice and alcohol
  • pelvic-floor physiotherapy (relaxing, not strengthening)
  • stress management

Emerging & experimental

  • Liposomal tacrolimus instillations
  • monoclonal antibodies

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Quercetin — a small study eased symptoms early / small studies
  • Aloe vera capsules — small studies early / small studies
  • Acupuncture — trials disagree mixed evidence
  • Marshmallow root tea — anecdotal anecdotal / traditional

ICD codes