IBS and Interstitial Cystitis (Painful Bladder Syndrome)

Interstitial cystitis (IC), also known as painful bladder syndrome, on the surface, looks like the urological counterpart of irritable bowel syndrome (IBS). If you have the misfortune of having both, you may be wondering if they are related. Let's take a look at what is known about interstitial cystitis and any possible overlap with IBS.

What Is IC?

Interstitial cystitis is a health condition in which a person experiences chronic pain and discomfort related to the bladder. IC can be experienced by men but is seen with significantly greater frequency in women. There are no known clear-cut causes of IC although, for some, IC may develop following a urinary tract infection, childbirth or hysterectomy. IC symptoms can wax and wane without any clear pattern. Similar to IBS, IC is diagnosed after other disorders have been ruled out.

Symptoms

The most common IC symptoms are:

• Recurrent bladder pain, pressure and/or discomfort
• Chronic pelvic pain
• Urinary urgency
• Increased frequency of urination
• Need to urinate through the night (nocturia)

The intensity of IC pain and discomfort may change as the bladder fills and empties. For women, IC symptoms may be exacerbated during menstruation. For both men and women, IC may contribute to pain during sexual intercourse.

Treatment Options

As you can see, the treatment options for IC range widely:

• IC medication, oral or inserted into the bladder directly
• Other medications, including OTC analgesics, tricyclic antidepressants, antihistamines, and antispasmodics
• Bladder training
• Physical therapy
• Biofeedback
• TENS (transcutaneous electrical nerve stimulation)
• Surgery

Dietary Interventions

Some types of foods have also been associated with exacerbating IC symptoms. An elimination diet should be used to identify problematic foods so as to avoid unnecessary nutrient restriction. As you will see, many of these foods are also foods that may trigger IBS.

• Acidic foods
• Alcoholic beverages
• Artificial sweeteners
• Caffeine
• Chocolate
• Citrus fruits and juice
• Coffee and tea
• Tomatoes and tomato sauce
• Spicy foods

Overlap Between IC and IBS

Research has shown that individuals who suffer from IC are more likely to suffer from other chronic disorders, including IBS. The reason for the overlap is unknown but does suggest a more system-wide dysfunction. Researchers are looking into the role of inflammatory processes, a "cross-sensitization" among the nerves of the bladder and the bowel, and other central nervous system dysfunction to better understand the underlying factors responsible for the initiation and maintenance of these chronic conditions.

What to Do If You Have Both

The establishment of a good working partnership with a healthcare provider would certainly be ideal if you are suffering from both IC and IBS. Your healthcare provider can help you to sort through the various treatment options for both conditions to sort out which options might benefit both, without exacerbating one or the other.

Since certain foods have a reputation for aggravating either condition, keeping a symptom diary and using an elimination diet may help you to identify foods that are contributing to your bowel or bladder symptoms.

As there may be some system-wide dysfunction that is contributing to both your IC and IBS problems, it might be helpful to look into holistic health approaches. Mind/body activities, such as yoga, meditation, and the regular use of relaxation exercises, can help to ease anxiety and stress, both of which can enhance pain sensations.