Interstitial cystitis is a chronic condition characterized by the presence of cystoscopic and/or histological features showing severe inflammation of the bladder wall without an infection present. The exact etiology is unknown but leading theories include inflammation/injury cascade, autoimmune disorder, and/or impaired urothelial proliferation. Flare ups or exacerbations are common and symptoms may intensify for hours, days or weeks(1). A diagnosis can be extremely challenging due to the lack of an evidenced based guide for diagnosis.
Questions to ask include the specific location of pain which may include bladder, urethral and pelvic pain in the suprapubic region along with urinary urgency and frequency. Pain may be increased when the bladder is full. There may be increased pain while in a flexed posture. Musculoskeletal findings may include sacroiliac and symphysis pubis joint dysfunction along with hypertonic pelvic floor muscles and myofascial restrictions. There may be increased daytime and nighttime frequency. Ask about dyspareunia and dysuria. The presence of symptoms greater than 6 months may also be indicative(1).