Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
PBS/IC is an inflammatory disease of the bladder that can cause ulceration and bleeding of the bladder's lining and can lead to scarring and stiffening of the bladder.
The symptoms of PBS/IC are pelvic pain as well as urinary frequency and urgency.
PBS/IC has a variable clinical course, meaning that symptoms can appear and disappear over time. Moreover, the intensity of symptoms varies among individuals and even within the same individual over time.
The cause of PBS/IC is unknown, but abnormalities in the leakiness or structure of the lining of the bladder are believed to play a role in the development of PBS/IC.
The diagnosis of PBS/IC is based on the symptoms, an abnormal potassium sensitivity test (PST), and elimination of other conditions that may be responsible for the symptoms.
Treatment for PBS/IC most commonly utilizes heparinoid drugs to help restore integrity of the bladder lining along with other oral medications. Bladder distension and intravesical drug therapy are other treatments that may provide relief in PBS/IC.
Overview of urinary function
The urinary system consists of the kidneys, ureters, bladder, and urethra. The kidneys, a pair of purplish-brown organs, are located below the ribs toward the middle of the back. The kidneys remove water and waste from the blood in the form of urine, keeping a stable balance of salts and other substances in the blood. The kidneys also produce erythropoietin, a hormone that stimulates the formation of red blood cells. Narrow tubes called ureters carry urine from the kidneys to the bladder, a triangle-shaped, muscular chamber in the lower abdomen. Like a balloon, the bladder's muscular, elastic walls relax and expand to store urine and contract and flatten when urine is emptied through the urethra. The typical adult bladder can store about 1 ½ cups of urine.
Adults urinate about 1 ½ quarts of urine each day. The amount of urine varies depending on the fluids and foods a person consumes. The volume formed at night is about half that formed during the day.
Normal urine contains fluids, salts and waste products, but it is free of bacteria, viruses, and fungi. The tissues of the bladder are isolated from urine and toxic substances by a coating on the inside of the bladder that discourages bacteria from attaching and growing on the bladder wall.
Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: William C. Shiel Jr., MD, FACP, FACR
About 750,000 people in the U.S. (about 90% of whom are
women) suffer from a chronic condition of the bladder known as interstitial cystitis.
Interstitial cystitis (IC) refers to a clinical syndrome characterized by
symptoms including chronic urinary urgency (feeling the need to urinate
immediately) and frequency (frequent urination). Pelvic pain may or may not be
present. The term cystitis refers to any inflammation of the bladder. Since
the wall of the bladder is inflamed, this can lead to pain and soreness in the
bladder and pelvic areas. The inflammation can also lead to scarringof the
bladder wall that can sometimes reduce the capacity of the bladder to hold
urine. In many cases of interstitial cystitis, small hemorrhages and ulcers are
present on the inner lining of the bladder wall.
Interstitial cystitis is diagnosed when the symptoms occur without evidence
for another cause of the symptoms, such as an infection of the bladder.