Interstitial cystitis (IC) is a serious debilitating disease often overlooked by medical and health professionals. This paper describes the elusive aetiology and the painful symptoms of IC and how it affects the patient’s life. The author outlines the treatments available and offers guidelines for supporting patients with the disease

Interstitial cystitis is a chronic and painful inflammation of the bladder wall. Patches of the lining of the bladder wall become raw and inflamed, causing bleeding. When urine comes into contact with the raw areas, it stings, so the patient finds it painful to hold urine in the bladder. Scar tissue forms and makes the bladder stiff, so that it cannot expand to hold urine. Parts, or all of the bladder may be involved, including the trigone and urethra. Cystoscopic examination of the bladder following distension under anaesthesia typically reveals submucosal pinpoint haemorrhages, called glomerulations, and some patients have fissures, known as Hunner’s ulcers (Hanno 1994). Box 1 shows the differences between interstitial cystitis and urinary tract infection.