The IC mystery

IC is fairly common. It’s estimated that, in the United States, 3-6% of adult women and about 1.3% of adult men have IC, which translates into about 7-12 million Americans. Yet, despite its prevalence, shockingly little is known about it. For example: 

There is no test that can be used to diagnose IC. IC is a diagnosis of exclusion. In other words, it’s the sad diagnosis that’s left for you after all the other likely suspects (e.g., a UTI, bladder cancer, endometriosis) have been ruled out, and it’s made in the absence of objective evidence. 

The cause of IC is unknown. When it comes to the origins of IC, all we have are flimsy theories. The most widely touted idea is that IC is caused by damage to the protective lining of the bladder, which allegedly results in chronic inflammation of the bladder wall due to its contact with the irritating substances found in urine. Other theories suggest that IC is caused by dysfunctional pelvic floor muscles, a food sensitivity, a nutritional deficiency, an autoimmune disease, histamine intolerance, allergies, a hormonal imbalance, a crappy microbiome, leaky gut, a chronic fungal infection, and/or an antibiotic-resistant bacterial biofilm. 

There is no standard treatment for IC. After receiving an IC diagnosis, you are given a long list of motley treatment options and invited to pick your poison. Some of these options are merely inconvenient (pelvic floor wand massage), while others are painful (bladder distension), heart-wrenching (elimination diets), or even dangerous (Elmiron). You will be led to believe that there is no cure for IC, and that the best thing that you can hope for is finding a combination of treatments that provides some degree of relief.