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What are the possible causes of BPS/IC?

It’s not yet known what causes BPS/IC as, unlike other types of cystitis, there’s no obvious infection in the bladder and antibiotics don't help. In some people with the condition, the bladder is inflamed, has lesions and may be scarred or stiff. Possible causes of the condition are believed to be:1,44

  • A symptom of a systemic autoimmune disease such as lupus
  • A symptom of a pain and/or fatigue syndrome such as fibromyalgia or chronic fatigue syndrome (CFS)
  • A symptom of another condition such as irritable bowel syndrome (IBS)
  • A problem with the pelvic floor muscles (used to control urination)
  • An allergic reaction
  • Genetic, a family member with BPS/IC may increase the risk of it occurring

It is also thought BPS/IC is an autoimmune response following a bladder infection. The infection and body’s defences damage the lining of the bladder, allowing urinary toxins to infiltrate the bladder wall and set up an inflammatory reaction. The inflammatory reaction damages nerve endings (which become sensitised) and make the pain worse.1,44

One field of research has focused on the layer that coats the lining of the bladder called the glycocalyx, which mainly consists of substances called mucins and glycosaminoglycans (GAGs).1,44

This GAG layer normally protects the bladder wall from the toxins in urine and researchers have found that it is defective in up to 70% of BPS/IC patients1,44,45


  • 1.Meijlink JM. Interstitial Cystitis/Bladder Pain Syndrome. Int Painful Bl Found. 2014.
  • 44.Fiander N. Painful bladder syndrome and interstitial cystitis: treatment options. Br J Nurs. 2013;22(9):27-33.
  • 45.Galen. Uracyst® (chondroitin sulfate, 2%). www.galen.co.uk/products/uracyst/importance-of-the-bladder-gag-layer. Published 2015. Accessed September 1, 2017.