Editing Interstitial cystitis (section)

==Diagnosis==
A diagnosis of IC is one of exclusion, as well as a review of clinical symptoms.<ref name=pmid23276554/> The American Urological Association Guidelines recommend starting with a careful history of the person, physical examination and laboratory tests to assess and document symptoms of interstitial cytitis,<ref>{{Cite web|url=https://www.auanet.org/guidelines/interstitial-cystitis/bladder-pain-syndrome-(2011-amended-2014)|title=American Urological Association -|website=www.auanet.org|access-date=2018-11-07|archive-date=20 September 2018|archive-url=https://web.archive.org/web/20180920145129/https://www.auanet.org/guidelines/interstitial-cystitis/bladder-pain-syndrome-(2011-amended-2014)|url-status=dead}}</ref> as well as other potential disorders.

The [[potassium chloride|KCl]] test, also known as the ''potassium sensitivity test'', is no longer recommended. The test uses a mild [[potassium]] solution to evaluate the integrity of the bladder wall.<ref name=pmid19808225/> Though the latter is not specific for IC/BPS, it has been determined to be helpful in predicting the use of compounds, such as [[pentosan polysulphate]], which are designed to help repair the GAG layer.<ref>{{Cite book |last1=Reynard |first1=John |url=https://books.google.com/books?id=3rBuAgAAQBAJ&dq=such+as+pentosan+polysulphate%2C+which+are+designed+to+help+repair+the+GAG+layer&pg=PT213 |title=Oxford Handbook of Urology |last2=Brewster |first2=Simon |last3=Biers |first3=Suzanne |date=2013-02-28 |publisher=OUP Oxford |isbn=978-0-19-101592-2 |language=en}}</ref>

For complicated cases, the use of [[hydrodistention]] with cystoscopy may be helpful. Researchers, however, determined that this visual examination of the bladder wall after stretching the bladder was not specific for IC<ref>{{cite journal |last1=MacDiarmid |first1=SA |last2=Sand |first2=PK |title=Diagnosis of Interstitial Cystitis/Painful Bladder Syndrome in Patients With Overactive Bladder Symptoms |journal=Reviews in Urology |volume=9 |issue=1|pages=9–16 |year=2007|pmid=17396167 |pmc=1832106}}</ref> and that the test, itself, can contribute to the development of small [[glomerulation]]s ([[petechia]]l hemorrhages) often found in IC. Thus, a diagnosis of IC is one of exclusion, as well as a review of clinical symptoms.

In 2006, the ESSIC society proposed more rigorous and demanding diagnostic methods with specific classification criteria so that it cannot be confused with other, similar conditions. Specifically, they require that a person must have pain associated with the bladder, accompanied by one other urinary symptom. Thus, a person with just frequency or urgency would be excluded from a diagnosis. Secondly, they strongly encourage the exclusion of confusable diseases through an extensive and expensive series of tests including (A) a [[medical history]] and [[Physical examination|physical exam]], (B) a dipstick [[urinalysis]], various urine cultures, and a serum [[Prostate-specific antigen|PSA]] in men over 40, (C) flowmetry and post-void residual urine volume by [[ultrasound scan]]ning and (D) cystoscopy. A diagnosis of IC would be confirmed with a hydrodistention during cystoscopy with biopsy.<ref>{{Cite journal|last1=van de Merwe|first1=Joop P.|last2=Nordling|first2=Jørgen|last3=Bouchelouche|first3=Pierre|last4=Bouchelouche|first4=Kirsten|last5=Cervigni|first5=Mauro|last6=Daha|first6=L. Kurosch|last7=Elneil|first7=Suzy|last8=Fall|first8=Magnus|last9=Hohlbrugger|first9=Gero|date=January 2008|title=Diagnostic Criteria, Classification, and Nomenclature for Painful Bladder Syndrome/Interstitial Cystitis: An ESSIC Proposal|journal=European Urology|volume=53|issue=1|pages=60–67|doi=10.1016/j.eururo.2007.09.019|pmid=17900797|issn=0302-2838}}</ref>

They also propose a ranking system based upon the physical findings in the bladder.<ref name=pmid19808225/> People would receive a numeric and letter based score based upon the severity of their disease as found during the hydrodistention. A score of 1–3 would relate to the severity of the disease and a rating of A–C represents biopsy findings. Thus, a person with 1A would have very mild symptoms and disease while a person with 3C would have the worst possible symptoms. Widely recognized scoring systems such as the O'Leary Sant symptom and problem score have emerged to evaluate the severity of IC symptoms such as pain and urinary symptoms.<ref name="Tyagi2014">{{cite journal|vauthors=Tyagi P, Kashyap MP, Kawamorita N, Yoshizawa T, Chancellor M, Yoshimura N |title=Intravesical liposome and antisense treatment for detrusor overactivity and interstitial cystitis/painful bladder syndrome|journal=ISRN Pharmacol |volume=2014 |issue=601653|pages= 601653|date=January 2014|pmid= 24527221|pmc=3914518|doi=10.1155/2014/601653|doi-access=free}}</ref>

===Differential diagnosis===
The symptoms of IC/BPS are often misdiagnosed as a [[urinary tract infection]]. However, IC/BPS has not been shown to be caused by a [[bacterial infection]] and [[antibiotics]] are an ineffective treatment.<ref name="Lim ORourke 2022 p. ">{{citation | last1=Lim | first1=Y | last2=O'Rourke | first2=S | title=Interstitial Cystitis | chapter=article-132252 | publisher=StatPearls Publishing | publication-place=Treasure Island (FL) | year=2022 | pmid=34033350 | url=http://www.ncbi.nlm.nih.gov/books/NBK570588/ | access-date=2022-01-26 | page=}}</ref> IC/BPS is commonly misdiagnosed as [[chronic prostatitis/chronic pelvic pain syndrome]] (CP/CPPS) in men,<ref name=pmid26813678>{{cite journal |pmid=26813678 |pmc=4708534 |year=2015 |last1=Arora |first1=Hans C. |title=The enigma of men with interstitial cystitis/bladder pain syndrome |journal=Translational Andrology and Urology |volume=4 |issue=6 |pages=668–76 |last2=Shoskes |first2=Daniel A. |doi=10.3978/j.issn.2223-4683.2015.10.01 }}</ref> and [[endometriosis]] and [[uterine fibroids]] (in women).