Common Treatment Options for Interstitial Cystitis
If you've been diagnosed with interstitial cystitis (IC) and haven't found relief through treatment, there's still hope. What brings relief to one person may not work for another. Sometimes it takes a number of tries before you and your doctor find the treatment, or combination of treatments, that works for you.
Talk with your doctor about your options, and don't give up until your condition is under control. Here are some treatments that have helped people with IC.
Oral pentosan polysulfate is an FDA-approved drug for IC that has been shown to relieve pain in about 30% of sufferers. It's usually taken three times a day, and side effects are uncommon. Scientists aren't exactly sure how it works, but it may help restore the protective coating on the bladder. The drug usually takes three to six months for users to see major improvements.
An antidepressant called amitriptyline may also help reduce pain, increase bladder capacity, and decrease frequency of urination. It works by slowing the nerves that carry pain messages and decreasing bladder spasms. Some people have difficulty taking amitriptyline because it can make them tired during the day.
Hydroxyzine is an antihistamine that's usually taken in the evening. Its sedative effect can help some people with IC get better rest and reduce their frequency of nighttime urination.
Some people find relief with an FDA-approved IC treatment that involves filling the bladder with liquid medication called dimethyl sulfoxide (DMSO). This procedure is sometimes referred to as a "bladder wash" or "bladder cocktail." Your doctor slowly fills your bladder with the medication via a catheter, and you release the liquid after 15 minutes.
It's not clear how DMSO works. But it's believed to help reduce inflammation, decrease pain sensations, and block toxins that can damage the bladder. The main side effect of DMSO is a garlic-like taste and smell that goes away within a day. The treatment is typically done about once a week for one to two months. People usually notice an improvement in symptoms after the third or fourth treatment.
Bladder distention—in which a doctor fills up the bladder to capacity—may help relieve symptoms of IC. It's often done to diagnose the condition by looking at the bladder wall directly, but it may be used as a treatment as well. Some researchers believe that stretching the bladder increases its capacity and interferes with pain signals. Patients are given anesthesia for the procedure because it can be painful. Bladder symptoms can get worse for up to two days after the treatment, but many people notice improvements within two to four weeks.
Electrical nerve stimulation
In this therapy, doctors use mild electrical pulses to stimulate the nerves to the bladder. The stimulation helps reduce pain and decrease frequency in some people. The electrical pulses can be administered through the skin or delivered through special devices temporarily inserted or implanted into the body. Patients work with doctors to determine how long, how often, and at what intensity the stimulation is performed. Scientists think the therapy may work by increasing blood flow to the bladder, strengthening muscles that help control the bladder, or blocking pain signals.
Living with IC and painful bladder symptoms isn't easy. But you have the power to help take control of your condition, and it's important to play an active role in your treatment. Ask your doctor about the risks and benefits of all treatment options. And take steps on your own to help reduce symptoms. Possible ways to lessen the effects of IC include modifying your diet by reducing consumption of alcohol, artificial sweeteners, and spicy pepper. Also, consider getting help to stop smoking if necessary, performing gentle stretches, and working with your doctor to try bladder retraining—training the bladder to void less often. As a team, you and your doctor can find a solution that's right for you.
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- Interstitial Cystitis/Painful Bladder Syndrome. National Institute of Diabetes and Digestive and Kidney Diseases. http://kidney.niddk.nih.gov/kudiseases/pubs/interstitialcystitis/
- What I need to know about Interstitial Cystitis/Painful Bladder Syndrome. National Institute of Diabetes and Digestive and Kidney Diseases. http://kidney.niddk.nih.gov/kudiseases/pubs/interstitialcystitis_ez/
- Interstitial Cystitis. American Urological Foundation Association. http://urologyhealth.org/adult/index.cfm?cat=03&topic=210