Interstitial Cystitis
Alternate Names : Painful Bladder Syndrome
What are the treatments for the condition?
Treatment of interstitial cystitis focuses on relief of symptoms. There is no cure. The general approach is to start with the therapy that has the fewest side effects. If this does not work, individuals may want to try other things.
Although the role of diet in interstitial cystitis hasn't been proven, many people find symptom relief by eliminating certain foods. It may be helpful to eliminate one food at a time to see if symptoms go away. Foods often associated with interstitial cystitis include:
alcohol
artificial sweeteners
caffeine
chocolate
citrus foods and drinks
foods high in acid
spices
tomatoesSome people report that smoking makes their symptoms worse. Cigarette smoking is a cause of bladder cancer. So it makes sense to quit smoking.
Bladder training may be helpful for some people with the condition. The person follows a set schedule for urinating. The time period between urination is gradually increased.
One medical option is bladder distention, which treats the stiffness of the bladder wall. Some people with interstitial cystitis can only hold a small amount of urine. They need to urinate frequently. After the initial cystoscopy with bladder distention, symptoms often get worse for a week or two. When the initial reaction goes away, most people will experience some relief. This can last from 1 to 6 months. A bladder instillation, or bladder wash, can also relieve symptoms. A solution of dimethyl sulfoxide, or DMSO, is inserted into the bladder with a catheter. It is held in the bladder for about 15 minutes.
A variety of oral medicines are used to treat interstitial cystitis. These include:
antidepressants, such as amitriptyline, to relieve pain and help deal with stress
antihistamines, which may also relieve pain
antiprostaglandins, such as ibuprofen and aspirin, to relieve pain
narcotics, such as codeine, for the most severe cases
pentosan polysulfate sodium, or Elmiron, which is believed to repair defects in the bladder lining
Transcutaneous electrical nerve stimulation, or TENS, may be used for pain relief. Wires are placed on the body or in the vagina or rectum. A mild electric current is passed through the wire. Researchers are not sure why the TENS works. Some theories about the electric pulse is that it:
improves blood flow to the bladder
starts the release of pain-blocking substances
strengthens pelvic muscles that control the bladder
When interstitial cystitis does not respond to anything else, surgery is an option. It is performed only in the worst cases. Results are often less than expected. Possible procedures include:
augmentation, which increases the bladder capacity
complete removal of the bladder
creation of an artificial bladder from a piece of the person's bowel
laser surgery to remove ulcers in the bladder
removal of a portion of the bladder
removal of ulcers in the bladder
sacral nerve root stimulation, which involves permanent insertion of a nerve stimulator and wires
What are the side effects of the treatments?
Antiprostaglandins may cause stomach upset or allergic reactions. Antidepressants and antihistamines may cause drowsiness and dry mouth. Pentosan polysulfate sodium
can cause abnormal liver function. Liver problems disappear when the medicine is stopped. DMSO can cause a garlic taste and odor. Surgery may cause bleeding, infection, or allergic reaction to anesthesia.
What happens after treatment for the condition?
The course of interstitial cystitis is often unpredictable. Individuals may or may not get better with treatment. Symptoms often come and go. Treatment may be needed for years in severe cases.
How is the condition monitored?
The affected person monitors his or her symptoms. The need for repeat examinations depends on the severity of the condition and the treatments used. Any new or worsening symptoms should be reported to the healthcare provider.
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