Interstitial Cystitis treatment

Interstitial cystitis (IC) is a condition that causes discomfort or pain in the bladder and abdomen. It is a chronic (long-term) inflammation of the bladder wall with an unknown cause.

It is 10 times more common in women than in men. The symptoms vary from case to case. Some people have an urgent or frequent need to urinate. Women's symptoms often get worse during their periods. They may also have pain with sexual intercourse.

Many scientists believe IC is actually several diseases. Many use the term painful bladder syndrome (PBS) to describe urinary pain for which they cannot find a cause. There is no one test to tell if you have IC/PBS. Doctors often run tests to rule out other possible causes of symptoms.

Symptoms

•  Urinary frequency (as often as every 10 minutes)
•  Urinary urgency
•  Urinary pressure
•  Pain in the bladder and/or pelvis
•  Pain during intercourse
•  Nocturia (need to get up during the night in order to urinate, thus interrupting sleep)
•  Pelvic floor dysfunction and tension
•  Discomfort and difficulty driving, travelling or working

Diagnosis

Diagnosis is made by ruling out other causes. Urine analysis, urine culture, and urine cytology tests are essential.

Usually, cystoscopy (endoscopy of bladder) and bladder biopsy are performed. The characteristic finding of interstitial cystitis during cystoscopy is pinpoint bleeding in the lining of the bladder or ulcers on the bladder wall.

In IC, the bladder does not hold as much urine as a normal bladder typically does.

A procedure called video urodynamics can reveal how much urine needs to be in the bladder before the patient feels the need to urinate.

Treatment

There is no cure for IC, nor are there any standard or consistently effective treatments. Results vary from individual to individual. As long as the cause is unknown, treatment is based on trial and error until relief is found.

Medicines may include:
•  Oral Elmiron (aka pentosan polysulfate) is believed to provide a protective coating in the bladder.
•  Tricyclic antidepressants such as Elavil (amitriptyline) may relieve pain and urinary frequency
•  Vistaril (hydroxyzine pamoate), an antihistamine that causes sedation helps reduce urinary frequency
•  Opioid painkillers for severe pain

Other therapies include:
•  Bladder instillation or intravesical therapy, also called a bladder wash or bath - medicines are placed directly into the bladder .
•  Surgery, ranging from cystoscopic manipulation to bladder removal (cystectomy)
•  Bladder distension or hydrodistension (filling bladder with fluid)
•  Bladder training (using relaxation techniques to train the bladder to go only at specific times)
•  Physical therapy and biofeedback (may help relieve pelvic floor muscle spasms)
•  Diet modification to avoid foods and beverages that can cause bladder irritation

Treatment results vary. Some people respond well to simple treatments and dietary changes. Others may require extensive treatments or surgery.

Cost of treatment

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