Interstitial Cystitis

Medical Treatments

A doctor may start with aspirin or ibuprofen and move to stronger non steroidal anti inflammatory agents such as naproxen or piroxicam . Sodium pentosanpolysulfate (Elmiron), an experimental drug used for bladder washes, may restore the bladder lining. Another experimental drug called nalmefene (Incystene) may block off pain receptors, thus alleviating this symptom. Amitriptyline , an antidepressant drug, may also alleviate pain and night voiding. In some cases, bladder distention may be tried, as some patients have noticed an improvement in symptoms following the procedure. Another approach involves periodically instilling RIMSO-50, a compound made from the industrial solvent DMSO, into the bladder. (This is the only FDA approved medical use of DSMO.) The substance passes into the bladder wall, reducing inflammation and perhaps halting painful muscle contractions. Its major drawback is that it produces a strong, garlic like breath and skin odor for up to 72 hours. In severe cases, surgery may be considered. However, the results vary and symptoms sometimes recur. Laser surgery may be used to seal off ulcerated areas; alternatively, resection consists of removing ulcers by cutting around them. In intractable cases, approaches may include: denervation, in which some nerves to the bladder are cut to alleviate pain; augmentation, which enlarges the bladder, usually by adding a section of the patient’s small intestine; and cystectomy, in which all or part of the bladder is removed. After a cystectomy, a stoma is needed to reroute urine. Or the bladder may be replaced with a pouch made from a piece of the large intestine.

Alternative Therapies

Although alternative therapies cannot cure the syndrome, some can alleviate its most troublesome symptoms.

Acupuncture And Acupressure

These techniques may be helpful in alleviating chronic pain.

Tens

In this approach, which stands for transcutaneous electrical nerve stimulation, mild electrical impulses are sent into the skin, creating a sensation that distracts from the pain impulses.

Yoga And Meditation

These and other relaxation techniques can help reduce stress, which aggravates symptoms.

Self Treatment

Bladder retraining sometimes helps. For a week or two, keep a careful diary of how often you urinate daily. Then try to extend the typical time between voiding’s by 10 or 15 minutes. Experts recommend experimenting with the diet to identify foods that provoke symptoms. Acidic and highly spiced foods often cause problems. Keep a food diary, then eliminate likely offenders, returning them one at a time. Abstain completely from smoking, alcohol, and artificial sweeteners, reduce or eliminate caffeine. Also, use caution when taking supplements, especially vitamin C, which irritates the bladder.