Page 2 - Interstitial Cystitis
P. 2
Interstitial cystitis
Establishing the diagnosis of IC is much like putting
together the pieces of a puzzle – gradually the picture Oral medication
becomes clear as the pieces fall into place. The main
pieces necessary to make a diagnosis of IC are the • Tricyclic antidepressants (e.g. amitriptyline) can
presence of typical symptoms, the absence of other relieve pain at doses much lower than those used
conditions and the response to treatment. to treat depression. They often cause bladder
relaxation, increasing the storage capacity of the
This process of establishing a diagnosis requires bladder and decreasing voiding frequency.
patience. The symptoms of IC are real, not imagined. Finally, their sedative effect is particularly helpful in
Once the diagnosis is clear, a comprehensive reducing nighttime urination.
treatment plan will help relieve and control symptoms. • Pentosan polysulfate (Elmiron™) is a medication
used specifically for treating IC. Over time, it may
Treatment restore and maintain the defective protective
coating of the bladder lining. Elmiron™ must be
The treatment of IC includes many components: used for several months before it becomes fully
patient education, self help, modification of diet effective.
and other external contributing factors, and often, • Antihistamines, like hydroxyzine (e.g. Atarax™), may
medication. Surgery may be helpful in rare cases. be helpful. They also have sedative and relaxing
Cure may not be possible, but relief can be achieved. effects.
• In some cases, other classes of medication may
Diet be prescribed. These include anticonvulsants
(e.g. gabapentin), anti-inflammatory drugs
• It may be helpful to avoid acidic and spicy foods, (e.g. ibuprofen), narcotic pain killers (e.g. codeine
carbonated beverages and caffeine. Many other or oxycodone), bladder relaxants (e.g. tolterodine
dietary factors may contribute to your symptoms or oxybutinin), drugs to reduce urinary acidity, and
such as: tomatoes, chocolate, citrus beverages, others. New oral medications are being developed
alcohol, and artificial sweetneers. Finding them will to help treat this challenging problem.
require careful observation.
• Eliminating various items from your diet and Bladder instillations
reintroducing them one at a time may determine
which is affecting your symptoms. Some patients with IC may respond to medication
placed directly into the bladder through a
Physical therapy narrow tube passed through the urethra (bladder
instillation). These medications may work by reducing
• Some people have found relief from bladder inflammation or restoring the protective coating of
training techniques (e.g. bladder emptying the bladder lining.
at designated times and using relaxation Medications administered by bladder instillation
techniques to lengthen the time between voiding). include:
• Pelvic floor physiotherapy can help releive • DMSO (Rimso™)
symptoms. • Glycosaminoglycan (heparin or Cystistat™)
• Special nerve stimulation which uses mild electrical
pulses can help bladder muscle relaxation to Your urologist may recommend various schedules of
releive symptoms (TENS). bladder instillations, often starting weekly and then
decreasing in frequency.
• Self-help measures, including exercise and learning
relaxation techniques to reduce stress, may make
your symptoms more tolerable.
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