Treatment Strategies for interstitial cystitis(IC)
Now it gets more complicated. “IC is so variable that it’s very difficult to point to any one particular therapeutic alternative as best,” Dr. O’Leary says. “That means it’s worth trying a lot of options, because there’s usually something that will work for someone. The good news is that many patients with IC have symptoms that just spontaneously resolve for reasons that we don’t understand.” For those who continue to be plagued with IC symptoms, here’s what’s currently recommended:
Elmiron — Also known by the generic name pentosan polysulfate sodium, this is the drug that most women start with. The U.S. Food and Drug Administration approved Elmiron in 1996 as the first drug specifically for IC. In clinical trials Elmiron improved symptoms in 38 percent of people treated. If you take this drug you may not feel any relief from IC pain for the first two to four months. Doctors urge you to stay with it for at least six months to see if it helps.
Aspirin and ibuprofen — These over-the-counter pain relievers can be helpful if your symptoms are mild.
Antidepressants such as amitriptyline and imipramine — Sold under the brand names, Elavil and Tofranil-PM, respectively, these can help reduce pain and also help you deal with the psychological stress associated with chronic pain.
Antispasmodics and muscle relaxants — These can help relax the bladder muscle.
Dimethyl sulfoxide (DMSO) — This medication is put directly into the bladder and is thought to work by reducing inflammation and blocking pain. DMSO also can be mixed with steroids, heparin and/or local anesthetics to help reduce pain.
Bladder distension — In this procedure, your bladder is filled with water under general anesthesia. The water is held in the bladder for 10 to 15 minutes before being emptied. It may increase bladder capacity and interfere with pain signals transmitted by nerves in the bladder.