Interstitial cystitis is a chronic inflammation of the bladder that causes people to urinate -- sometimes painfully -- as often as 40, 50, or 60 times a day. Their quality of life, research suggests, resembles that of a person on kidney dialysis or suffering from chronic cancer pain. Not surprisingly, the condition is officially recognized as a disability.
There's no cure for interstitial cystitis, but many treatments offer some relief, either on their own or in combination.
Treatment (see chart) is aimed at relieving pain and reducing inflammation. The two main approaches are oral medications and bladder instillations -- drugs that are introduced into the bladder by catheter and held for 15 minutes. The procedure usually takes place in a physician's office, but in some cases these drugs can be self-administered at home.
Common treatments for interstitial cystitis |
| Treatment | Comment |
| Oral drugs |
Tricyclic antidepressants | Taken at low doses, tricyclic antidepressants relax the bladder and interfere with the release of neurochemicals that can cause bladder pain and inflammation. They may also improve sleep. Amitriptyline is the medication most commonly prescribed for interstitial cystitis. |
Pentosan polysulfate sodium (Elmiron) | Elmiron is the only oral drug approved by the FDA specifically for interstitial cystitis. It improves the bladder lining, making it less leaky and therefore less inflamed and painful. The full effect may take three to six months. Side effects, which are rare, include reversible hair loss, diarrhea, nausea, and rash. |
Antihistamines | Antihistamines such as hydroxyzine (Atarax, Vistaril) interfere with the mast cells' release of histamine, helping to relieve bladder inflammation and pain, urinary frequency, and nighttime voiding. Because antihistamines can cause drowsiness, they are usually best taken at bedtime. |
Painkillers | Nonsteroidal anti-inflammatory drugs (aspirin, naproxen sodium, ibuprofen) and acetaminophen can help relieve mild to moderate pain. Check with your clinician about possible side effects of long-term use of these over-the-counter medications. |
| Bladder instillations |
Dimethyl sulfoxide (DMSO) | DMSO is the only FDA-approved bladder instillation drug for interstitial cystitis. It helps relax the bladder and alleviate pain and inflammation. Some research suggests that more than half of patients improve after six weeks of once-a-week treatments. It may cause a burning sensation during and after instillation and can cause a garlicky odor on the skin and breath for up to three days following treatment. DMSO is sometimes combined with other medications. |
Hyaluronic acid (Cystistat) | Cystistat may help repair the bladder lining. |
No single treatment alleviates all symptoms, and some may stop working over time, so finding what works is often a matter of trial and error. The good news is that in 50% of cases, the disease will disappear on its own.
Other options
In a procedure called transcutaneous electrical nerve stimulation (TENS), pain pathways are modified by a device worn on the body. The device produces electrical impulses, which pass through electrodes that are attached to the body with small adherent pads. Patients can adjust the level of electrical stimulation themselves. Good results have been reported in about one-quarter of those using TENS.
An implantable device called InterStim directly stimulates the sacral nerve in the lower back. Already approved for treating bladder control problems, it's under study as a potential treatment for interstitial cystitis pain.
Some people report that stress reduction, exercise, biofeedback, or warm tub baths improve their symptoms, but no research has evaluated the effectiveness of these strategies. Bladder training -- that is, learning to urinate only at specific times (despite the urge to go) -- can help reduce urinary frequency. There's no scientific evidence linking diet to interstitial cystitis, but many people believe that their symptoms are made worse by tomatoes, chocolate, caffeine, alcohol, and beverages that acidify the urine, such as cranberry juice.
Surgery is usually a last resort and undertaken only when the pain is crippling. The surgical procedure typically involves removal of the bladder and the creation of a new one (a neobladder) using intestinal tissue. Most people need to catheterize the neobladder themselves in order to empty it.
Scientists seeking a diagnostic test have begun to identify substances unique to the urine of interstitial cystitis patients. They've also found that certain factors required for healthy cell growth appear to be missing from the urine, a discovery that could lead to a new therapy.
FAQs
Sacral nerve stimulation.
Stimulating these nerves may reduce urinary urgency associated with interstitial cystitis. With sacral nerve stimulation, a thin wire placed near the sacral nerves sends electrical impulses to your bladder, similar to what a pacemaker does for your heart.
What is the most common treatment for interstitial cystitis? ›
Nonsteroidal anti-inflammatory drugs (NSAIDs) and antihistamines may help reduce inflammation and relieve pain. Antidepressants in low doses may help relieve IC symptoms, perhaps by blocking pain receptors. Medications to restore the bladder lining such as pentosan polysulfate sodium (Elmiron).
How to calm an interstitial cystitis flare? ›
How to calm an interstitial cystitis flare
- Increase water intake – Drinking more water may help curb the severity of your symptoms.
- Take medication – Your healthcare provider may prescribe medication when you have a flare.
over-the-counter painkillers – such as paracetamol and ibuprofen. medicines for nerve pain – such as amitriptyline, gabapentin and pregabalin. tolterodine, solifenacin or mirabegron – these can reduce the urgency to pee.
What does a urologist do for interstitial cystitis? ›
Some people who have IC find relief after a treatment in which a doctor puts a small amount of liquid medicine into the bladder, called bladder instillation or a bladder wash or bath. The doctor guides a tube called a catheter into your bladder and slowly adds a liquid that eases irritation of the bladder wall.
What is the best home remedy for interstitial cystitis? ›
Self-Help & Natural Methods for IC/BPS
- Adequate water intake. IC patients often reduce water intake to reduce their trips to the restroom. ...
- Diet modification. ...
- Heat or Cold Therapy. ...
- OTC Supplements. ...
- Meditation & Stress Management. ...
- Muscle Relaxation & Guided Imagery. ...
- Bladder Training. ...
- Emotional Support.
Interstitial cystitis (IC) is an inflamed or irritated bladder wall. Experts don't know what causes IC. It does not get better with antibiotics.
What worsens interstitial cystitis? ›
Eliminating certain foods, such as those that are acidic or spicy, may decrease the severity of IC symptoms. Also, cigarettes, coffee, tea and alcohol may irritate IC.
What is first line therapy for interstitial cystitis? ›
As with most diseases first line therapy for IC is conservative management with techniques including education, behavioral modification, and stress control. Patient education as to the normal function of the bladder as well as what behaviors may lead to increased bladder pain is integral to symptom control.
How do I get instant relief from cystitis? ›
Consider taking one teaspoon of bicarbonate of soda dissolved in water and repeat this every three to four hours, or buy an over the counter cystitis remedy containing potassium citrate. These both act to reduce the acidity of the urine and help to relieve the stinging.
Foods That Can Alleviate IC Symptoms
Vegetables: Try to eat a mix of leafy green vegetables, cruciferous vegetables, root vegetables, and gourds such as squash and cucumber. Low acid fruit: Try to make fruits like bananas, pears, blueberries, melons part of your diet.
Is walking bad for interstitial cystitis? ›
Exercise can release endorphins, which are like nature's painkillers. Be careful to not place pressure on the bladder as vigorous exercise can backfire and make symptoms worse. Long walks are great. Swimming and water aerobics are terrific because the bladder feels nicely supported when you're in the pool.
What drinks soothes interstitial cystitis? ›
Pick a new beverage: Try a vegetable-based product such as Cafix®, Pero®, Roma, and Postum®. Herbal teas such as chamomile and mint are usually well tolerated by IC/BPS patients. Keep trying until you find a product you like.
Is it OK to take azo for interstitial cystitis? ›
The use of over the counter medications such as AZO may help if there are no other health conditions to prevent its usage. The use of over the counter supplements like Prelief prior to meals may help reduce the chance of an IC flare up due to acidic foods.
How did I heal interstitial cystitis? ›
Pelvic floor physical therapy works to release tension from these muscles, clear out inflammation, and restore normal function. It's the only treatment shown to sustainably help a majority of IC patients, and the only treatment given an 'A' evidence grade by the American Urological Association.
What rebuilds bladder lining? ›
Pentosan polysulfate sodium — Pentosan polysulfate sodium (PPS; Elmiron) is an oral medication that was developed to repair the lining of the bladder in people with IC/BPS.
What is the second line treatment for interstitial cystitis? ›
Second-Line Treatments for Interstitial Cystitis
If lifestyle changes aren't enough, then try the next line of treatments: Physical therapy. Different techniques are used to help relax your pelvic muscles. Amitriptyline.
Has anyone cured interstitial cystitis? ›
How do you fix interstitial cystitis/bladder pain syndrome? You can't fix or cure IC/BPS. However, there are many ways to treat it. The goal of IC/BPS treatments is to relieve your symptoms.
What happens if you don't treat interstitial cystitis? ›
Interstitial cystitis can result in a number of complications, including: Reduced bladder capacity. Interstitial cystitis can cause stiffening of the bladder wall, which allows your bladder to hold less urine. Lower quality of life.
