Urinary System
Interstitial cystitis is a chronic painful inflammatory disease of the urinary bladder associated with urinary frequency and urgency and moderate to severe pain when the bladder begins to fill, when urination is postponed, when eating certain foods that irritate the bladder and during times of physical exertion or emotional distress. You may have a small bladder capacity and glomerulations (small open ulcers) on the inside of your bladder. McPhee and Papadakis, in "Current Medical Diagnosis & Treatment" and the National Kidney & Urologic Diseases Information Clearinghouse (NKUDIC) outline treatment options.
Lifestyle Changes
Acidic urine increases pain in some people, so you may benefit from a low acid diet. Highly acidic foods include those fermented or aged (cheese, yogurt, sour cream, buttermilk), spices, chocolate, meats, poultry and fish (especially organ meats and eggs), corn, beans, and fruits (plums, cranberries). You should avoid alcoholic beverages and those containing caffeine (cola, tea, coffee), which are irritating to the bladder. Smoking may increase bladder irritation and pain, so you should stop smoking. You may benefit from bladder training to increase your bladder capacity. This involves scheduled urination, increasing the time between urination to stretch your bladder and reduce urgency and frequency.
Medications/Treatments
The cause of interstitial cystitis is unclear and symptoms vary among individuals, so you may need to try different treatments. The over-the-counter dietary supplement calcium glycerophosphate (Prelief®) makes urine more alkaline and may help to relieve your pain. You may need analgesics (pain medications) to control your pain, including aspirin, ibuprofen, or acetaminophen. In some cases, tricyclic antidepressants (Elavil®), commonly used to treat chronic pain, or calcium channel blockers may reduce your symptoms. The first FDA-approved drug for interstitial cystitis is pentosan polysulfate, but it can take six months before relieving symptoms.
Trans-cutaneous electrical nerve stimulation (TENS) uses small pulses of electricity to the nerves to reduce pain. Special electrodes are placed on the back, the lower abdomen, or inside the vagina for treatments twice daily. You can also have a permanent nerve stimulation device implanted under the skin if your pain is severe and responds to TENS. You may also try alternative medical treatments, such as acupuncture and relaxation techniques.
Bladder Distention/Instillation
Diagnostic testing includes distending (over-filling) the bladder with fluid, and this alone provides relief of symptoms for some people. Bladder instillation requires a catheter (plastic tube) inserted into the bladder to fill the bladder with medicated fluid (dimethyl sulfoxide---DMSO), which is retained for about 15 minutes and then emptied through urination. You may need a bladder instillation once or twice weekly for up to 8 weeks with repeat instillation as needed to control pain. If DSMO instillation reduces your pain, you may learn to do the bladder instillation at home.
Tags: your pain, your bladder, benefit from, bladder capacity, bladder instillation, bladder with, nerve stimulation