Treatments for Interstitial Cystitis

Scientists have not yet found a cure for interstitial cystitis, nor can they predict who will respond best to which treatment. Symptoms may go away for no reason or at the same time as a change in diet or treatment. Even when symptoms go away, however, they may return after days, weeks, months, or years. Scientists do not know why. Because the causes of IC are unknown, treatments are aimed at relieving symptoms.

Treatments for IC include:

• Oral medicines, including pentosan polysulfate sodium (Elmiron), which the Food and Drug Administration (FDA) approved for IC treatment in 1996. (Because Elmiron has not been tested in pregnant women, it is not recommended for use during pregnancy, except in severe cases.) Other oral medicines used include aspirin and ibuprofen, stronger painkillers, antidepressants, and antihistamines.

• Bladder instillation (a bladder wash or bath). During bladder instillation, the bladder is filled with a solution that is held for varying periods of time before being emptied. The only drug approved to date by the FDA for use in bladder instillation is dimethyl sulfoxide (DMSO). Other drugs for this use are being studied.

• Transcutaneous electrical nerve stimulation (TENS), which delivers mild electric pulses to the bladder area. Scientists do not know exactly how TENS works, but it helps relieve pain and urinary frequency in some people. Sacral nerve stimulation implants are being studied as another way to relieve IC symptoms.

• Self-help strategies such as bladder training, dietary changes, stress reduction, and low-impact exercise.

• Surgery, considered a treatment of last resort. Surgery does not necessarily improve symptoms.