Treatments for Interstitial Cystitis and Bladder Disorders

Interstitial cystitis (IC) and other bladder disorders are painful and can be quite embarrassing. These conditions can cause pain, incontinence, and frequent urination—all of which decrease quality of life. 

If you have been affected by any of these conditions, you know that finding a safe and effective treatment can be almost as difficult as dealing with the condition itself. For example, Elmiron—one of the most prominent medications for IC—has been linked to vision loss. Some of the more invasive treatment options include frequent catheterization and surgery. 

The main objectives of any treatment for bladder disorders and IC are typically reducing pain, frequency, and urgency. Finding the ideal treatment will likely take time, particularly because many people find the most relief from a combination of treatments. Some common treatments don’t begin improving symptoms for months, which can make the process that much more frustrating.

Treatments for IC and Bladder Disorders

The good news is that there are a lot of treatment options to try for bladder disorders, many of which are relatively easy to implement. Consider beginning with less invasive lifestyle changes before trying medications or more invasive treatments.

Lifestyle Changes

• Diet changes: Try an elimination diet to determine what triggers your symptoms. Some of the common triggers include alcohol, citrus, cranberries, soda, spicy food, caffeine, and artificial sweeteners. Once you eliminate common triggers, add them back into your diet one at a time until one triggers your symptoms. 
• Increase water intake 
• Exercise: Regularly practice low-impact exercise such as tai chi, yoga, pilates, or walking. 
• Reduce stress: Practice stress reduction techniques such as meditation, mindfulness, progressive muscle relaxation, or gratitude journaling.  (Some of the above lifestyle modifications can also reduce stress, including exercise and diet changes.)
• Avoid tight clothing in your pelvic region
• Pelvic floor exercises: Schedule an appointment with a pelvic floor physical therapist who can advise you on exercises that may help your situation. Do not begin pelvic floor exercises without medical guidance; popular exercises such as kegels can exacerbate bladder problems. 
• Train your bladder: Bladder training includes using the bathroom at timed intervals, and you should also avoid going to the bathroom “just in case” every time you leave the house.
• Acupuncture: Consider making acupuncture a part of your routine. These treatments may help with incontinence, pain, and more.

Adjusting your lifestyle alone might improve your symptoms enough that you don’t need to try any other strategy. Lifestyle changes can also potentially reduce the dose of medications or the frequency of other treatments.

Medication and Other IC and Bladder Disorder Treatments

Medications and more invasive treatments can be effective, but they can also come with unwanted side effects. Never begin a drug or other invasive treatment without consulting with your healthcare provider.

• Elmiron: This is one of the most common treatments for IC, but the drug has been linked to a type of vision damage called pigmentary maculopathy, leading to lawsuits against Jansseen Pharmaceuticals, who manufactures Elmiron. 
• Dimethyl Sulfoxide (DMSO or Rimso-50): This drug is inserted with a catheter once every week for six weeks. It is believed that this drug reduces both inflammation and free radicals. 
• Nonsteroidal anti-inflammatory drugs (NSAIDs): These include drugs like Tylenol and Advil, which are available over-the-counter and can help reduce inflammation. 
• Antihistamines: Antihistamines such as hydroxyzine or loratadine (Claritin) can help reduce your urge to urinate frequently. 
• Tricyclic antidepressants: This type of antidepressant can work as an antihistamine, and it can also block pain by slowing the nerves that carry pain signals to the brain. It can even relax the bladder to reduce spasms. 
• Heparin: For bladder problems, this blood thinner (which also reduces inflammation) is placed directly into the bladder via a catheter. Because it is only administered in the bladder, it does not usually affect the rest of the body. 
• Nerve stimulation: Two common nerve stimulation techniques for bladder problems include sacral nerve stimulation or transcutaneous electrical nerve stimulation (TENS).
• Ulcer cauterization: If a bladder ulcer is causing problems, your doctor may choose to cauterize the ulcer under anesthesia or to use steroid injections. 
• Botox: These injections paralyze muscles locally, which can reduce pain. 
• Cyclosporine: Cyclosporine is an immune suppressor, and it is one of the last options doctors try before surgery. 
• Bladder distention: This technique involves filling the bladder with water to stretch it out.
• Surgery: Often as a last resort, your healthcare provider may suggest surgery if you aren’t able to control your symptoms with any other method.

Bladder disorders can be difficult to treat, and symptoms of IC and other bladder disorders can come back even after years of remission. When you find treatments that work for you, be sure to continue with your course of treatment, and never stop taking medication without consulting with your healthcare provider.