Ask Dr. K: Bladder condition treatable
DEAR DOCTOR K: I have interstitial cystitis. Medications have helped, but not much. What else could help relieve my symptoms?
DEAR READER: Interstitial cystitis is a puzzling bladder condition in which the bladder wall becomes irritated or inflamed. We don’t know what causes the condition.
The symptoms are similar to those of a bacterial urinary tract infection. However, in interstitial cystitis, there is no bacterial infection, and the symptoms do not respond to antibiotics.
Symptoms include frequent urination, an intense urge to urinate and a burning sensation during urination. People may also experience pain, pressure or tenderness in the bladder area.
There is no therapy that cures the disorder, so the goal of treatment is to reduce symptoms:
DIETARY CHANGES. Caffeinated beverages, alcohol, chocolate, and high-acid foods such as citrus fruits are some of many foods that can aggravate the condition. Smoking aggravates it in some people.
BLADDER TRAINING. Patients can learn to reduce frequent urination by following a schedule for urinating. While bladder training cuts down on the frequent urination, it doesn’t reduce the pain of urination.
ORAL MEDICATIONS. Pentosan polysulfate sodium (Elmiron) is the only medication approved for the treatment of interstitial cystitis. Other drugs not approved for the condition that may offer relief include analgesics, tricyclic antidepressants, antihistamines and H2 blockers.
BLADDER DISTENTION. Sterile water is used to stretch the bladder. This may allow the bladder to hold more urine and interfere with pain signals from nerves in the bladder.
BLADDER WASH. The bladder is filled with a sterile solution containing one of the ingredients that work directly on the bladder wall to reduce inflammation and block pain.
ELECTRICAL NERVE STIMULATION. Mild electrical impulses are used to stimulate nerves to the bladder. They may increase blood flow to the bladder, strengthen pelvic muscles or trigger the release of substances that block pain.