IC treatments depend on the severity of the symptoms. Most women require more than one type of therapy to manage their pain and urinary symptoms. Right now, there is no cure for IC, but the symptoms can be treated and controlled. Sometimes a period of trial and error is required to figure out the best combination of treatments for you.
Women with IC often find that certain foods and drinks irritate their symptoms. In fact, one study found that 90% of patients with IC had food sensitivities. Identifying which items are bothersome to you and restricting or limiting them can help control symptoms. Food sensitivities can vary. However, there are foods and beverages that appear to trigger a flare among many women. Often women eliminate these foods and slowly add them back individually to determine which ones they can still eat safely. It’s helpful to meet with a Registered Dietitian Nutritionist to identify individual trigger foods.
|Most Bothersome Foods and Drinks
- Cranberry juice
- Grapefruits and grapefruit juice
- Lemon juice
- Oranges and orange juice
- Pineapples and pineapple juice
- Hot peppers
- Tomatoes and tomato products
- Salad dressings
- Coffee (caffeinated and decaffeinated)
- Tea (caffeinated and some decaffeinated)
- Carbonated drinks (cola, non-cola, diet, caffeine-free)
- Wine (red and white)
- Indian food
- Mexican food
- Thai food
- Spicy food
- Artificial sweeteners
For most women, stress can worsen IC symptoms. Find an activity that relaxes you. It might be meditation, yoga, hypnosis, acupuncture, or taking a walk. Whatever it is, schedule time so you can help manage stress. In some cases, seeking professional psychological care is beneficial for patients with IC.
A specially trained physical therapist (PT) can manually maneuver your pelvic area to help relieve pelvic pain. This therapy may loosen tight pelvic floor muscles and tissues. Women with IC should NOT do pelvic floor strengthening exercises (called Kegel Exercises) unless under the care of a PT. These exercises can worsen symptoms.
Your provider may prescribe one or a combination of medicines. Pentosan polysulfate sodium (ElmironTM) is the only FDA-approved oral medicine for IC. It helps about one third of women control their symptoms. Other drugs that may help include:
Some find it helpful to get medicine inserted directly into their bladders. A series of these bladder instillations is usually done in the office. Treatments can be 1 to 2 times a week for 6 to 8 weeks.
Cystoscopy Under Anesthesia
Simple cystoscopy in the office can be more uncomfortable for IC patients than other people. If done with sedation, Hunner’s lesions or epithelial cracks can be treated with cautery or injected with steroids for symptomatic relief. In addition, stretching the bladder wall, called hydrodistension, can also be helpful. Because this can be painful, it is often performed as an outpatient surgery with general anesthesia. This procedure provides relief for some women, but in others, it may actually cause a flare immediately afterward.
Electrical stimulation devices can be placed outside of your body (TENS unit) or surgically implanted inside the body for sacral nerve modulation (call InterStim). They intercept the pelvic nerves that control and affect the bladder, urethra and pelvic floor. Sacral nerve modulation may relieve IC symptoms, specifically the urinary symptoms of urinary frequency and urgency.
Botulinum Toxin (Botox)
Botox can increase bladder capacity, which can help a patient with IC urinate less often. Using local anesthetic or sedation, your doctor uses a small camera (cystoscopy) and a needle to inject Botox into the bladder wall. Typically, the injection needs to be repeated 1 to 2 times a year. A small number of women experience side effects, such as difficulty emptying the bladder or urinary tract infection.
Surgery is reserved for the rarest and most extreme cases. Most women never need surgery. In these cases, the bladder can be removed or enlarged using the bowel to make a new bladder.