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Interstitial Cystitis: Treatment, Procedure, Cost and Side Effects

Last Updated: Aug 27, 2019

What is the Interstitial cystitis treatment?

Interstitial cystitis is a type of chronic pain that affects the bladder. Its treatment includes lifestyle changes, procedures, and medications. There is no cure for interstitial cystitis. Treatments can improve symptoms. Medications may include ibuprofen, pentosane, poly sulfate or amitriptyline. There are mainly six lines of treatments for this interstitial cystitis. Dietary changes can also lead to sufficient amount of improvement in symptoms for many patients suffering from interstitial cystitis. Pharmacological options which can aid in treating Interstitial cystitis are:- non- steroidal anti-inflammatory drugs , trycyclic antidepressants, antihistamines and pentosan. Bladder distention, electrical nerve stimulation and surgery are also done as a treatment to Interstitial Cystitis. Surgery is the last line treatment when other options have failed to succeed. There are some specialized physical therapies like exercises which can help to provide relief to the patients.

How is the Interstitial cystitis treatment done?

The six line of treatments include- first line of treatment: patient education, self care, stress management; second line of treatment- physical therapy, oral medications, bladder instillations; third line of treatment- treatment of Hunner’s ulcers, hydrodistention ; fourth line treatment- neuromodulation; fifth line treatment- cyclosporine A, botulinum toxin; sixth line of treatment-surgical intervention . Physical therapist can assist in relieving the associated pain through various physical exercises. Exercises help to improve muscle tenderness, restrictive tissues or muscle abnormalities in pelvic floor. Drugs like ibuprofen, aspirin, naproxen help to reduce associated inflammation; amitriptyline or imipramine help to reax the bladder muscles and reduce pain; loratadine help to reduce urinary urgency; pentosane helps to restore epithelial cells of the bladder and also protect surrounding tissues from irritation. Dimethyl sulfoxide is given by way of a catheter with regular treatments for six to eight weeks followed by maintenance doses as needed. Simulation of sacral nerves may help to reduce urinary urgency. TENS help to relieve pain and reduce frequency of urination by increasing muscular control. Bladder distention is useful in certain situations like after a cystoscopy. Surgery procedures like Fulguration is used to burn ulcers causing severe pain in bladder, resection cuts around ulcer for their removal. Bladder augmentation replaces the damaged section of bladder with connective tissue from the colon.

Who is eligible for the treatment? (When is the treatment done?)

Patients suffering from Interstitial cystitis need to undergo the necessary treatment. If a person is undergoing symptoms like chronic pain of the bladder, feeling the need to urinate right away, need to urinate right away, burning sensation in urethra, pain with sex etc, then it is safe to enter the treatment to check the cause of the symptoms. Everyone if not affected by any other diseases or are having some restrictions are eligible for the treatments and medications. Patients should consult doctor and check their eligibility to undergo the appropriate treatment.

Who is not eligible for the treatment?

If any patient is suffering from any grave and serious disease before hand then it is better to inform the doctor before starting any medications because certain drugs show serious side effects which may worsen the patient’s condition further .

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Are there any side effects?

Some evidences have been found which conclude that the long term oral antibiotics, bladder instillation of Bacillus Calmette-Gurin and bladder instillation of resiniferatoxin are harmful. Interstitial cystitis can lead to stiffening of bladder wall and reduce bladder capacity. The chronic pain and interrupted sleep as a consequence of interstitial cystitis cause emotional stress and lead to depression state. Tricyclic antidepressants have side effects like sleepiness, dry mouth and weight gain. There are some pain killers which can be taken during interstitial cystitis which have been proved to be addictive. Cyclosporine A has serious side effects like uncontrollable trembling, muscle or joint pain and enlarged gums. Pentosan polysulfate sodium has side effects like hair loss, gastrointestinal symptoms and increased liver function tests. Common side effects of Amitriptyline are fatigue, dry mouth, decrease in blood pressure and weight gain.

What are the post-treatment guidelines?

The treatments for interstitial cystitis are long term and are helpful in removing all the symptoms effectively. Interstitial cystitis is not curable. Certain foods can be avoided which can affect interstitial Cystitis like tomatoes, citrus fruits, coffee and chocolate. Other restrictions are like avoiding spicy foods, carbonated water and alcoholic drinks.

How long does it take to recover?

This Interstitial Cystitis is not curable. Treatment can be helpful but this condition cannot be cured. This chronic disease can last for years or can be lifelong. Sometimes interstitial cystitis is seen recurring in some cases. This can be effectively treated by using suitable treatment methods. The doctors will prescribe medications and instructions which can help to prevent the recurrence of Interstitial Cystitis after the initial treatment.

What is the price of the treatment in India?

Interstitial cystitis is a costly disease associated with comorbidities. There are a number of hospitals across India providing treatment to Interstitial cystitis and the cost varies depending upon the method chosen to treat the condition and on the health condition of the patient.

Are the results of the treatment permanent?

This condition is not curable and can last lifelong but the symptoms can be treated and can also be prevented to return by appropriate medications.

What are the alternatives to the treatment?

There are some alternatives to the treatments mentioned earlier- like simple changes to diet and life style lead to considerable improvement in symptoms. Eating whole, fresh, unrefined food. Include fruits and vegetables and whole grains. Avoid sugar, dairy products, refined foods, coffee, chocolates, alcohol, citrus fruits, tomato, carbonated drinks. Some complementary therapies have been proved to be beneficial for many patients such as- acupuncture, hypnosis and thiele massage. Herbal medicines too can be used for treatment which have no side effects if used at suggested doses like Gotu kola taken 30 mg standardized extract triterpenses 3 times per day. Homeopathy treatments may also be effective. As chronic pain is an isolating experience generally psychological support can also prove to be beneficial for a patient’s treatment. Some behaviour changes are also helpful like avoiding anything which can lead to flare-ups.

Transcutaneous electrical nerve stimulation

Safety: Medium

Effectiveness: High

Timeliness: Medium

Relative Risk: Medium

Side Effects: Medium

Time For Recovery: Very High

Price Range: Rs.500-Rs. 10000

References

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Written ByDr. Rajeev Sarpal DNB - Urology/GenitoUrinary SurgeryUrology
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