Pain Relief: The L.A. Pain Clinic Guideby Sota Omoigui

INTERSTITIAL CUSTITIS

This is a bladder condition that produces the same symptoms as a bladder infection but with no obvious cause. The glycosaminoglycan (GAG) layer that coats the bladder is thought to be damaged thereby exposing the bladder wall to irritants in the urine and bacteria. This results in inflammation and pain of the bladder wall. Symptoms include the need to urinate frequently (sometimes up to 50 times a day), a feeling of urgent need to urinate and urinary discomfort including pain, burning or cramping. Pain may also accompany sexual intercourse. Unlike bacterial cystitis, which is an actual infection of the bladder, there is no obvious cause for interstitial cystitis. Interstitial cystitis (I.C.) affects mostly women (9 women affected for every 1 man) and generally occurs after the age of 40. I.C. is diagnosed after ruling out other causes such as bladder infection, sexually-transmitted disease, bladder cancer, vaginal infection, endometriosis or other causes. On cystoscopy (insertion of a tiny picture tube into the bladder), there is pinpoint bleeding (hemorrhage), in the lining of the bladder. This can be confirmed by a biopsy of the bladder.
Bladder ‘retraining’ (by increasing time between each urination) and avoiding chocolate. alcohol and spicy foods may be helpful. Call for an appointment with your doctor if you have symptoms suggestive of interstitial cystitis. Make sure you mention that you suspect this disorder; it is not well recognized nor is it easily diagnosed. Many doctors still mistakenly consider interstitial cystitis a psychological problem.
Various treatments have been tried and results vary from individual to individual. Take herbal supplements such as Quercetin, Rutin, Curcumin, Red Wine tablets, Cinnamon and Ground Clove Extracts. These contain polyphenols which are the best anti-inflammatory agents that nature has provided to us. An effective medication is Elmiron. It is taken by mouth (100 mg three times daily) and coats the bladder and aids in restoration of the glycosaminoglycan (GAG) layer thus reducing inflammation. Another therapy is the instillation of the anti-inflammatory medication DMSO (Dimethyl sulfoxide) directly into the bladder using a catheter or aspeto syringe.. This may be done every two weeks until you get relief. Side effects include a garlic like taste in your mouth, bladder spasm and discomfort. Other therapies include instillation of the medication chlorapactin or silver nitrate into the bladder, or dilation of the bladder by water pressure. Your physician may prescribe antidepressant medications, which have a pain relieving effect as well as being helpful for depression. Other drugs that help control the bladder inflammation include a subcutaneous injection of the biologic drug Kineret as well as an intravenous (IV) or intramuscular (IM) injection of cortisone, plus an IV infusion of the anti-seizure drug Depacon combined with IV infusion of magnesium sulfate and IV mini bolus doses of Ketamine. Sometimes antispasmodic medications such as Pro-banthine may be useful in reducing bladder spasms. Antibiotics are not helpful unless there is also a bladder infection. Surgery such as cystolysis should be reserved as the last resort. In some people, MRI of the low back shows pinching of the fifth lumbar nerve (L5) – with referral of pain to the bladder. In such cases surgical release of the nerve can lead to relief of pain.

Call your Doctor : if your pain is severe or if you have a reaction to your medications.

National Organization: Obtain answers to your questions or information of a local support group near you by contacting the Interstitial Cystitis Association (www.ichelp.org)