The goal of treatment is to reduce symptoms. No one therapy is so successful that it should always be tried first. Often a person with interstitial cystitis needs to try several therapies before finding the right combination. The symptoms of interstitial cystitis may go away over time, but there is no therapy that cures the disorder.
Dietary modification — Caffeinated beverages, alcohol, citrus fruits, spicy foods and chocolate are just a few in a long list of foods that aggravate interstitial cystitis in some people. Each person needs to discover what she or he needs to avoid.
Bladder training — In this therapy, patients learn to reduce frequent urination by following a schedule for urinating. The training does not reduce pain.
Oral medications — Pentosan polysulfate sodium (Elmiron) is the only medication specifically approved for the treatment of interstitial cystitis. About 30% of people with interstitial cystitis have fewer symptoms while taking this medication. Side effects are uncommon.
There is a long list of other oral medications that are not approved specifically for interstitial cystitis, but may offer relief. These include ibuprofen (Advil, Motrin and others); naproxen (Aleve, Naprosyn and others); aspirin; acetaminophen (Tylenol and others); tricyclic antidepressants, such as amitriptyline (Elavil, Endep); hydroxyzine (Atarax, Vistaril); and cimetidine (Tagamet).
Bladder distention — Sterile water is used to stretch the bladder. Most patients feel worse for a couple weeks after the procedure. After that, 30% to 50% of patients feel better. The beneficial effect lasts only three months, and the procedure is done under general anesthesia, which carries certain risks.
Bladder instillation (also called bladder wash) — In this procedure, the bladder is filled with a sterile solution containing one of a number of ingredients that work directly on the bladder wall. The solution is put into the bladder through a catheter (hollow tube) that is placed through the urethra. After a variable period of time, the person is instructed to empty his or her bladder. Several active ingredients have been used in this procedure, but DMSO, heparin and topical anesthetics are the ones tried most frequently. As with other therapies, success is variable. Repeating the procedure risks causing more irritation of the bladder wall and introducing infection.
Electrical nerve stimulation — Traditionally, this has been done with a device called a TENS (transcutaneous electrical nerve stimulator) unit. Mild electrical impulses are passed into the body through wires placed below the navel, on the lower back, or inside the rectum or vagina. The patient controls the timing and intensity of these electrical impulses.