Interstitial Cystitis

• An urgent need to urinate, both in the daytime and during the night (yet you may pass very small amounts of urine each time)
• Pressure, pain and tenderness around the bladder, pelvis and perineum (the area between the anus and vagina or the anus and the scrotum). This pain and pressure may increase as the bladder fills and decrease as it empties in urination.
• A bladder that won't hold as much urine as it did before
• Pain during sexual intercourse
• In men, discomfort or pain in the penis or scrotum

• You have to urinate often or urgently
• You have pelvic or bladder pain
• A urologist (a doctor whose specialty is problems of the urinary tract) finds bladder wall inflammation, pinpoint bleeding or ulcers during an exam with a special scope (called a cytoscope) that looks inside your bladder
• Your doctor has ruled out other diseases such as urinary tract infections, vaginal infections, bladder cancer, endometriosis, kidney stones, sexually transmitted infections and, in men, chronic prostatitis

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• Diet. Your doctor may tell you to change what you eat. You may need to avoid alcohol, acidic foods and tobacco.
• Bladder distention. Under anesthesia, a doctor overfills your bladder with gas or fluid. This stretches the walls of the bladder. Doctors are not sure exactly why distension helps. It may make your bladder be able to hold more urine. It may also interfere with the pain signals sent by nerves in the bladder.
• Medicine. Your doctor may have you take an oral medicine called pentosan polysulfate (brand name: Elmiron). This medicine helps to protect the lining of the bladder wall from the toxic parts of urine. Another oral medicine used to treat interstitial cystitis is an antihistamine called hydroxyzine (two brand names: Vistaril and Atarax). This medicine reduces the amount of histamine that is made in the bladder wall. Another medicine that may help is amitriptyline (brand name: Elavil). It blocks pain and reduces bladder spasms. This medicine can make you sleepy, so it is usually taken at bedtime. Your doctor may also suggest that you take an over-the-counter pain medicine to ease pain.
• Bladder instillation. During a bladder instillation, a catheter (a thin tube) is used to fill your bladder with liquid medicine. You hold the medicine inside your bladder for a few seconds to 15 minutes. Then the liquid is released through urination. Treatments are given every one to two weeks for six to eight weeks. The treatment can be repeated as needed.

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• Diet. Alcohol, tomatoes, spices, carbonated drinks, chocolate, caffeine, citrus fruits and drinks, pickled foods, artificial sweeteners and acidic foods may irritate your bladder. That makes symptoms worse. Try removing these things from your diet for a couple of weeks. Then try eating one food at a time to see if it makes your symptoms worse.
• Smoking. Many people who have interstitial cystitis find that smoking makes their symptoms worse. Because smoking is also a main cause of bladder cancer, people with interstitial cystitis have another good reason to quit smoking.
• Bladder training. Many people can train their bladder to urinate less often. You can train your bladder by going to the bathroom at scheduled times and using relaxation techniques.
• Physical therapy and biofeedback. People who have interstitial cystitis may have painful spasms of pelvic floor muscles. If you have muscle spasms, you can learn exercises to help strengthen and relax your pelvic floor muscles.
• TENS (this stands for "transcutaneous electrical nerve stimulation"). You can use a TENS machine to put mild electrical pulses into your body through special wires. Some doctors think that electrical pulses increase blood flow to the bladder. The increased blood flow strengthens the muscles that help control the bladder. It also releases hormones that block pain.

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