What medications can interstitial cystitis take? What exercises can patients with interstitial cystitis do

The treatment mode of IC is directly formulated based on one or two advantageous theories of current disease causes. We have developed a comprehensive, systematic, and actionable clinical treatment plan for this clinical problem.

a: Oral medication treatment

1. Pentosan polysulfate sodium

This drug is the only FDA approved drug for treating IC. Its mechanism of action is to correct the deficiency of glycosaminoglycans in the bladder epithelium. According to different literature, 30-40% of patients reported a 40-50% improvement in symptoms. As it may take 6 months or 1 year to take effect, long-term oral medication treatment is recommended.

2. Antihistamine drugs

The changes in the effectiveness of antihistamines can be attributed to the pathological and physiological patterns mentioned above, where mast cell degranulation is only one step in the event chain that triggers inflammatory reactions and related events. Hydroxyazine should be administered from 10 milligrams to 75 milligrams before bedtime. There is a possibility of symptoms easing in approximately 1-3 months.

3. Antidepressants

The therapeutic effects of antidepressants (TCA, SSRIs) on IC mostly stem from the mechanism of action of pain neuromodulators. The dosage of this type of medication should be gradually increased to avoid its side effects as much as possible. Medications can be used at the beginning of the disease, especially when pain is the main symptom. Amitriptyline usually starts at 10 or 20 milligrams before bedtime, and can be tolerated up to 75 milligrams. The starting dose of fluoxetine hydrochloride (Prozac) is 20mg/d, and 40mg can be added if necessary. Sertraline is another available antidepressant with good durability, with an initial dose of 50mg/d to 100mg/d. The mechanism of action of antidepressants is multifaceted: they can promote sleep and reduce nocturia; By increasing the pain threshold, it plays a neuromodulatory role; Improve emotions; Has anticholinergic effects on the bladder, reducing urinary frequency caused by detrusor instability

4. Anti bile alkaline drugs and anti spasmodic drugs

Patients with mild symptoms or unstable bladder can use this medication to relieve pain, but the effect is poor for moderate to severe symptoms.

B: Intravesical treatment

1. Dimethylene sulfide (DMSO)

DMSO is an organic solvent with anti-inflammatory, analgesic, and muscle relaxation effects. At the same time, it has a collagen dissolving effect. Long term application of DMSO can increase the possibility of tissue fibrosis, and after some courses of treatment, it may cause potential specific and progressive resistance. A retrospective analysis of the experience of more than 300 patients who have been published shows that their incidence rate is hours, and quite a few patients respond well (32). This drug remains the main therapeutic drug and can be used in conjunction with hydrocortisone, heparin, and sodium bicarbonate to improve its effectiveness.