There is a common perception that there are few treatments for interstitial cystitis. In 2017, this couldn’t be farther from the truth. From natural therapies to oral medications, bladder treatments to neuromodulation, there are many treatment options available. The challenge you face is which to try first.
Questions Worth Asking Your Doctor – Confused about what to ask your doctor? Here’s a list of questions you should ask as you discuss potential treatments, including: risk of side effects, success vs. failure rate, costs, etc.
AUA Guideline Treatment Protocol
In 2011, the American Urological Association released new treatment guidelines for IC/BPS that have dramatically improved the treatment of IC patients across the USA. Prior to their release, patients often received random treatments, were rarely told about diet modification and simple self-help strategies that work. These new guidelines have organized treatments in a simple, easy to follow six step treatment protocol that are arranged with respect to patient safety. They want you to try everything in Step One, before proceed to Step Two, etc. They do not want patients to start with serious, risky therapies such as neuromodulation and/or Botox which are located in Step Four. Surgery, of course, is the last resort and rarely used.
Please note that these guidelines were released in 2011 prior to the use of subtyping. As a result, they are best suited for patients with a bladder wall dysfunction, such as chemo cystitis. Obviously a patient with pelvic floor dysfunction will turn to physical therapy sooner rather than later. Patients with Chronic Overlapping Pain Conditions will benefit from therapies which calm their “wound up” central nervous system, such as progressive relaxation, meditation, anxiety management and other Mind-Body medicine approaches. Patients with pudendal neuralgia will be focusing on releasing the muscles that are constricting the nerves, as well as nerve calming medications. That said, the guidelines are a good place to start.
Should you expect your doctor to know about these treatment guidelines? No. Released in just 2011, many doctors are unaware of this new national standard and/or may be treating IC out of old text books. Please bring a copy of these guidelines with you for your doctor!
Watch Our Video – Do You Know The Six Steps of Treatment?
In Step One of the AUA Guidelines, the use of OTC neutraceuticals is encouraged. Though they do not recommend brand names, several supplements are routinely suggested by practicing clinicians. The key ingredients to look for are chondroitin, which is believed to have a bladder coating effect, combined with quercetin for its antihistaminic effect. (Read the ICN Supplement Guide here!) There are several supplements now available, including: