What Are IC Treatments?

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.

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?

Step One – First Line Treatments

• Water Intake
• Diet Modification
• Heat or Cold Therapy
• Self-Help
• OTC Supplements
• Meditation & Stress Management
• Muscle Relaxation & Guided Imagery
• Bladder Training
• Emotional Support
• Treat Other Pain Sources
• Avoid Known Triggers

Step Two: Second Line Therapies

• Physical Therapy
• Pain Management
• Oral Medications
• Bladder Instillations

Step Three: Third Line Therapies

• Hydrodistention
• Hunner’s Ulcer Treatment

Step Four: Fourth Line Therapies

• Neuromodulation – Urgent PC, Interstim
• Botulinum Toxin

Step Five: Fifth Line Therapies

• Cyclosporine

Step Six: Sixth Line Therapies

• Surgical Options

Other Therapies

• PainShield MD – Therapeutic Ultrasound
• Antispasmodics – Ditropan, Oxytrol
• Anesthetics – Pyridium, AZO Bladder Pain Relief, Uribel
• OAB Medications – Detrol, Myrbetriq

Discontinued Therapies

• Long Term Antibiotics
• Bacillus Calmette Guerin (BCG)
• Resiniferatoxin (RTX)
• High Pressure Hydrodistention
• Long Term Glucocorticoids
• Silver Nitrate, Chlorpactic, Argyrol

OTC Neutraceuticals & Supplements

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 including:

• Prelief – reduces the acid level of food
• CystoProtek – developed by Dr. Theoharis Theoharides (Tufts)
• Desert Harvest Aloe
• CystaQ, CystaMD
• ProstaQ, Qurol
• BladderQ
• CystoRenew – developed by Dr. Geo Espinosa (NYU)

Suggested Reading

References for Professionals

• USA – AUA Guidelines – Provides an extensive review of the literature and related studies of the six step treatment plan discussed above.
• International – International Society for the Study of BPS (ESSIC) – Treatment guidelines and suggestions offered by an international organization of IC researchers and clinicians.
• Japan – Clinical guidelines for IC and hypersensitive bladder syndrome
• Bladder Pain Syndrome: A Guide for Clinicians (2012) – For Clinicians & Researchers