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Treatment approaches for painful bladder syndrome/interstitial cystitis

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By TC Theoharides • • February 21, 2007

[Note: Interstitial cystitis is commonly diagnosed in Fibromyalgia and IBS patients of both sexes.] Journal: Drugs. 2007;67(2):215-35. Author and affiliation: Departments of Pharmacology and Experimental Therapeutics, Biochemistry and Internal Medicine, Tufts University School of Medicine, Tufts-New England Medical Center, Boston, Massachusetts. PMID: 17284085 Painful bladder syndrome/interstitial cystitis (PBS/IC) is a disease of unknown aetiology, characterized by severe pressure and pain in the bladder area or lower pelvis that is frequently or typically relieved by voiding, along with urgency or frequency of urination in the absence of urinary tract infections. PBS/IC occurs primarily in women, is increasingly recognized in young adults, and may affect as many as 0.1 percent to 1.0 percent of adult women. PBS/IC is often comorbid with allergies, endometriosis, Fibromyalgia, irritable bowel syndrome and panic syndrome, all of which are worsened by stress. As a result, patients may visit as many as five physicians, including family practitioners, internists, gynecologists, urologists and pain specialists, leading to confusion and frustration. There is no curative treatment; intravesical dimethyl sulfoxide, as well as oral amitriptyline, pentosan polysulfate and hydroxyzine have variable results, with success more likely when these drugs are given together. Pilot clinical trials suggest that the flavonoid quercetin may be helpful. [Quercetin is a plant-based flavonoid/supplement known to support antioxidant & anti-inflammatory action.] Lack of early diagnosis and treatment can affect outcomes and leads to the development of hyperalgesia/allodynia [extreme sensitivity to pain/pain from stimula that are not normally painful].

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