- How to treat cystitis - not engage in independent action
- Acute and chronic
Methods of treatment of interstitial cystitis
Formulations for oral use
Preparations for oral administration are the basis of treatment of interstitial cystitis. Most often patients with this disorder medications prescribed following:
PPS - a drug whose use for the treatment of interstitial cystitis has received official approval. It restores the inner shell of the bladder, making it through the wall will not be able to penetrate substances that stimulate nerve endings.
During the research, the results of which the drug has received official approval, it has proved effective more than 25% of patients (among study participants who received the placebo, the improvement occurred only in 16% of cases). Further clinical trials showed a higher efficacy. In general, it is believed that PPS causes a significant improvement in 42-62% of cases. The results of treatment are visible, usually only two or three months after you start taking the drug. PPS is well tolerated by most patients. Among the side effects of the drug - indigestion, and alopecia (hair loss). The coat is recovering after treatment.
Amitriptyline - a drug from the group of the tricyclic antidepressants, which is often used to treat cystitis. This medicine can be helpful to patients with interstitial cystitis, for several reasons. Firstly, amitriptyline reduces the reuptake of serotonin and norepinephrine, thereby weakening pain. Second, it helps to stabilize mast cell membranes (mast cells) - is immune cells of connective tissue that secrete substances that promote inflammation, such as allergies. Finally, amitriptyline helps to some extent reduce the frequency of urination - perhaps through effects on beta-adrenergic receptors located on the walls of the bladder. Amitriptyline is one of the most effective drugs for patients with interstitial cystitis
Interstitial cystitis - inflammation of the bladder
It causes severe pain and discomfort.
Clinical trials are also talking about the effectiveness of the drug: the subjects treated with amitriptyline, occurred significantly more improvement than those who took a placebo
Placebo - an effective tool for self-hypnosis
. However, 92% of the subjects receiving amitriptyline caused anticholinergic side effects such as dry mouth and constipation. In addition, the sedative effect of amitriptyline may make a person lethargic and apathetic, but if you take it in the evening, it can improve sleep. However, interstitial cystitis, are assigned significantly lower doses of the drug than in the treatment of depression, so these side effects are usually expressed rather weakly. However, the doctors prescribed to patients amitriptyline, are obliged to warn them about possible side effects, as they can reduce the concentration of attention, because of what a person can make mistakes when driving or performing other tasks.
Hydroxyzine - a drug from the group H1-histamine blockers. It inhibits degranulation of mast cells, resulting in decreased production of histamine. This explains the effectiveness of hydroxyzine treatment of interstitial cystitis - it is believed that an excess of histamine leads to the appearance of certain symptoms of the disease.
Some studies have shown that hydroxyzine alleviates the symptoms of interstitial cystitis in approximately 55% of patients. At the same time, there is evidence that allow question the effectiveness of hydroxyzine as a means for the treatment of interstitial cystitis - in one study, the drug was not more effective than placebo.
In addition to these drugs, physicians prescribe patients with interstitial cystitis and other drugs, such as:
- Tricyclic antidepressants: imipramine, nortriptyline, doxepin;
- Antihistamines. Some patients can achieve improvement in using loratadine, or diphenhydramine;
- Antiepileptic drugs - gabapentin, pregabalin, and carbamazepine. They have not received official approval for use in the treatment of interstitial cystitis, but they are effective in relieving some of the symptoms of the disease;
- Muscle relaxants are useful at elevated tone the pelvic floor muscles;
- Opioid analgesics are administered to patients with chronic pain, which do not help other medications;
- Selective serotonin reuptake inhibitor, such as venlafaxine and paroxetine;
- H2-blockers of histamine receptors, such as cimetidine;
- Leukotriene inhibitors such as montelukast;
- Phenazopyridine - analgesic, specifically for patients suffering from painful urination;
- Alpha-blockers such as doxazosin and terazosin.
Intravesical instillation therapy or bladder involves injecting a drug or "cocktail" of several drugs directly into the bladder. In most cases, bladder instillation used as second-line therapy; it can also be used in combination with other types of medical therapy.
Dimethyl sulfoxide (DMSO) - the only drug whose use for intravesical therapy for cystitis officially approved. This substance - a byproduct of the pulp and paper industry. It has anti-inflammatory and analgesic properties, as well as a muscle relaxant.
DMSO is introduced into the bladder through a catheter; patient should refrain from urinating for at least 15 minutes after administration. It is included in the so-called drug cocktails, with heparin, corticosteroids and sodium bicarbonate. Bladder instillation procedure is carried out once a week for 6-8 weeks.
According to studies, DMSO effective in 70% of cases; drug eliminates symptoms of cystitis, and the effect lasts from several months to a year. Side effects of DMSO include garlic taste
Garlic health: almost a panacea
mouth and discomfort associated with catheterization.
Other drugs for intravesical therapy
Somewhat less than DMSO for the treatment of interstitial cystitis use other drugs, such as lidocaine and heparin - they may be used alone or in combination with other drugs.
Gidrodistenziyu frequently used for diagnosis, but it also has short-term therapeutic effect in about 50% of cases. The procedure is performed under general anesthesia. The doctor examines the state of the walls of the bladder, taking urine sample, and for one or two minutes of the bladder expands, filling it with sterile water. Then, the bladder is emptied and filled again - in tension on its walls the best views of various injuries. The next time the bladder is expanded at the approximately eight minutes. Finally, it again devastate and urologist carries fence tissue (biopsy) for analysis.
About half of patients say that after gidrodistenzii IC symptoms become less pronounced, but the effect is rarely lasts longer than six months. Experts believe that this procedure increases the capacity of the bladder, and disrupts the transmission of pain signals through the nerve endings located on its walls.
Surgery may only be assigned to a patient with severe interstitial cystitis, and only if it has tried all the other methods of treatment, and they were ineffective. The operation is carried out to improve the functioning of the bladder, eliminating damage to its walls, and the factors that cause the reverse flow of urine. Among used to treat cystitis surgical techniques - cystoscopy, implantation of pacemaker Interstom and open surgery. Cystoscopy includes a resection of the bladder wall, or laser ablation, with which the walls of the bladder was removed ulcers typical for many patients with interstitial cystitis.
An implantable stimulator approved for the treatment of urinary incontinence and frequent urination, which are observed in many patients with interstitial cystitis, but it will be less effective for those who have this disease causes severe pain. Studies have shown that at least 50% of patients after pacemaker implantation less complain of incontinence and other symptoms of cystitis
Cystitis - symptoms: spasms, cramps and discomfort
Which can significantly reduce quality of life.
Open surgery typically used to increase the capacity of the bladder. Unfortunately, even after radical surgery, some patients continue to experience pain in the pelvis - this may cause spasm of the pelvic floor and features of the functioning of the nervous system.
When to call a specialist
Preparations for oral administration and some others for the treatment of cystitis patient may appoint a regular family doctor. If using standard medications fail to achieve relief, or if the doctor has doubts about the diagnosis, you should consult a urologist.