Treatment approaches for painful bladder syndrome/interstitial cystitis.
Painful bladder syndrome/interstitial cystitis (PBS/IC) is a disease of unknown aetiology, characterised 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 recognised in young adults, and may affect as many as 0.1-1% 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, gynaecologists, 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. Lack of early diagnosis and treatment can affect outcomes and leads to the development of hyperalgesia/allodynia.
Theoharides
Theoharis C
TC
Department of Pharmacology and Experimental Therapeutics, Tufts University School of Medicine, Tufts-New England Medical Center, Boston, Massachusetts, USA. theoharis.theoharides@tufts.edu
D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D015897:Comorbidity; D018856:Cystitis, Interstitial / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D006634:Histamine H1 Antagonists / Q000627:therapeutic use; D006728:Hormones; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D008297:Male; D010146:Pain / Q000188:drug therapy*; D015995:Prevalence; D020011:Protective Agents / Q000627:therapeutic use
D000700:Analgesics; D000893:Anti-Inflammatory Agents; D006634:Histamine H1 Antagonists; D006728:Hormones; D007155:Immunologic Factors; D020011:Protective Agents