IC bladder spasms & not being able to pee at night.

Dr. Burks
I've had IC for at least 4 years, they only diagnosed me with it about 2 years ago. I'm on Elmiron and Vesicare. Is it normal to get BAD bladder spasms.??  And some days I go to the restroom at least 30 + times. And sometimes only be a few drips of urine. And the pain on some days is terrible, all I can do is lay down with a heating pad on me. Is this all normal with IC.???  And I have IBS as well, (mostly I have bad contipation), can that make my IC worse.?? There are days 2-3 days I dont have a BM. Now the last week or so, I've got up in the middle of the night to use the restroom and I cant go pee I sit there for about 5 minutes and I have to go but it will not come out, so I go back to bed and go back to sleep and will wake up maybe 1/2 an hour later to go to the restroom and I'll be lucky most of the time I can pee. Is this normal.??  I'm sorry to ask so many questions but I go to a MD doctor and I dont think she knows much about IC. And where I live  I cant seem to find a Doctor that knows about IC that will take my insurance. Thank-you.

[David A Burks, MD]

Hi,
You need to go to the ICA website:  ishelp.org.  There is a listing of physicians across the country that have expertise in IC.  You would need to see the nearest one and at least do a consultation visit, bring your old records and let him/her give you an opinion regarding the next steps.  Unfortunately, like many other IC patients you have a second pain disorder: IBS.  You will need to so a gastroenterologist for a workup and treatment.  Bladder spasms and the constant urge to void with little or no urine in your bladder is common in IC.  Elavil is an antidepressant but is a first line drug to treat IC, especially when getting up frequently at night is a real problem.  It helps patients sleep, and reduces pain in most IC.  The dose is 10mg for 7 days then 25mg, with gradual increase to 75mg as tolerated.  Drowsiness is the #1 side effect so the dose is  slowly increased.  This may be more effective than Vesicare.  Good Luck.