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Cystitus /Elmiron/Pre-lief. Pain correlation to severity?
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Cystitus /Elmiron/Pre-lief. Pain correlation to severity?

I have been diagnosed with Interstitial Cystitis after recieving two cystoscopies and a biopsy.  During the two cystoscopies I was able to see the peocedure on a computer monitor.  There was a roundish red blotch on the otherwise white interior of my bladder.  The biopsy confirmed the diagnosis as cystitis.  I subsequently started treatment with Elmiron.  I noticed no improvement after a few months. Then I also started taking Pre-lief which takes the acid out of food.  To my amazement the pain was reduced dramatically.  I asked my urologist if I still needed to take the Elmiron, and he said yes, it would help to rebuild the bladder wall.  My question is this:

Does the reduction in pain correlate to a healthier, healing bladder wall or just to less irritation?

Does cystitis continue to progress even if the irritant (acid) is removed from contact with the bladder wall?

Does Elmiron work?  I have read many articles that state simply "sprinkling" the Elmiron (pentosan polysulfate sodium)over the area of cystitis does no good even if the mucus lining of the bladder is composed of (how much I don't know)pentosan polysulfate sodium.

Thank you.

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To answer your questions:

Pain associated with interstitial cystitis may be due to abnormal bladder epithelial permeability.  As the bladder wall is healing, it should result in a reduction of pain.  

It is unclear what exactly causes interstitial cystitis, although stress seems to exacerbate the problem.  I am unaware of consensus studies suggesting that removing acid can help.

Elmiron is a urinary analgesic used for interstitial cystitis.  The optimal treatment is unclear, and there are no studies that demonstrate that Elmiron works in everyone.  However, given the lack of any other clear treatment options, it would seem to be a reasonable choice.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
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