Monday, March 9, 2020

Interstitial Cystitis Conclusion

As this review has demonstrated, IC is a life-altering disease riddled with multiple uncomfortable and disruptive physical symptoms. Oftentimes the disease goes undiagnosed or misdiagnosed and is oftentimes referred to as a diagnosis of exclusion. The rate of comorbidity is elevated in those suffering from IC, displaying the additionally challenging issues that accompany the management of multiple disorders. Equally distressing is the elusive nature of causality for IC, leaving patients with a sense of helplessness, in addition to the inability of doctors to confidently recommend preventative measures. Though multiple diagnostic tests are performed, none have been specifically created for the diagnosis of IC. Some are invasive or uncomfortable and oftentimes the diagnosis is a result of simply eliminating a whole host of other diagnostic possibilities before arriving at the IC determination. This process can be frustrating, lengthy and defeating to the patients who have been suffering for long periods of time. Of even great importance is the questionable validity of treatment modalities. As has been observed above, pharmacological treatment is oftentimes ineffective or perhaps mildly effective but carries with it the significant risk of adverse side effects. More complementary and alternative methods (CAM) such as yoga, physical therapy, acupuncture, probiotics, dietary interventions and psychological strategies have shown benefit in a number of studies. However, oftentimes sample sizes are small and the amount of credible and substantial evidence is lacking, thus calling into question the advisability of assuming any one of these techniques provides the curative key to IC. The overarching benefit to CAM is the absence of notable risks and adverse side effect profiles. Perhaps the bottom line in light of this review is to focus on the issues that can be improved or solved and let further research determine the direction for the unanswered questions at hand. Using a variety of CAM techniques provides the potential for benefit and should perhaps be considered first-line treatment, while steering clear of the riskier pharmacological methods.  Though this appears to be a logical approach to a difficult problem, the unfortunate reality is that oftentimes logic is lacking in the overall outlook on health. As always, lots of work to be done.


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