Ask Dr R: overactive bladder, interstitial cystitis, and ulcerative colitis

Hi,

Can you tell me if you have helped any patients suffering from OAB/IC with Ulcerative Colitis?  Every medication I take for OAB is giving me a colitis flare up and I am desperate for help.  I cannot take Elmiron b/c of the Colitis also.  Can you offer any advice?  Thanks, L

Hello L,

You may benefit from transdermal OAB medications, of which there are 2 options, one gel and one patch. If you’ve tried these already, you may do well with an old-school treatment regimen using Elavil, a medication approved for depression that has a track record as a successful incontinence medication. Or it may be time to give electrical stimulation, pelvic floor physical therapy with biofeedback and bladder retraining a try. But first, make sure you actually have overactive bladder. You mention Elmiron, which is not an overactive bladder medication, it is a medication for interstitial cystitis (IC). Therapies for OAB and IC are fundamentally different, although occasionally therapies may overlap in certain patients with a bit of both syndromes.

To find a consultant for second opinion evaluation (be ready to repeat tests you may have done in the past), see www.augs.org patient section, and www.ichelp.org.

Dr R

Hi,

Can you tell me if you have helped any patients suffering from OAB/IC with Ulcerative Colitis?  Every medication I take for OAB is giving me a colitis flare up and I am desperate for help.  I cannot take Elmiron b/c of the Colitis also.  Can you offer any advice?  Thanks, L

Hello L,

You may benefit from transdermal OAB medications, of which there are 2 options, one gel and one patch. If you’ve tried these already, you may do well with an old-school treatment regimen using tri-cyclic antidepressants, medications approved for depression, one of which has a track record as a successful incontinence medication. Or it may be time to give electrical stimulation, pelvic floor physical therapy with biofeedback and bladder retraining a try. With regard to Elmiron for interstitial cystitis (IC), there are other treatment options for IC. Therapies for OAB and IC are fundamentally different, although  therapies may overlap in certain patients such as yourself who suffer both syndromes. Women with your mix of conditions often need a lot of tweaking and frequent follow up in order to find the individual regimen that works for you, no small task as you are well aware.

To find a consultant for second opinion evaluation (be ready to repeat tests you may have done in the past), see www.augs.org patient section, and www.ichelp.org.

Lastly, I trust you’ve already looked at dietary and lifestyle factors that may be exacerbating your conditions. If not, start with a nutritionist skilled with IC and UC management.

Best Regards,

Dr R