Can I take opioids to manage Interstitial Cystitis flare?

Question

Hi doctor,

I was diagnosed with IC over a year ago, and at first, the pain was manageable. Now, my flares have gotten worse, especially during my cycle. I have pelvic pain, back pain, and urethral pain, all of which are five times worse during periods.

I have been working with my urogynecologist on bladder instillation and my primary doctor for medications. My physician has given me Amitriptyline, Hyoscyamine, and Ibuprofen. None of this touches the pressure pain that I am having during my menstruation.

I have tried yoga, physical therapy, and lots of other non-medical treatments. When is the appropriate time to discuss using Opiates during this time of the month for flares? I know it is a sensitive subject, but I have tried all the alternative therapies.

This seems like the only logical step, and I know that doctors are too scared to prescribe opioids because of their side effects. As they are still expected to relieve pain, I would need a small amount to get me through my monthly cycle flares. Do pain management doctors see IC patients? I am a 33-year-old female, and I weigh 240 lbs.

I also have other gynecological issues, such as a history of fibroids. Some have been removed, with current ones growing. I would greatly appreciate any advice or help.

Answer 1

Hello,

Welcome to icliniq.com.

I feel sorry about your health condition. Interstitial cystitis is a chronic bladder condition that causes recurring bouts of pain and pressure in the bladder and pelvic area, often accompanied by an urgent and frequent need to urinate. There is no exact cause for it.

Different theories are proposed, but the exact one is not known. I suggest you follow these instructions:

Avoid caffeinated drinks and alcohol. Avoid citrus fruits and chemical irritants. Every individual responds differently to a treatment. NSAIDs (nonsteroidal anti-inflammatory drugs) may be useful to relieve pain.
Along with that, Tramadol 50 mg, thrice a day after food, may alleviate pain.
Regular exercise and yoga also relieve symptoms.
Continue Amitriptyline to reduce pain.
Cyclosporine and bladder instillation with normal saline or potassium-containing solutions may give relief.
Still, if the symptoms do not improve, please consult with your urologist. He will examine and treat you accordingly.

Thank you.