Interstitial Cystitis/

Painful Bladder Syndrome

National Kidney and Urologic Diseases Information Clearinghouse

U.S. Department 

of Health and 

Human Services

NATIONAL 

INSTITUTES 

OF HEALTH

What is IC/PBS?

Interstitial cystitis (IC) is a condition that 

results in recurring discomfort or pain in 

the bladder and the surrounding pelvic 

region. The symptoms vary from case to 

case and even in the same individual. People 

may experience mild discomfort, pressure, 

tenderness, or intense pain in the bladder 

and pelvic area. Symptoms may include an 

urgent need to urinate, a frequent need to 

urinate, or a combination of these symptoms. 

Pain may change in intensity as the bladder 

fills with urine or as it empties. Women’s 

symptoms often get worse during menstruation. They may sometimes experience pain 

during vaginal intercourse.

Because IC varies so much in symptoms and 

severity, most researchers believe it is not 

one, but several diseases. In recent years, 

scientists have started to use the terms bladder pain syndrome (BPS) or painful bladder 

syndrome (PBS) to describe cases with painful urinary symptoms that may not meet the 

strictest definition of IC. The term IC/PBS 

includes all cases of urinary pain that can’t be 

attributed to other causes, such as infection 

or urinary stones. The term interstitial cystitis, or IC, is used alone when describing cases 

that meet all of the IC criteria established by 

the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

In IC/PBS, the bladder wall may be irritated and 

become scarred or stiff. Glomerulations—

pinpoint bleeding—often appear on the 

bladder wall. Hunner’s ulcers—patches of 

broken skin found on the bladder wall—are 

present in 10 percent of people with IC. 

Kidney

The urinary system

Bladder

Ureter

Urethra

Some people with IC/PBS find that their 

bladder cannot hold much urine, which 

increases the frequency of urination. Frequency, however, is not always specifically 

related to bladder size; many people with 

severe frequency have normal bladder capacity when measured under anesthesia or during urologic testing. People with severe cases 

of IC/PBS may urinate as many as 60 times a 

day, including frequent nighttime urination, 

also called nocturia.
2    Interstitial Cystitis/Painful Bladder Syndrome

IC/PBS is more common in women than in 

men.  An estimated 3.3 million U.S. women, 

or 2.7 percent, who are 18 years of age or 

older have pelvic pain and other symptoms, 

such as urinary urgency or frequency, that 

are associated with IC/PBS.1  An estimated 

1.6 million U.S. men, or 1.3 percent, who 

are 30 to 79 years old have persistent symptoms, such as pain with bladder filling or pain 

relieved by bladder emptying, that are associated with PBS.2

1Berry SH, Elliott MN, Suttorp M, et al.  Prevalence of 

symptoms of bladder pain syndrome/interstitial cystitis 

among adult females in the United States.  Journal of 

Urology.  2011;186:540–544.

2Link CL, Pulliam SJ, Hanno PM, et al.  Prevalence 

and psychosocial correlates of symptoms suggestive 

of painful bladder syndrome:  results from the Boston 

area community health survey.  Journal of Urology.  

2008;180:599–606.

What causes IC/PBS?

Some of the symptoms of IC/PBS resemble 

those of bacterial infection, but medical tests 

reveal no organisms in the urine of people 

with IC/PBS.  Furthermore, people with  

IC/PBS do not respond to antibiotic therapy.  

Researchers are working to understand 

the causes of IC/PBS and to find effective 

treatments.

Many women with IC/PBS have other conditions such as irritable bowel syndrome and 

fibromyalgia.  Scientists believe IC/PBS may 

be a bladder manifestation of a more general 

condition that causes inflammation in various organs and parts of the body.

Researchers are beginning to explore the 

possibility that heredity may play a part in 

some forms of IC.  In a few cases, IC has 

affected a mother and a daughter or two 

sisters, but it does not commonly run in 

families.

How is IC/PBS diagnosed?

Because symptoms are similar to those of 

other disorders of the bladder and there is 

no definitive test to identify IC/PBS, doctors must rule out other treatable conditions 

before considering a diagnosis of IC/PBS.  

The most common of these diseases in both 

sexes are urinary tract infections and bladder 

cancer.  In men, common diseases include 

chronic prostatitis or chronic pelvic pain 

syndrome.  In women, endometriosis is a 

common cause of pelvic pain.  IC/PBS is not 

associated with any increased risk of developing cancer.

The diagnosis of IC/PBS in the general population is based on the

• presence of pain related to the bladder, 

usually accompanied by frequency and 

urgency of urination

• absence of other diseases that could 

cause the symptoms 

Diagnostic tests that help rule out other 

diseases include urinalysis, urine culture, 

cystoscopy, biopsy of the bladder wall and 

urethra, and distention of the bladder under 

anesthesia.
3 Interstitial Cystitis/Painful Bladder Syndrome

Urinalysis and Urine Culture

Examining urine with a microscope and 

culturing the urine can detect and identify 

the primary organisms that are known to 

infect the urinary tract and that may cause 

symptoms similar to IC/PBS. A urine sample 

is obtained either by catheterization or by 

the clean catch method. For a clean catch, 

the patient washes the genital area before 

collecting urine midstream in a sterile container. White and red blood cells and bacteria in the urine may indicate an infection of 

the urinary tract, which can be treated with 

an antibiotic. If urine is sterile for weeks or 

months while symptoms persist, the doctor 

may consider a diagnosis of IC/PBS.

Culture of Prostate Secretions

Although not commonly done, in men without a history of culture-documented urinary 

tract infections, the doctor might obtain 

prostatic fluid and examine it for signs of a 

prostate infection, which can then be treated 

with antibiotics.

Cystoscopy under Anesthesia 

with Bladder Distention

The doctor may perform a cystoscopic 

examination in order to rule out bladder 

cancer. During cystoscopy, the doctor uses 

a cystoscope—an instrument made of a hollow tube about the diameter of a drinking 

straw with several lenses and a light—to see 

inside the bladder and urethra. The doctor 

might also distend or stretch the bladder to 

its capacity by filling it with a liquid or gas. 

Because bladder distention is painful for 

people with IC/PBS, they must be given some 

form of anesthesia for the procedure.

Biopsy

A biopsy is a tissue sample that can be 

examined with a microscope. Tissue samples 

of the bladder and urethra may be removed 

during a cystoscopy. A biopsy helps rule out 

bladder cancer.

Cystoscope

Prism

Rod lenses

Telescope lenses

Light pillar

Prism
 

What are the treatments for 

IC/PBS? 

Scientists have not yet found a cure for 

IC/PBS, nor can they predict who will 

respond best to which treatment. Symptoms 

may disappear with a change in diet or treatments or without explanation. Even when 

symptoms disappear, they may return after 

days, weeks, months, or years. Scientists do 

not know why. 

Because the causes of IC/PBS are unknown, 

current treatments are aimed at relieving 

symptoms. Many people are helped for 

variable periods by one or a combination 

of treatments. As researchers learn more 

about IC/PBS, the list of potential treatments 

will change, so patients should discuss their 

options with a doctor. 

Bladder Distention 

Many people with IC/PBS have noted an 

improvement in symptoms after a bladder 

distention has been done to diagnose the 

condition. In many cases, the procedure is 

used as both a diagnostic test and initial therapy. Researchers are not sure why distention helps, but some believe it may increase 

capacity and interfere with pain signals transmitted by nerves in the bladder. Symptoms 

may temporarily worsen 4 to 48 hours after 

distention, but should return to predistention 

levels or improve within 2 to 4 weeks. 

Bladder Instillation 

During a bladder instillation, also called a 

bladder wash or bath, the bladder is filled 

with a solution that is held for varying 

periods of time, averaging 10 to 15 minutes, 

before being emptied. 

The only drug approved by the U.S. Food 

and Drug Administration (FDA) for bladder 

instillation is dimethyl sulfoxide (Rimso-50), 

also called DMSO. DMSO treatment 

involves guiding a narrow tube called a 

catheter up the urethra into the bladder. 

A measured amount of DMSO is passed 

through the catheter into the bladder, where 

it is retained for about 15 minutes before 

being expelled. Treatments are given every 

week or two for 6 to 8 weeks and repeated 

as needed. Most people who respond to 

DMSO notice improvement 3 or 4 weeks 

after the first 6- to 8-week cycle of treatments. Highly motivated patients who are 

willing to catheterize themselves may, after 

consultation with their doctor, be able to 

have DMSO treatments at home. Selfadministration is less expensive and more 

convenient than going to the doctor’s office. 

Doctors think DMSO works in several ways. 

Because it passes into the bladder wall, it 

may reach tissue more effectively to reduce 

inflammation and block pain. It may also 

prevent muscle contractions that cause pain, 

frequency, and urgency. 

A bothersome but relatively insignificant side 

effect of DMSO treatments is a garliclike 

taste and odor on the breath and skin that 

may last up to 7 hours after treatment. 

Long-term treatment has caused cataracts 

in animal studies, but this side effect has not 

appeared in humans. Blood tests, including 

a complete blood count and kidney and liver 

function tests, should be done about every 

6 months. 

4 Interstitial Cystitis/Painful Bladder Syndrome 
 

Oral Drugs



Pentosan Polysulfate Sodium (Elmiron)



This first oral drug developed for IC was 

approved by the FDA in 1996. In clinical 

trials, the drug improved symptoms in 

30 percent of patients treated. Doctors do 

not know exactly how the drug works, but 

one theory is that it may repair defects that 

might have developed in the lining of the 

bladder. 

The FDA-recommended oral dosage of 

Elmiron is 100 milligrams (mg), three times 

a day. Patients may not feel relief from IC 

pain for the first 4 months. A decrease in 

urinary frequency may take up to 6 months. 

Patients are urged to continue with therapy 

for at least 6 months to give the drug an 

adequate chance to relieve symptoms. If 

6 months of Elmiron therapy provides no 

benefit, it is reasonable to stop the drug. 

Elmiron’s side effects are limited primarily to 

minor gastrointestinal discomfort. A small 

minority of patients experienced some hair 

loss, but hair grew back when they stopped 

taking the drug. Researchers have found no 

negative interactions between Elmiron and 

other medications. 

Elmiron may affect liver function, which 

should therefore be monitored by the doctor. 

Because Elmiron has not been tested in 

pregnant women, the manufacturer recommends it not be used during pregnancy, 

except in the most severe cases. Because 

Elmiron has mild blood-thinning effects, 

it should be discontinued prior to planned 

surgery. 

Other Oral Medications 

Aspirin and ibuprofen may be a first line of 

defense against mild discomfort. Doctors 

may recommend other drugs to relieve pain. 

Some people have experienced improvement 

in their urinary symptoms by taking tricyclic 

antidepressants or antihistamines. A tricyclic 

antidepressant called amitriptyline (Elavil) 

may help reduce pain, increase bladder 

capacity, and decrease frequency and nocturia. Some people may not be able to take it 

because it makes them too tired during the 

day. In people with severe pain, narcotic 

analgesics such as acetaminophen (Tylenol) 

with codeine or longer-acting narcotics may 

be necessary. 

All drugs—even those sold over the 

counter—have side effects. A person should 

always consult a doctor before using any drug 

for an extended amount of time. 

5 Interstitial Cystitis/Painful Bladder Syndrome 
 

Electrical Nerve Stimulation 

Mild electrical pulses can be used to stimulate the nerves to the bladder—either 

through the skin or with an implanted device. 

The method of delivering impulses through 

the skin is called transcutaneous electrical 

nerve stimulation (TENS). With TENS, mild 

electric pulses enter the body for minutes 

to hours, two or more times a day either 

through wires placed on the lower back or 

just above the pubic area—between the 

navel and the pubic hair—or through special 

devices inserted into the vagina in women or 

into the rectum in men. Although scientists 

do not know exactly how TENS relieves pelvic pain, it has been suggested that the electrical pulses may increase blood flow to the 

bladder, strengthen pelvic muscles that help 

control the bladder, or trigger the release of 

substances that block pain. 

TENS is relatively inexpensive and allows 

people with IC/PBS to take an active part 

in treatment. Within some guidelines, the 

patient decides when, how long, and at what 

intensity TENS will be used. It has been 

most helpful in relieving pain and decreasing 

frequency in people with Hunner’s ulcers. 

Smokers do not respond as well as nonsmokers. If TENS is going to help, improvement 

is usually apparent in 3 to 4 months. 

A person may consider having a device 

implanted that delivers regular impulses to 

the bladder. A wire is placed next to the tailbone and attached to a permanent stimulator 

under the skin. The FDA has approved this 

device, marketed as the Inter-Stim system, to 

treat urge incontinence, urgency-frequency 

syndrome, and urinary retention in people 

for whom other treatments have not worked. 

Diet 

No scientific evidence links diet to IC/PBS, 

but many patients find that alcohol, tomatoes, spices, chocolate, caffeinated and citrus 

beverages, and high-acid foods may contribute to bladder irritation and inflammation. 

Some people also note that their symptoms 

worsen after eating or drinking products 

containing artificial sweeteners. Eliminating 

various items from the diet and reintroducing them one at a time may determine which, 

if any, affect a person’s symptoms. However, 

maintaining a varied, well-balanced diet is 

important. 

Smoking 

Many people feel smoking makes their symptoms worse. How the by-products of tobacco 

that are excreted in the urine affect IC/PBS 

is unknown. Smoking, however, is a major 

cause of bladder cancer. One of the best 

things smokers can do for their bladder and 

their overall health is to quit. 

Exercise 

Many patients feel that gentle stretching 

exercises help relieve IC/PBS symptoms. 

6 Interstitial Cystitis/Painful Bladder Syndrome 
7    Interstitial Cystitis/Painful Bladder Syndrome

Bladder Training

People who have found adequate relief

from pain may be able to reduce frequency

by using bladder training techniques.

Methods vary, but basically patients decide

to void—empty their bladder—at designated

times and use relaxation techniques and

distractions to keep to the schedule.

Gradually, they try to lengthen the time

between scheduled voids. A diary in which

to record voiding times is helpful in keeping

track of progress.

Bladder diary from What I need to know about 

Bladder Control for Women at www.kidney.niddk.nih.gov

Physical Therapy

New evidence indicates that certain types of

physical therapy, when administered by an

experienced physical therapist, may improve

IC/PBS symptoms.  Patients should discuss

this option with their health care provider.

Surgery

Surgery should be considered only if all available treatments have failed and the pain is

disabling.  Many approaches and techniques

are used, each of which has advantages and

complications that should be discussed with a

surgeon.  A doctor may recommend consulting another surgeon for a second opinion

before taking this step.  Most surgeons are

reluctant to operate because some people

still have symptoms after surgery.

People considering surgery should discuss

the potential risks and benefits, side effects,

and long- and short-term complications with

a surgeon, their family, and people who have

already had the procedure.  Surgery requires

anesthesia, hospitalization, and weeks or

months of recovery.  As the complexity of the

procedure increases, so do the chances for

complications and failure.

People should check with their doctor to

locate a surgeon experienced in performing

specific procedures.

Two procedures—fulguration and resection

of ulcers—can be done with instruments

inserted through the urethra.  Fulguration

involves burning Hunner’s ulcers with

electricity or a laser.  When the area heals,

the dead tissue and the ulcer fall off, leaving new, healthy tissue behind.  Resection

involves cutting around and removing the
 

ulcers. Both treatments are done under 

anesthesia and use special instruments 

inserted into the bladder through a cystoscope. Laser surgery in the urinary tract 

should be reserved for people with Hunner’s 

ulcers and should be done only by doctors 

with the special training and expertise 

needed to perform the procedure. 

Another surgical treatment is augmentation, 

which makes the bladder larger. In most of 

these procedures, scarred, ulcerated, and 

inflamed sections of the patient’s bladder are 

removed, leaving only the base of the bladder 

and healthy tissue. A piece of the patient’s 

colon—also called large intestine—is then 

removed, reshaped, and attached to what 

remains of the bladder. After the incisions 

heal, the patient may void less frequently. 

The effect on pain varies greatly; IC/PBS can 

sometimes recur on the segment of colon 

used to enlarge the bladder. 

Even in carefully selected patients—those 

with small, contracted bladders—pain, frequency, and urgency may remain or return 

after surgery, and they may have additional 

problems with infections in the new bladder and difficulty absorbing nutrients from 

the shortened colon. Some patients become 

incontinent, while others cannot void at all 

and must insert a catheter into the urethra to 

empty the bladder. 

Bladder removal, called a cystectomy, is 

another, infrequently used surgical option. 

Once the bladder has been removed, different methods can be used to reroute the 

urine. In most cases, ureters are attached 

to a piece of colon that opens onto the skin 

of the abdomen. This procedure is called a 

urostomy and the opening is called a stoma. 

Urine empties through the stoma into a bag 

outside the body. Some urologists are using 

a second technique that also requires a stoma 

but allows urine to be stored in a pouch 

inside the abdomen. At intervals throughout 

the day, the patient puts a catheter into the 

stoma and empties the pouch. Patients with 

either type of urostomy must be very careful 

to keep the area in and around the stoma 

clean to prevent infection. Serious potential 

complications may include kidney infection 

and small bowel obstruction. 

A third method to reroute urine involves 

making a new bladder from a piece of the 

patient’s colon and attaching it to the urethra. After healing, the patient may be 

able to empty the newly formed bladder by 

voiding at scheduled times or by inserting a 

catheter into the urethra. Only a few surgeons have the special training and expertise 

needed to perform this procedure. 

Even after total bladder removal, some 

patients still experience variable IC/PBS 

symptoms in the form of phantom pain. 

Therefore, the decision to undergo a cystectomy should be made only after testing all 

alternative methods and seriously considering the potential outcome. 

Removing the bladder is not always done in 

patients with severe disease. Some urologists recommend rerouting urine to a piece 

of bowel connected to the abdominal wall. 

Urine is then collected in an external bag 

that is emptied periodically. While this 

procedure may or may not improve pelvic 

pain, it can decrease frequency and improve 

quality of life for patients who experience 

frequent urges to urinate. 

8 Interstitial Cystitis/Painful Bladder Syndrome 
 

Are there any special 

concerns regarding IC/PBS? 

Cancer 

No evidence exists that IC/PBS increases the 

risk of bladder cancer. 

Pregnancy 

Researchers have little information about 

pregnancy and IC/PBS but believe that the 

disorder does not affect fertility or the health 

of the fetus. Some women find that their 

IC/PBS goes into remission during pregnancy, while others experience a worsening 

of their symptoms. 

Coping 

The emotional support of family, friends, and 

other people with IC/PBS is very important 

in helping patients cope. Studies have found 

that people who learn about the disorder and 

become involved in their own care do better 

than people who do not. The Interstitial 

Cystitis Association maintains a list of support 

groups that can viewed at www.ichelp.org. 

Hope through Research 

Although answers may seem slow in coming, 

researchers are working to solve the painful 

riddle of IC/PBS. Some scientists receive 

funds from the Federal Government to help 

support their research, while others receive 

support from their employing institution, 

drug pharmaceutical or device companies, or 

patient support associations. 

The NIDDK’s investment in scientifically 

meritorious IC/PBS research across the 

United States has grown considerably since 

1987. The Institute now supports research 

that looks at various aspects of IC/PBS, such 

as how the components of urine may injure 

the bladder and what role organisms identified by nonstandard methods may have 

in causing IC/PBS. In addition to funding 

research, the NIDDK sponsors scientific 

workshops where investigators share the 

results of their studies and discuss future 

areas for investigation. 

Clinical Research Network 

The Interstitial Cystitis Clinical Research 

Network (ICCRN) is a product of two 

NIDDK programs: the Interstitial Cystitis 

Database (ICDB) Study and the Interstitial 

Cystitis Clinical Trials Group (ICCTG). 

Established in 1991, the ICDB was a 5-year 

prospective cohort study of more than 

600 men and women with symptoms of 

urinary urgency, frequency, and pelvic pain. 

The study described the longitudinal changes 

of urinary symptoms, the impact of IC on 

quality of life, treatment patterns, and the 

relationship between bladder biopsy findings and patient symptoms. The ICCTG 

was established in 1996 as a follow-up to 

the ICDB study. The clinical trials group 

developed two randomized, controlled 

clinical trials of promising therapies, one 

using oral therapies—pentosan polysulfate sodium (Elmiron) and hydroxyzine 

hydrochloride (Atarax)—and the other 

administering intravesical treatment using 

Bacillus Calmette-Guérin (BCG). BCG is a 

vaccine for tuberculosis that stimulates the 

immune system and may have an effect on 

the bladder. The ICCTG also developed and 

conducted ancillary studies of various biomarkers such as heparin-binding epidermal 

growth factor-like growth factor (HB-EGF) 

and anti-proliferative factor (APF). 

In 2003, the ICCTG became the ICCRN, 

which has conducted additional clinical trials 

over a second 5-year period. One of these 

trials studied the effectiveness of amitriptyline in treating PBS, which includes IC. 

Amitriptyline has FDA approval for the 

treatment of depression, but researchers 

9 Interstitial Cystitis/Painful Bladder Syndrome 
 

 

believe the drug may work to block nerve 

signals that trigger pain in the bladder and 

may also decrease muscle spasms in the 

bladder, helping to cut both pain and frequent urination. The study could not prove 

that amitriptyline was effective in treating 

IC/PBS, although many patients seemed to 

benefit from a combination of amitriptyline 

and behavioral modification with stress 

reduction. 

In 2008, the NIDDK launched the Multidisciplinary Approach to the Study of Chronic 

Pelvic Pain (MAPP) Research Network. The 

MAPP Research Network is designed to 

take a collaborative, whole-body approach to 

the study of IC/PBS and chronic prostatitis/ 

chronic pelvic pain syndrome (CP/CPPS). 

This program brings together experts from 

nonurologic fields such as neurology and 

epidemiology as well as traditional urologic 

researchers to study IC/PBS and CP/CPPS 

in the context of other chronic pain syndromes such as fibromyalgia, chronic fatigue 

syndrome, and irritable bowel syndrome. 

While traditional research has focused on 

the bladder as the source of pain in IC/PBS 

and on the prostate as the source of pain 

in CP/CPPS, researchers now believe that 

an underlying cause common to all chronic 

pain syndromes may lie somewhere outside 

these specific organs. The MAPP Research 

Network includes six Discovery Sites that will 

conduct individual and collaborative trials 

and two Core Sites for data and tissue banking and analysis. The program is scheduled 

to be funded for 5 years. 

Participants in clinical trials can play a more 

active role in their own health care, gain 

access to new research treatments before 

they are widely available, and help others 

by contributing to medical research. For 

information about current studies, visit 

www.ClinicalTrials.gov. 

Suggested Reading 

The materials listed below may be found 

in medical libraries, in many college and 

university libraries, through interlibrary loan 

in most public libraries, and at bookstores. 

Items are listed for information only; inclusion does not imply endorsement by the 

National Institutes of Health. 

Articles and Book Chapters 

Keay SK, Warren JW. Is interstitial cystitis 

an infectious disease? International Journal 

of Antimicrobial Agents. 2002;19(6):480–483. 

The Interstitial Cystitis Clinical Trials Group. 

A pilot clinical trial of oral pentosan polysulfate and oral hydroxyzine in patients 

with interstitial cystitis. Journal of Urology. 

2003;170(3):810–815. 

The Interstitial Cystitis Clinical Trials Group. 

A randomized controlled trial of intravesical 

Bacillus Calmette-Guérin for treatment of 

refractory interstitial cystitis. Journal of 

Urology. 2005;173(4):1186–1191. 

Hanno P, Lin AT, Nordling J, Nyberg L, van 

Ophoven A, Ueda T. Bladder pain syndrome. In: Abrams P, Cardozo L, Khoury 

S, Wein A, eds. Incontinence. Paris: Health 

Publication Ltd.; 2009: 1459–1518. 

Books and Booklets 

Moldwin RM. The Interstitial Cystitis Survival 


Guide: Your Guide to the Latest Treatment 


Options and Coping Strategies. Oakland, 


CA: New Harbinger Publications, Inc.; 2000. 


(Available by calling 1–800–HELP–ICA or 


1–800–435–7422.)
 

Sandler GG, Sandler A. Patient to Patient: 

Managing Interstitial Cystitis & Overlapping 

Conditions. New Orleans, LA: Bon Ange 

LLC; 2000. 

Sant G, ed. Interstitial Cystitis. Philadelphia: 

Lippincott-Raven; 1997. 

10 Interstitial Cystitis/Painful Bladder Syndrome 
11 Interstitial Cystitis/Painful Bladder Syndrome

For More Information

American Urological Association Foundation

1000 Corporate Boulevard 

Linthicum, MD 21090 

Phone: 1–800–828–7866 or 410–689–3700

Fax: 410–689–3998 

Email: auafoundation@auafoundation.org 

Internet: www.UrologyHealth.org

American Chronic Pain Association

P.O. Box 850 

Rocklin, CA 95677 

Phone: 1–800–533–3231 

Email: ACPA@pacbell.net 

Internet: www.theacpa.org

American Pain Society

4700 West Lake Avenue 

Glenview, IL 60025 

Phone: 847–375–4715 

Email: info@ampainsoc.org 

Internet: www.ampainsoc.org

American Urogynecologic Society

2025 M Street NW, Suite 800 

Washington, D.C. 20036 

Phone: 202–367–1167 

Fax: 202–367–2167 

Email: info@augs.org 

Internet: www.augs.org

International Association for the 

Study of Pain

111 Queen Anne Avenue North, Suite 501 

Seattle, WA 98109–4955 

Phone: 206–283–0311 

Email: IASPdesk@iasp-pain.org 

Internet: www.iasp-pain.org

Interstitial Cystitis Association

100 Park Avenue, Suite 108A 

Rockville, MD 20850 

Phone: 1–800–HELP–ICA (1–800–435–7422)

 or 301–610–5300

Fax: 301–610–5308 

Email: ICAmail@ichelp.org 

Internet: www.ichelp.org

National Kidney Foundation 

30 East 33rd Street 

New York, NY 10016 

Phone: 1–800–622–9010 or 212–889–2210 

Internet: www.kidney.org

National Organization of Social Security 

Claimants’ Representatives

560 Sylvan Avenue 

Englewood Cliffs, NJ 07632 

Phone: 1–800–431–2804 

Email: nosscr@att.net 

Internet: www.nosscr.org

Social Security Administration

Office of Public Inquiries 

Windsor Park Building 

6401 Security Boulevard 

Baltimore, MD 21235 

Phone: 1–800–772–1213 

Internet: www.ssa.gov

Local offices can be found in the telephone 

book under U.S. Government, Department 

of Health and Human Services.

United Ostomy Associations of America, Inc. 

P.O. Box 512 

Northfield, MN 55057–0512 

Phone: 1–800–826–0826 

Email: info@ostomy.org 

Internet: www.ostomy.org

Acknowledgments

Publications produced by the Clearinghouse 

are carefully reviewed by both NIDDK scientists and outside experts. This publication 

was reviewed by Philip Hanno, M.D., University of Pennsylvania.
You may also find additional information about this 

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medications.  When prepared, this publication 

included the most current information available.   

For updates or for questions about any medications, 

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AND HUMAN SERVICES

National Institutes of Health

NIH Publication No. 11–3220

September 2011