Interstitial Cystitis-Painful Bladder Syndrome
By Sarah Kashdan ND 2018 and Dr. Hillary Martin
What is it?
Interstitial cystitis(IC) is a thickening or scarring of the bladder wall which causes loss of bladder capacity. IC results in frequent urination, urgency, recurring pain or discomfort in the bladder and surrounding pelvic region.
What are the causes?
The exact cause of IC is unknown however there are a multitude of factors that may predispose someone to the condition. Those patients with another diagnosed pain disorder such as irritable bowel syndrome or fibromyalgia may be at greater risk. Research has also found a possible hereditary correlation.
Possible Pathogenesis:
- Autoimmunity
- Chemical Irritation
- Hormonal/Estrogen Dominance
- Food Allergies increasing mast cell inflammation
- GAG damage at the epithelium increasing permeability
- Unidentified urine toxins/dormant microbes causing toxic or immune irritation
- Migrating flora from vagina tract or rectum
- Nitric Oxide Deficiency leading to bladder spasm
- Trauma
Signs and symptoms of IC
The symptoms of IC are non-specific. Although IC mimics many of the symptoms of a urinary tract infection, these patients do not have bacterial infections. Patients may experience a variety of the following:
- Urinary frequency-needing to urinate up to 60 x a day
- Bladder Pain(worse with a full bladder and better with voiding)
- Pelvic pain with variable tenderness of the abdomen
- Non-Specific Pelvic Pain
- Pain during sexual intercourse
- Symptoms tend to wax and wane.
- Urinalysis generally negative.
- Histamine metabolites can be elevated.
- Possible triggers from coffee, carbonated beverages, cranberry, tomatoes, alcohol,
vinegar, chocolate, strawberries, tea
Who is affected?
Over 3 million in the US have been formally diagnosed with Interstitial Cystitis. Some sources say that up to 12 million Americans may have the condition. Most of these diagnoses are found in Caucasian females age 30 or older.
How is IC diagnosed?
IC is considered a diagnosis of exclusion after all other conditions are ruled out. According to the National Institute of Health, a patient must have presence of pain related to the bladder, usually accompanied by frequency and urgency of urination as well as the absence of other diseases that could cause the symptoms. There are no definitive laboratory tests to diagnosis IC however the following can help to rule out other diseases:
- Urinalysis and culture
- Biopsy of the bladder wall and urethra
- General bloodwork
- Cystoscopy
- Ultrasound
Conventional Treatment
Because the cause of IC is relatively unknown, treatment is geared towards relief of symptoms.
- Elmiron(glycosaminoglycan)Oral- the only FDA approved oral drug for IC.
- Bladder instillations- also known as a bladder wash where a solution is introduced via catheter. Bladder instillations are done with FDA approved DMSO to reduce inflammation. Often antibiotics and antispasmodic drugs are included.
- Electrical nerve stimulation- increase blood flow to the bladder, strengthen pelvic muscles that help control the bladder, or trigger the release of substances that block pain
- Surgery
Naturopathic Treatment
Best results are found with a full naturopathic evaluation addressing the body as a whole, a full review of organ functions and overall assessment if immune function and inflammation.
- Stress management can play a huge role in symptoms relief
- Food allergy testing and elimination: avoid acidic foods, wheat, whey, citrus, spicy, artificial sweeteners, caffeine, alcohol, yeast
- Avoidance of B vitamins
- Arginine, L-Citrulline to reduce spasm
- Herbs to soothe the urinary tract, reduce pain, and support the immune system
- Anti-Histamines: Bromelein and Quercetin
- Melatonin to reduce inflammation and preserve GAG layer
- Castor oil packs for relaxation to the smooth muscle wall
- Homeopathy, Acupuncture, Meditation
- Kegel exercises, Bowen technique, PT
Other considerations
- IC can greatly disrupt daily life. Mental health support should be considered along with medical intervention
- While there is no known cure for IC, many naturopathic treatments can help alleviate pain and help the patient feel supported both physically and emotionally
Have Questions? Lets talk!
Schedule a free 15 minute consult with NWW
Naturopathic Womens Wellness
1295 Yellow Pine Ave. Boulder CO 80304
P: 303-545-2021 | F: 303-545-2003
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