What is Interstitial Cystitis?

October 2, 2015

Natural Treatments

Interstitial cystitis or IC is a multi-factorial syndrome characterized by pelvic pain, urinary bladder inflammation, frequent urination and urgency.  The pain can range from mild to debilitating.  It is a syndrome that waxes and wanes, affects primarily women, however men can also be affected.  IC is typically diagnosed after urinary tract infections and other pelvic diseases have been ruled out.  Many people with IC also struggle with fibromyalgia, irritable bowel syndrome, rheumatoid arthritis, allergies and asthma.  Stress and anxiety are known to exacerbate IC symptoms.  Menstruation and intercourse often trigger pain.

Interstitial Cystitis or Lower Urinary Dysfunction Epithelia in men is characterized by symptoms similar to an acute lower urinary tract infection but without an identifiable pathogen.  Symptoms include bladder pain, urinary frequency, nocturia, urgency and pain with urination.

Over time, interstitial cystitis can cause physical damage to the bladder wall. Scarring of the bladder wall may occur as a result of the chronic inflammation, leading to a decrease in bladder capacity.  Pinpoint bleeding and petechial bladder mucosa hemorrhages may be seen on the bladder wall.  Bladder ulcers called Hunner’s ulcers may be seen on cystoscopy and are detected in about 10% of people.

The cause of IC has not been determined.  There appear to be two primary factors involved, inflammation and permeability of the epithelium or what I think of as “leaky bladder”, meaning components of urine seep into and irritate the bladder.  What causes the inflammation?  There are a number of theories.  One theory is that mast cells, which are known for their role in both allergic reactions and inflammatory disease, release their inflammatory mediators which then damage the bladder and cause increased activation of nerves.   Another theory is that the glycosaminoglycan layer of the bladder epithelium deteriorates and becomes leaky.

How can IC be treated?

I view treatment as a wholistic process that includes all aspects of our lives.  This means lifestyle – how much rest do we receive, hours sitting, exercise, nutrition, and the strength or challenges of the other systems of our unique physiology.  Food and digestion is the foundation of our health.  Blood sugar affects inflammation.  Stress affects all of our hormones and neurotransmitters.  Following a thorough assessment of body systems, I recommend beginning with nutrition.  Individuals with IC will report that certain foods aggravate their symptoms.  Typical foods include coffee, chocolate, alcohol, carbonated drinks, tomatoes, citrus, spicy foods, vinegar, and others that may be unique to the person.  I highly recommend an elimination challenge diet to determine which foods increase your symptoms.

Exercise has been shown to decrease the symptoms of IC for many individuals.  Look at the effects of exercise and the type of exercise that supports you.

Supplements and herbs to support the bladder

Support to replace the GAG layer:

  • N-Acetyl glucosamine or glucosamine sulfate can be used to heal or replace the deficient epithelial GAG layer. Vitamin A plays a major role in maintaining the mucosal surface of the bladder.  It also inhibits mast cell growth and proliferation.  Typical dose of vitamin A is 5000IU’s.
  • Herbs that are demulcent soothe and heal mucous membranes by forming a protective coating over inflamed tissues. My favorite demulcent for IC is Corn Silk.  Others include slippery elm, marshmallow leaf and root.  A starting dose for Corn Silk is 60mg.

To decrease pain anx urgency:

  • There is some research that suggests that L-arginine decreases both the frequency of pain and improvement in urgency of urination. A typical dose is 1000mg per day.

To decrease inflammation:

  • Quercitin is an antioxidant flavonoid and a mast cell stabilizer.  A typical dose is about 1000 mg per day.  Another anti-inflammatory herb that is both immune modulating and anti-inflammatory is glycyrrhiza glabra (licorice root).

To reduce spasm:

  • Peony often made in a tincture is helpful to reduce spasm and enhance mood.
  • Kava is one of my favorite herbs to reduce anxiety and stress as well as relaxing the muscles.

What about mind-body techniques?

I have found that there is always a stress component to every illness or chronic condition, especially when there is pain.  I utilize ETT or Emotional Transformation Therapy to eliminate the pain and stress associated with IC.  ETT is a system of healing that uses light and color to entrain the brain to the state you are experiencing and then changes that state.  ETT was developed by Dr. Steven Vazquez, which uses techniques of visual brain stimulation within an interactive process to access somatic and emotional experiences.  The frequency of light associated with pelvic pain may bring up emotions, memories or sensations long forgotten as you tune into the experience while looking at light or color.  The light is changed as we monitor your experience while dialoguing.  This process occurs rapidly.  My experience has been that ETT significantly decreases the pain of IC.

Using herbs energetically:

I will often support individuals using a low dose of a balanced herbal mixture that supports the systems of the body challenged.  One of the herbs for someone with IC may be Actea or Stellaria, plus an herb with an affinity for a particular mental/emotional or spiritual issue.

If you have IC, I recommend that you get a complete medical evaluation and talk to your healthcare provider about treatments that best serve you and your individual preferences.

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Understanding Naturopathic Primary Care

Dr. Moira Fitzpatrick, a specialist in naturopathic care and holistic medicine, promoting well-being and integrative health practices