Bladder Pain Syndrome, Interstitial Cystitis (IC), Painful Bladder Syndrome (PBS)  

Statistics:

• 3.3 million U.S. women (2.7% of the population) greater than 18 years of age have urinary pain
• 1.6 million U.S. men (1.3%) between the ages of 30-79 have pain associated with urinating 
• Some people with this condition have been known to need to use the bathroom up to 60 times within a 24 hour period

If you know of someone with this condition, you can be sure that their lives are totally centered around where all the toilets are—even when taking short trips.

Interstitial cystitis (in-tur-STISH-ul sis-TIE-tis) is defined as recurring pain or discomfort in the bladder and surrounding pelvic (perianal) regions in both men but mostly women over the age of 30. This condition is a sign of a toxic body and is often associated with other inflammatory conditions such as Irritable Bowel Syndrome and Fibromyalgia. Interstitial Cystitis causes scarring and stiffness of the bladder which affects the nerves in that area that signal the need to urinate. Some people with this condition have been known to need to use the bathroom up to 60 times within a 24 hour period—as you can imagine this interferes greatly with any social, work and sexual intimacy situations.

Natural medicine can greatly help many of these cases which is why I’m writing about it for the Featured Case this month.

Symptoms Associated with Interstitial Cystitis include (IC):

• • Decreased bladder capacity
  • Discomfort in the bladder (much like a chronic urinary tract infections but without the bacteria)
  • Emotional stress (from broken sleep due to getting up too many times to urinate)
  • Frequent night urination (nocturia)
  • Frequent urination — also called pollakyuria (up to 60 times/day)
  • Glomerulations (pinpoint hemorrhages) on the wall of the bladder
  • Hunner’s ulcers—patches of broken skin found on the inside of the bladder wall—in 10% of IC cases
  • Increased bladder pressure
  • Intense pain in the pelvic region
  • Pain between the base of the scrotum and anus in males
  • Pain in the area of the prostate
  • Pain upon filling or emptying bladder
  • Pelvic pain increases with menstruation or vaginal intercourse
  • Periods of flare-ups and remissions
  • Persistent/urgent need to urinate as the bladder fills
  • Tenderness in the bladder/pelvic region 

What Causes Interstitial Cystitis?

By performing a urinalysis on these cases, the medical community has not associated Interstitial Cystitis (IC) with any type of bacterial infection within the bladder. These cases do not respond to antibiotics, so we need to look at the different core causes and learn how to manage them on an individual basis.

When an area of the body is not happy and not able to move stagnated toxins, the tissues attract water to that area making it look larger. Knowing this, one can see why some people have big hips and thighs or carry more weight below the belly button with bladder issues. One symptom of chronic bladder issues is stinky feet. Even tiny little clues add together to reveal a health plan that will assist in optimizing all body functions.

Some suspected core causes include:

• Alcohol (from the grains, flavoring agents or sulfites perhaps)
• Allergies
• Artificial sweeteners
• Auto Immune reactions
• Bacterial infection
• Bathing instead of showering (is the bathtub as clean as it could be?)
• Caffeine
• Carbonation
• Cheeses
• Chocolate
• Citrus beverages
• Defects in the lining of the bladder
• Dehydration
• Exercise
• Heavy metal toxicity
• Heredity
• High Acid foods
• Irritation from IUDs
• Nightshades (Potato, tomato, eggplant, peppers—both sweet and hot varieties, tomatillo, mustard greens, tobacco, mandrake, nightshade, belladonna, garden huckleberries and ground cherries.)
• Nuts
• Peppers
• Processed meat (nitrates perhaps?)
• Refined flours
• Scar tissue from past abdominal/pelvic procedures (catheterizations, abortions, ablations, etc.)
• Sexual intercourse—not urinating after intercourse or not drinking a full glass of water before/after intercourse
• Sexual activity
• Sitting for extended periods of time
• Smoking (Note that tobacco is in the nightshade family, so other nightshades are suspect as well. Smoking is also a major cause associated with bladder cancer.)
• Spicy foods (so. . .pepper flakes—a nightshade)
• Stress
• Supplements that contain Vitamin C (ascorbic acid specifically)
• Tomatoes
• Use of douche bags or contaminated douche solution or a contaminated bag itself
• Vinegar (for blood types A and O especially)
• Viral infection
• Wiping from the back to the front after using the toilet (causes urinary tract infections)
• Yeast infections https://naturalhealthtechniques.com/specificdiseasesyeast_tactics1.htm 

Diagnosis of Interstitial Cystitis:

There are no definitive tests for the diagnosis of Interstitial Cystitis but some tests will rule out urinary tract infection, kidney disease and cancer of the bladder, so don’t be discouraged if tests come back negative for IC. Other treatable conditions should be addressed if they come up. Tests for IC include the urinalysis, urine culture, cystoscopy, biopsy of the urethra/bladder and bladder capacity tests. Sometimes by distending the bladder with water, air or potassium iodide, the bladder tissue will be stretched enough so that the pain will go away for several weeks.

The Potassium Sensitivity test is when water followed by potassium iodide is instilled into the bladder. If you don’t have IC (Interstitial Cystitis) then you should feel no pain with either the water or the potassium inside your bladder. If you have IC, then the potassium will definitely hurt and that may give a definitive diagnosis of IC.

How to Prepare for Your Appointment: You’ll need to gather a few things together before talking to your health care provider (of any type).

• Write down any symptoms you have been experiencing in the last few months (even though you don’t think they could be associated with your bladder).
• Keep a Bladder Diary for a few days which should include the times of the day you have to urinate, the pain associated with urination (is it when filling or releasing urine?), any urinary incontinence, and noticing if you have to urinate within 2 minutes or so after just urinating. When was your last sexual intercourse? What kind of contraception do you use? On a scale of 1-10 with 10 being the most painful, how much pain are you in? How is this affecting your life in general?
• Have a list of questions/concerns that can be reviewed and addressed if the consult does not cover everything.

Other preparation that will be very important for a naturopathic practitioner like myself will be to:

• Have all of your supplements and medications with you at the time of the consult (a list often doesn’t tell us what brands or ingredients within your supplements that may be causing any urinary challenges).
• Know and be prepared to list items you eat and drink for breakfast, lunch, dinner, snacks and desserts and what restaurants you eat at—not just the items you ate yesterday but the main foods that make up your diet. Some allergic symptoms may manifest up to three days after eating the offending substance, so this is important. 

Finding a practitioner that will take your concerns seriously–one who will listen to you and attend to your concerns—is where you want to place your time and dollars. Don’t give up! We’re out here and willing to help.

Medical Treatments and Management of Interstitial Cystitis: Let’s attend to the medical (allopathic) treatments first and then I’ll list possible alternative therapies. There is no cure for Interstitial Cystitis so most people say, but the medical community is using several techniques and drugs to attend to the symptoms.

• Acupuncture: Some medical doctors are recommending this.
• Bladder Distention or Flushing using water, potassium iodide, heparin, local anesthetics, etc.
• Bladder Training: Using will-power to use the bathroom at specific times.
• Decreasing Stress levels
• Drugs: Antihistamines like Loratadine (Claritin)
• Drugs: NSAIDS for the pain including aspirin, Advil, Aleve, Ibuprofen, Motrin IB, Tylenol and Tylenol with Codeine
• Drugs: Pentosan (Elmiron) which is taken for 2-4 months before noticing a diminished pain response. This is a weak blood thinner so taking other NSAIDS with this drug is not well tolerated or recommended. More info on Elmiron (pentosan polysulfate sodium) can be found on their website: https://www.orthoelmiron.com/about-elmiron
• Drugs: Tricyclic Antidepressants such as Elavil (Amitriptyline) or Imipramine (Toframil) to help relax the bladder and block the pain.
• Drugs: Tylenol with Codeine or other narcotics to block the pain.
• Electrical Nerve Stimulation: Either directly on the skin or implanted under the skin (for long term). Examples of this would be a TENS unit (Transcutaneous Electrical Nerve Stimulator) or Sacral Nerve Stimulation.
• Exercise
• Gentle stretching exercises
• Guided Imagery is not being recommended by the mainstream medical community but it may be helpful
• Instilling DMSO (a cleaning solvent) every two weeks for several treatments—it is recommended to follow up with a Complete Blood Count and kidney/liver function tests every 6 months with this treatment. DMSO has been known to cause cataracts in animals. Another name for DMSO is Rimso-50. DMSO is often combined with local anesthetics, sodium bicarbonate (baking soda to alkalize the inside of the bladder), Pentosan (an approved FDA drug used for this condition) or heparin.
• Physical Therapy: Pelvic floor exercises, restrictive connective tissue exercises and light massage for muscle tenderness.
• Smoking Cessation
• Surgery: A last resort and only used for disabling chronic pain because the techniques may or may not work and the pain may return. Surgeries take weeks to months of recovery. Phantom pains may replace the pain. Surgeries include cauterizing the ulcers within the bladder, resecting and removing the bladder and creating a stoma where a bag is hung to collect urine and making a new bladder from a piece of the large intestine.
• Wear loose-fitting clothing: Avoid belts and other tight clothing around the abdomen. 

Note: Pregnancy has no effect on IC. Some women find they go into remission with pregnancy yet in other women the symptoms get worse.

Alternative Medicine Treatments for Interstitial Cystitis:

• Activated Quercetin, Source Naturals is a good brand—a natural antihistamine
• Acupuncture
• Alka Life Drops—to alkalize the body
• Allergy Allersodes—to detox the core causes such as Nightshades, Pollens and Caffeine
• Allerplex, Standard Process—a natural antihistamine
• Antibiotics, natural include Albaplex, Immuplex and other Standard Process supplements
• Baking soda to alkalize the body (I don’t advocate this at all as one can easily overdose themselves causing high blood pressure and increased fluid retention)
• Bentonite Clay Baths—Aids in detoxification
• Birch (Betula) Tincture: High in Quercetin, diuretic, high in flavonoids
• Buchu (Agathosoma betulina) tea—high in antioxidants
• Carob powder for heavy metal detox
• Colloidal Silver (Note that if a little is good a lot may harm you—this is a heavy metal)
• Couch Grass (Agropyron repens or Elymus repens)
• Cranberry Concentrate juice (This is not the same as juice made from concentrate and capsules don’t work very well—get the real stuff at a health food store—ask if you have any questions and don’t let them point to the fruit juice section of the store.)
• Dandelions (Taraxacum officinalis) (tea or greens)—a natural diuretic and liver cleanser
• Decreasing stress loads
• Dietary Changes (Staying away from the foods that are part of the core cause)
• Eating the correct Essential Fatty Acids and fats for your body
• Eating for you Blood Type (www.dadamo.com) You can order a test kit online to determint your blood type on Amazon.com
• Eating more fresh fruits and fresh and cooked veggies to alkalize the body—sometimes this is a challenge for the IC patients, but I suspect the correct kinds of fruits/veggies are the key.
• Echinacea capsules or tincture (a natural antibiotic)
• Epsom Salt baths—to aid in detoxification
• Exercises like Yoga and Tai Chi
• Fish Oil (Actually eating the fish itself is much more effective—many people are allergic to some of the components—like Tartaric Acid– in the gel capsule and often their bodies don’t vibe with the processing of the oil. If you’re burping up your supplements, then your body doesn’t like them.)
• Flax Seed Oil (not recommended for thyroid patients as flax is a goitrogen food)
• Glutathione—Glycine-Glutamine-Cysteine. Suggested brand name of LipoCeutical–an easier form for the body to absorb
• Goldenrod (Solidago virgaurea)—not a good choice for those with seasonal allergies
• Grapefruit Seed Extract
• Guided Imagery
• Lovage (Levistcum officinale) a diuretic

• 

  Lovage is used in the treatment of interstitial cystitis.

• Marsh Mallow Root Tea or Extract (Althea officinalis) repairs the bladder lining

• 

  Althea officinalis (Marsh mallow) plant.

• NAC (A natural source of Glutathione)—Antioxidant and natural detoxifier
• Onions, cooked—contains quercetin—a natural antihistamine
• Pineapple, Fresh/Raw—contains digestive enzymes to help with inflammation. Pick the perfect pineapple every time.
• Pychnogenol—Pine bark derived—natural antioxidant
• Smoking cessation
• Stinging Nettles (Urtica dioica)—great source of easy-to-absorb calcium and this one is great for itchy allergy symptoms
• Uva Ursi (Kinnikkinick or Bearberry)
• Water, Drinking—alkalized

Note: Some of these products are bundled and sold as “Support Packs” but this is often just an overpriced shotgun approach which is fine IF it works, but I believe getting to the core cause of the issue and only taking the supplements your body wants is the safest, most efficient and economical way to handle any disease—especially this one because allergies to supplements may be a core cause of Interstitial Cystitis.

Foods Known To Be Helpful For Overall Bladder Health:

• Blueberries
• Carrots
• Celery
• Cranberries—tossing in a few frozen cranberries occasionally into smoothies is a great idea.
• Cucumbers
• Parsley—a great highly-dense trace mineral food with natural calcium. Read more at: https://naturalhealthtechniques.com/herb-parsley.htm
• Yogurt—plain

Helpful Links and References for Interstitial Cystitis:

• National Institution of Diabetes & Digestive & Kidney Diseases (NIDDK)
• Bladder Diary: www.kdiney.niddk.nih.gov (What I need to know about bladder control for women)
• American urological Association Foundation: www.urologyhealth.org
• Book: The Green Pharmacy by James A Duke, Ph.D. © 1997
• Interstitial Cystitis Association: www.ichelp.org