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Interstitial cystitis

Interstitial cystitis (commonly abbreviated to "IC") is a urinary bladder disease of unknown cause characterised by pelvic and intense bladder pain, urinary frequency (as often as every 10 minutes), pain with sexual intercourse, and often pain with urination. It is not unusual for patients to experience nocturia and pain with sexual intercourse. IC is also known as painful bladder syndrome (PBS), particularly outside of the USA. more...

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IC affects men and women of all cultures, socioeconomics and ages. Previously believed to be a condition of post menopausal women, growing numbers of men and women are being diagnosed in their twenties and younger. IC is not a rare condition. Recent research suggests that IC prevalence ranges from 1 in 100,000 to 5.1 in 1,000 of the general population. New epidemiological data for the United States should be released in 2006.

It is not unusual for patients to have beeen misdiagnosed with a variety of other conditions, including: overactive bladder, urethritis, urethral syndrome, trigonitis, prostatitis and other generic terms used to describe frequency/urgency symptoms in the urinary tract.


The cause of interstitial cystitis is unknown, though several theories have been put forward (these include autoimmune, neurologic, allergic and genetic). Regardless of the origin, it is clear that IC patients struggle with a damaged mucin, aka the GAG layer, aka bladdering lining. When this protective coating is damaged (perhaps via a UTI, excessive consumption of coffees or sodas, traumatic injury, etc.), urinary chemicals can "leak" into surrounding tissues causing pain, inflammation and urinary symptoms. Oral medications like Elmiron and medications which are placed directly into the bladder via a catheter work to repair and hopefully rebuild this damaged/wounded lining, allowing for a reduction in symptoms.

Recent work by the University of Maryland indicates that genetics are a factor in, and may even (in some cases) be the cause of IC. Two genes, FZD8 and PAND, are associated with the syndrome. FZD8, at gene map locus 10p11.2, is assocated with an antiproliferative factor secreted by the bladders of IC patients which "profoundly inhibits bladder cell proliferation," thus causing the missing bladder lining. PAND, at gene map locus 13q22-q32, is associated with a constellation of disorders (a "pleiotropic syndrome") including IC and other bladder and kidney problems, thyroid diseases, serious headaches/migraines, panic disorder, and mitral valve prolapse.


It may well be that the symptoms of interstitial cystitis have multiple causes, and IC is actually several syndromes which will eventually be discerned. For example, patients with Hunner's Ulcers are believed to be the most advanced cases. They have larger "wounds" in the bladder that are much more difficult to treat. It is estimated that only 5 to 10% of patients have these ulcers. Far more patients may experience a very mild form of IC, inwhich they have no visible wounds in their bladder, yet struggle with symptoms of frequency, urgency and/or pain. Still other patients may have discomfort only in their urethra, while others struggle with pain in the entire pelvis. Some patients may experience pelvic floor tightness and dysfunction, while others have normal muscle tone.


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Help for chronic interstitial cystitis
From Saturday Evening Post, 9/1/05 by Cory SerVaas

Dear Dr. SerVaas,

I just read in the latest Saturday Evening Post about chronic interstitial cystitis and the excrutiating pain Mrs. Martin Zacha's relative has been suffering for years.

I wanted to pass along a response from a letter printed in Nutrition & Healing dated June 2002, where a person got miraculous relief of bladder pain in 24 hours taking D-Mannose. I hope others can obtain the identical type of "almost instant pain relief." I wish her much luck! Please pass on the information to Mrs. Zacha.

Ted Hayashida, M.D., F.A.C.S.

Gardena, California

Dear Dr. SerVaas,

I have some answers for Mrs. Martin Zacha's relative who has interstitial cystitis [May/June 2005].

You are on the right track by eliminating acids from your diet. I suffered from IC and vulvar pain for about six years before I had the good fortune to find Dr. Clive Solomon, who was doing research on oxalic acid and its role in IC and vulvar pain.

All it took was following the low oxalate diet and taking calcium a half hour before meals. Oxalic acid attaches to calcium to be eliminated from the body. Within two months I was 95 percent free of pain, and have remained so for the past 15 years.

Celery was my biggest problem. Celery, in some form, is in most commercially packaged main dishes, and it takes very little to cause a lot of pain. Other foods that are very high in oxalate are rhubarb, berries, chocolate, spinach and other dark green vegetables. For more about oxalate and to order a low-oxalate cookbook, contact the VP Foundation, P.O. Drawer 177, Graham, NC 27253.

Grace Thompson

Graham, North Carolina

Dear Dr. SerVaas,

I've had IC--interstitial cystitis--for over eight years and wasn't diagnosed until a year and a half ago. Since then I've taken (one a day) 10 mg nortriptyline (antidepressant), and it keeps the pain away. Of course sometimes I have flareups, but even then the pain isn't bad. I also drink cranberry juice and take cranberry capsules when I have a flareup, and it helps.

For my bad arthritis, for a year, I've been taking glucosamine sulfate, 1,000 mg capsules, one a day, and it helps so much. It's like a miracle! When I stop it for a few days or a week, the pain comes back, so I start it again. It rebuilds or restores cartilage.

Carol Collum

Woodville, Texas

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