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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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Interstitial cystitis: treating this painful condition naturally
From Better Nutrition, 2/1/05 by Mary Bove

Jan, a 67-year-old woman, came to me with the complaint of chronic urinary pain, which varied from mild to severe. The episodes lasted from days to weeks, and her symptoms returned periodically.

Jan's condition, interstitial cystitis (IC), is a urinary pain syndrome that is poorly understood. There are several theories as to its cause, but most involve conditions that lead to an increase in inflammatory mediators in the bladder tissue. Minimizing the triggers that stimulate these mediators--along with rebalancing immune function--is key. This isn't an easy condition to treat. Therapy must be carried out for at least a year, and beneficial effects may not be seen until months have passed.

There are several foods that seem to be connected with IC, including coffee, alcohol, chocolate, carbonated drinks, vinegars, citrus, tomatoes and many fruits. So I recommended eliminating them from Jan's diet. On the other hand, dietary fiber in the form of legumes, hemp seed, flaxseed and whole grains acts to improve detoxification, so I encouraged Jan to eat more of these foods.

Jan's pain management regimen involved the use of herbs and nutritional supplements. I recommended N-acetyl-glucosamine (NAG) at a dosage of 500 milligrams (mg) three times per day to act as an anti-inflammatory and analgesic. And L-arginine, which increases enzyme activity in the urine, can decrease urgency and the intensity and frequency of pain.

I also introduced Jan to herbal pain relievers that reduce spasms and irritability. These include California poppy, Jamaican dogwood, cramp bark and pasque flower. They can be taken in a mixture of several together or as single substances. I suggested taking them in a line warm water several times per day.

Herbal medicines to decrease inflammation and heal the bladder tissue include calendula flowers, licorice root, marshmallow root and nettle leaf. I suggested to Jan that she could brew these herbs into a tea, which can be taken several times a day, or she could take a mix of tinctures at a dose of 1 teaspoon several times per day.

Finally, I recommended nutritional antioxidants such as vitamins A and E, zinc and bioflavonoids, which also aid in decreasing inflammatory complex and increasing tissue regeneration.

Mary Bore received her doctorate of naturopathic medicine and midwifery certification from Bastyr University of Natural Health in Seattle. She currently practices naturopathic family medicine at the Brattleboro Naturopathic Clinic in Vermont.

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