Interstitial Cystitis

Interstitial cystitis is a painful condition involving inflammation in the bladder. The condition can cause significant pain with attacks that seem to have no specific cause. We do not know specifically of a general cause for interstitial cystitis (IC). Patients get frustrated and doctors become very puzzled in how to treat this difficult condition. Often times it is through much trial and error that the patient finds out what works and what does not. The treatments need to be different for each patient, so it is important that patients affected by interstitial cystitis know various treatment options.

IC has historically been an enigma in both cause and treatment. It is characterized by pain in the pelvis, higher frequency and increased urgency to use the restroom. Some think that frequent antibiotics for bladder infections may play a role in initiating the process. Others think the infections themselves may play a role. Females are affected 90 percent of the time and are more likely to experience recurrent bladder infections.  Muscle spasms in the area of the pelvis and bladder have also been implicated in aggravating symptoms.

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Like most conditions, what we eat and drink seems to affect interstitial cystitis. Clinically, many patients see improvement when they eliminate aspartame from the diet. Aspartame, or Equal, is an artificial sweetener used in place of sugar in soft drinks and many sugar-free foods. Quite frankly, one should be careful of any artificial sweetener when dealing with IC, but aspartame seems to be especially irritating and avoiding it is recommended. Some patients note that during acute attacks, avoiding other triggers such as alcohol, caffeine, coffee and tea can be helpful. Also, watching out for certain foods such as tomatoes and fruit juices may help calm symptoms down [Source: Czarapata]. Patients with frequent or daily IC symptoms are strongly encouraged to study the diet and watch for any foods that seem to consistently aggravate the bladder. For some patients, even supplemental vitamin C may aggravate symptoms.

Other treatments should try to improve the overall health of the bladder. For example, probiotics can be taken to promote the healthy bacteria in the body. Some patients have found the supplement D-mannose helpful for IC.  D-mannose is predominately used to treat early signs of bladder discomfort due to a bladder infection.  This does not necessarily mean that IC is caused by a bladder infection. In fact, many people feel it is not due to infection at all, but D-mannose may still benefit symptoms. It can be taken at 1500 to 3000mg a day in divided doses. One of the simplest and safest treatments to try for IC is the bioflavonoid nutrient quercetin. Quercetin is a nutrient naturally occurring in many fruits. As a supplement, 500mg twice a day of quercitin has been found to be helpful in the treatment of IC symptoms [Source: Katske]. Quercetin is well-tolerated and also can be useful for allergy symptoms. Interestingly, urologists are using DMSO in IC, dimethyl sulfoxide, a long considered a nontraditional treatment. Infusions of DMSO have been shown to help with IC symptoms [Source: Wein]. DMSO is also used to treat arthritis pain or may be used in combination with other treatments because it is very well-absorbed in the skin and will help other medications be absorbable. If muscle cramps and spasm are common, they may be aggravating the bladder symptoms. They are often treated with extra magnesium (250-500mg a day). Testosterone cream used intravaginally may also help with muscle pain in the pelvis (this is done by prescription from a physician).

Additional treatments for IC involve maintaining healthy lifestyle habits, particularly for the bladder. This means getting optimal amounts of water, 60 ounces a day or more. The bladder should be emptied regularly throughout the day and always after intercourse. Again, improving the diet seems to play a significant role in decreasing symptoms. I always question toxin exposure with IC sufferers as I have had a few patients who live near areas with higher levels of various toxins. Drinking filtered water, such as reverse osmosis filtration, is also recommended. 

Interstitial cystitis can be both painful and perplexing. Its original cause is unknown, most likely because there are many causes. Lifestyle changes in diet and supplements targeting the bladder can often modify the condition to where it is no longer a regular problem.

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Related Articles

  • Czarapata, B. J. Reid, C.R.N.P., C.U.N.P  .Interstitial Cystitis: An Alternative Approach,", Advanced PA, October, 1996;41-44.
  • Katske F, Shoskes, DA, Sender M, et al.  Treatment of interstitial cystitis with a quercetin supplement.  Tech Urol.  2001 Mar:7(1):44-6.
  • Wein, Alan J., M.D. and Broderick, Gregory A., M.D., Interstitial Cystitis: Current and Future Approaches to Diagnosis and Treatment. Urology Clinics of North America, February 1994;21(1):153-161.
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