An introduction to interstitial cystitis
Interstitial cystitis is the chronic (long-term) inflammation of the bladder. Also known as ‘painful bladder syndrome’, it is a poorly understood condition, which presents many of the same symptoms as cystitis, UTIs and bladder infections.
However, with interstitial cystitis, there is usually no apparent infection and the exact cause is difficult to determine. This makes treating the condition very difficult. People who suffer from interstitial cystitis will experience these symptoms for long periods of time, or even their whole lives.
It affects mostly women, though about 10% of cases are men.
Symptoms of interstitial cystitis
Like regular cystitis, interstitial cystitis presents symptoms affecting the bladder, lower pelvic region and urination. These symptoms will be persistent and chronic, and can often make daily life difficult, with some sufferers needing to go to the bathroom up to 60 times a day!
Symptoms include:
- Intense or severe pelvic pain, which can also affect the abdomen, vagina and urethra
- A sudden urge to pee
- A frequent need to pee, even if only a small amount comes out
- Needing to get up throughout the night to pee – also known as nocturia.
These symptoms may get worse during the menstrual period or after eating certain ‘trigger foods’.
Possible causes
The exact cause of interstitial cystitis is not yet fully understood as it occurs without the presence of an infection.
There are several theories as to what could cause interstitial cystitis, including:
- Damage, ulceration or scarring of bladder lining. This could be caused by previous infections, urine retention or inflammatory substances in the urine
- A defect in bladder tissue which allows toxic substances to enter the bladder, causing irritation and inflammation
- A problem with the nerves surrounding the bladder which causes them to send pain signals in response to normal bladder function, such as filling up or emptying
- Weakened pelvic floor muscles
- The immune system attacking the bladder
- An allergic reaction to a substance in your urine.
In addition, there are a number of factors that are thought to be associated with or contribute to interstitial cystitis. These include:
- Stress. Chronic stress can cause the body to overreact to minor situations, resulting in an extreme immune response, inflammation or an allergic reaction
- Constipation. A full bowel can put pressure on the bladder, plus the bowel contains many toxins, so the longer it is left stagnant, the more toxins may leak into the bladder and the tissues surrounding it
- Poor diet and an unhealthy lifestyle. These can contribute to constipation, but also to the consumption of a number of toxins and chemicals, and overall poor health
- Thrush. It is unclear if this is a cause or a symptom, but the extra irritation and infection in the vagina and intimate area caused by thrush certainly won’t help inflammation further up the urinary tract.
Treatment
Treatment for interstitial cystitis is very difficult, as the cause is not fully understood, so it is not clear exactly what to treat. Interstitial cystitis is not caused by infection, so antibiotics don’t help.
In some cases, conventional medicine may help if there are strong suggestions towards a cause. This could include prescription drugs such as anti-histamines to calm an allergic reaction, or medication that can help heal the bladder lining or relax the bladder muscles. Some surgeries are also possible, such as surgery to heal ulcers, remove inflamed or damaged parts of the bladder, or to insert an electrical implant to reduce pain and the urge to pee.
Unfortunately, these are not effective for everyone, as an exact cause can rarely be identified. In this case, lifestyle changes can help relieve symptoms. These include:
- Keeping a food diary to try and identify if your symptoms worsen after certain foods. Common trigger foods are caffeine, alcohol, tomatoes or spicy food
- Reducing stress. Try our stress management tips, or try a stress herb such as AvenaCalm or Stress Relief Daytime
- Reduce the amount of toxins and chemicals you consume. This includes switching to organic foods, cutting out processed foods, alcohol and recreational drugs and quitting smoking. Did you know that, according to Cancer Research UK, when a cigarette burns it creates over 5,000 different chemicals, over 70 of which are known to cause cancer? Just imagine how irritating they must be to your bladder if they end up in your urine!
- Adjusting your diet. Many of the dietary tips for cystitis may also help interstitial cystitis: reduce your intake of refined sugar, increase your intake of fresh fruit and vegetables and increase your intake of complex carbohydrates like brown rice, brown bread and quinoa
- Increase your intake of water. This helps to keep the urine less concentrated and less irritating to the bladder – and this can actually stop you peeing so frequently, as sometimes the irritation caused by strong, acidic urine can trigger the urination response, even if your bladder isn’t full
- Eat plenty of fibre-rich foods such as seeds and nuts to keep the bowel moving regularly – at LEAST once a day.
- You should consider bladder training, which helps the bladder re-learn how to function correctly. Speak to your doctor about this, as it has to be done safely to prevent urine retention or the development of infection
- Prevent thrush by taking a probiotic, as well as a prebiotic such as Molkosan to create a healthy environment for good bacteria to thrive
- Painkillers such as Paracetamol can help reduce pelvic pain, but I don't recommend using these for long-term treatment. Instead try acupunture or warm compresses, and save the paracetamol for sudden flare ups!
Are there any herbal remedies to help?
Unfortunately, as the causes of interstitial cystitis are not fully understood, it is difficult to recommend any herbal remedies for the condition itself.
However, I can suggest trying Uva-ursi, which some women have reported being helpful for this condition. It is unlikely to treat the condition itself but may provide relief from some of the symptoms.
To support your urinary tract more generally I would recommend Golden Rod tea. This also contains Knotgrass, Birch, Horsetail and Wild Pansy, which are all great for urinary tract health. A couple of cups a day helps to detox the kidneys and urinary system, so may provide some help for interstitial cystitis.
When to seek medical advice
If you begin to experience the symptoms of cystitis more regularly, or even permanently, and they don’t disappear with regular cystitis treatment, it is time to visit your GP. They can run a number of tests including ultrasounds and urine analysis to rule out any other causes.
If you are male and experiencing these symptoms, you should also consult your GP as you are likely suffering from an enlarged prostate.
