What is the main cause of interstitial cystitis?



Qualified Nutritionist (BSc, MSc, RNutr)
@emmatalkshealth
emmatalksutis
@EmmaThornton
Ask Emma


09 September 2022

What are the main causes of interstitial cystitis?

The exact cause of interstitial cystitis isn't well understood. However, it's likely a variety of different factors may contribute, including structural issues, damage to the lining, or epithelium of the bladder, or other factors including minor, underlying, often unresolved infections, digestive or hormonal factors having an influence, or even side effects of medications.

Here I run through these possible contributing causes, as well as what could be done to help in these instances:

1. Typical symptoms of interstitial cystitis

The symptoms of interstitial cystitis can often be fairly similar to traditional cases of cystitis. This means there can be quite a bit of overlap in terms of some of the pain or the discomfort experienced, the frequency of urination, the urgency or feeling that you need to go to the toilet often and quite quickly.

1. Infection

With interstitial cystitis, a more obvious easily detected infection is less likely to be a factor, such as with traditional cases of cystitis.
However, there could be a low-grade, or more underlying infection, or perhaps a previously unresolved infection that could be lingering, and over time and these can rise to some degree of inflammation.
Also, if you've not recovered properly from an infection, or there's been a history of antibiotic use, these contributing factors can also risk throwing off the balance of your gut or intimate area bacteria, which can build to create some unwanted inflammation.
Now, if there is likely to be some sort of infection underlying, that's where Uva-ursi & Echinacea complex can come in. This is licensed for urinary symptoms relating to cystitis.


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2. Digestive issues

Digestive symptoms and interstitial cystitis are thought to be connected in many cases. Digestive symptoms may present themselves as food triggers, cases of SIBO or fungal infections, to name a few.

But dehydration can also contribute to digestive symptoms such as constipation, which can then have a structural and/or chemical influence on your bladder.

The other area worth mentioning when it comes to digestion is stress.

Stress can really negatively impact your digestion initially (i.e. on the stomach) and this can then have a bit of a domino effect throughout the rest of the digestive tract.

Therefore, there could also be a bit of an immune element going on as well. Sometimes an autoimmune element is suspected in cases of interstitial cystitis, remembering, of course, that 80% of your immune system resides in your digestive system.

For the digestive side of things, which as we've explored can go on to have other benefits, such as some indirect immune support, something like Molkosan which acts as a prebiotic might be one you want to consider introducing.

Once established for a little while (start on a low dose for best effects too), prebiotics can then be combined with a probiotic, for some extra benefits.

3. Structural factors

Structural concerns would be something that a physical therapist would have to firstly diagnose and then treat.

However, it can be helpful to understand that there can be so many different areas that may be affected, and different types of physical issues that could be contributing.

Firstly, you have muscular dysfunction, for example, your pelvic floor muscles; these could be too restrictive or too loose, just as a very basic example.

Then there could be nerve issues; you could have alignment issues with your spine. There could be prolapses in women (perhaps as a result of childbirth or menopause), or enlarged prostate in men, and all of these can impact the bladder and how the bladder works; how it empties, and/or how much underlying inflammation there is.

Then there could be very specific damage to the bladder lining, the epithelium. This would, of course, be something your doctor would need to diagnose, but it's just to be aware that there are these structural elements that could be contributing.

4. Hormones

Hormones are another area to consider if your symptoms have been lingering for a while with no obvious cause.

Consider if you can identify any patterns in your symptoms; perhaps monthly patterns in the case of PMS, or symptoms of perimenopause or menopause, which may be slightly more erratic.

And we need to remember that an imbalance in hormones can often give rise to inflammation and this could translate into other areas; especially considering that there are oestrogen receptors that line almost every system of our body.

Histamine is another chemical that's quite often thought to play a part in cases of interstitial cystitis, and histamine is part and parcel of that immune reaction that we mentioned could be underlying.

5. Side effects of medications

The side effects of medications can be quite far-reaching and may not be the typical ones that you may be more aware of.

So, medications like diuretics, for example, may more obviously have some effects on the bladder.

But actually, other medications such as antihistamines, or even decongestants, could also potentially impact the bladder.

So, once again, trying to detect any possible patterns and just considering every possible contributing factor can be very helpful. Obviously, also if you're on medications, always refer to the PIL for the full list of side effects.

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