Interstitial Cystitis

Interstitial cystitis (IC) is a chronic, debilitating, multifactorial syndrome characterized by excessive urgency and frequency of urination, suprapubic pain, dyspareunia and pelvic pain along with negative urine cultures. The course of the disease is usually marked by flare-ups and remissions. IC generally persists throughout the patient’s life. This symptom complex has also been referred to as painful bladder syndrome, leaky bladder syndrome and irritative bladder syndrome

What are the Symptoms of Interstitial Cystitis?

Women (and sometimes men) with interstitial cystitis frequently present with frequent urination, urgency and pelvic pain. One of the hallmarks of IC is that patients have pain with a full bladder which is relieved with urination. Because the symptoms are very similar to a urinary tract infection, patients with IC are often misdiagnosed and wrongly prescribed antibiotics making their condition worse.

What causes Interstitial Cystitis?

Interstitial cystitis is a very complex pain syndrome affecting the bladder. The pain often arises from mast cell activation (cells involved in allergic reaction), inflammation and/or lack of glycosaminoglycans comprising the protective layer of the bladder. The exact cause or causes still remains unknown. In naturopathic medicine, we look to uncover what is causing all three of the components in the interstitial cystitis pain cascade. Since inflammation is primarily caused by the body’s immune system, immune support and regulation should be an important part of IC/BPS treatment. Other key factors in the development and persistence of IC are nutrient deficiencies, mood and hormonal dysregulation and sleep. Pelvic floor disorders and pelvic pain are associated with a deficiency of vitamin D, a known immunoregulatory hormone. This is why it is imperative for suffers of IC to have Vitamin D levels checked and supplement if deficient. The neurotransmitter, serotonin, is not just important for mood regulation but is also one of the ways our body regulates immune-mediated inflammation. There exists a strong comorbitity of both depression and anxiety for patients with IC and low levels of serotonin could be the contributing factor to both conditions. Poor sleep patterns and lack of melatonin may play a role in IC. Some studies have shown a beneficial effect on bladder symptoms and inflammation with melatonin supplementation

What naturopathic remedies are used for Interstitial Cystitis?

As a naturopathic doctor I don’t believe in a one-fits-all approach and IC is not an exception. IC in most cases is related to an autoimmune and/or allergic destruction of the glycosaminoglycan (GAG) component of the protective layer of the bladder. The biggest contributors to inflammation for patients with IC are stress, hormonal imbalances, poor sleep quality and food allergies/intolerances. While the underlying root cause(s) are addressed nutrient and herbal support is given to reduce histamine release, build up a healthy bladder lining and provide symptomatic relief. My top choices in my IC naturopathic medicine kit include quercetin, glucosamine and kava kava.

What is the best diet for Interstitial Cystitis?

Diet is a crucial component in the recovery process for IC patients. It has been shown that about 53%-63% of IC patients can identify foods that exacerbate symptoms or cause a flare-up. The worst offenders for IC patients are high acidic foods such as alcoholic beverages, carbonated drinks, caffeine, spicy foods, tomatoes, vinegar, chocolate and citrus fruits. Another class of food triggers are arylalkylamines (tryptophan, tyrosine, phenylalanine and tyramine) which are found in bananas, beer, mayonnaise, nuts, onions, raisins and yogurt. Because many patients with IC can have flares due to a wide variety of foods, it is often advisable to undergo a food elimination/challenge or complete a full IgG food allergy panel to identify more specific food triggers. Because reducing inflammation is so vital for IC avoiding pro-inflammatory saturated fats from fried foods, red meat and hydrogenated oils is encouraged. Over all the emphasis should be including foods rich in omega-3 fatty acids like flax and fish and fruits and vegetables high in antioxidants and anti-inflammatory properties to reduce inflammation and stabilize mast cells.

Additional treatment options: Pelvic Floor Physical Therapy

Another treatment option for Interstitial Cystitis is Pelvic Floor Physical Therapy.

Our colleague, Dr. Kristin Sapienza, is a Pelvic Floor Physical Therapist in NYC who helps patients with IC.

Pelvic floor physical therapy treatments are specialized exercises which strengthen and stretch the muscles on the pelvic floor that support the uterus, rectum, bowel, and bladder.

Together, we can combine naturopathic treatment with Pelvic Floor Physical Therapy to create the best outcome for our patients.

Is Naturopathic Telemedicine effective for Interstitial Cystitis?

Absolutely! Even before the pandemic Dr Ivy has offered virtual appointments to patients for various reasons including international and out-of-state patients, patients with small children, patients with mobility or transportation issues and patients preferring the convenience of having their appointments from their home or office. These patients have been able to achieve the same results as Dr Ivy’s in-office patients as Dr Ivy uses:

A HIPAA compliant electronic medical records system called CHARM
- Patients can upload past diagnostic and blood work as well as recommend additional testing including the DUTCH test for review.
- Uses a private and secure version of Zoom.
An online Dispensary for patients to easily order physician grade herbs and nutrients that are quickly delivered to the patient.