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Interstitial Cystitis: Painful Bladder Syndrome

Bladder pressure, bladder pain, even pelvic pain can cause chronic and fairly severe pain for about 6 percent of women. This phenomenon occurs when the signals that tell your brain the #bladder is full become a bit mixed up so that you feel you need to use the bathroom more frequently and you may have a smaller volume than most. This condition is far more frequent in women, than it is in men, and can really impair one's quality of life. Diagnosis is often in the third decade of life. Many of these women have great discomfort during #intercourse and may even use the restroom upwards of 60 times per day.

Symptoms vary per person, as with all conditions, and there may be periods where you don't experience any symptoms at all. These symptoms are often confused with urinary tract infections. Interstitial cystitis however, is not infection at least specifically within the bladder. Some develop scar tissue within the bladder because of the chronic irritation, even stiffening of the bladder. Small ulcerations and pinpoint bleeding are present in 90 percent of those with interstitial cystitis.

Some believe interstitial #cystitis may be due to a defect in the protective lining of the bladder. It may also be related an underlying autoimmune reaction, allergy, infection, or could be heredity. There is a link between gastrointestinal health and interstitial cystitis as well. Specifically, the connection between small intestinal bacterial overgrowth (SIBO) and interstitial cystitis is clear. More than half of those who suffer test positive for SIBO and half of those who are treated show improvement in their interstitial cystitis symptoms.

Ruling out gut infections is an important part of treatment. If we can uncover a gut infection and get that treated, there's a good chance that symptoms may improve. Other interventions for improving symptoms are avoiding caffeine and alcohol, avoiding acidic juices such as cranberry juice, and adopting an anti-inflammatory diet. Try a yeast-free diet by eliminating sugar, vinegar, and malt. Eliminating wheat, grains, sugar, and processed foods helps for many. Of course, reduce stress and get tested for food sensitivities.

Conventional Therapy

The most common medical intervention is offering the prescription, Elmiron, but that of course, comes with side effects and works for less than 38 percent of women. Not to mention that the method of action isn't really understood.

Elmiron is said to coat the wall of the bladder, creating a protective layer. It also acts as an anticoagulant and fibrinolytic effect, which can act on #biofilms. The thought is that Elmiron repairs, to some degree, the protective layer of the bladder by binding sulfur molecules. In a healthy body, the glucosaminoglycan layer can be repaired and replenished appropriately but if there is not enough sulfur, glucuronic acid or proper sugar metabolism then the layer cannot heal itself.

The sulfation process uses sulfur in the liver to detoxify drugs, food additives and especially toxins from intestinal bacteria and the environment so sometimes this can get used up. Supplementing with cysteine sulfate can be helpful, but finding out why the body is using its supply of sulfur is the real work. Studies have shown that in unresponsive cases of IC/PBS, supplementation with glucosamine-sulfate and chondroitin-sulfate can help. But why was the protective layer of the bladder damaged in the first place?

Glucuronidation in the liver helps detoxify aspirin, menthol, vanillin, food additives and some hormones like estrogen. It is especially common to be deficient if you have been on birth control for an extended period of time. Eliminating xenoestrogens, plastics and balancing hormones helps get to the root of glucuronic acid metabolism and ultimately GAG health.

Proper Sugar Metabolism is also Critical for GAG Synthesis

GAG synthesis takes more time and is of less immediate importance than regulation of your blood sugar, so when your body needs sugar because it keeps going high and then low, the body can’t use it to repair tissue and joints with with this protective layer. The body always prioritizes immediate needs and that is why chronic problems like interstitial cystitis develop. A diet with more complex carbohydrates as well as good fats and protein sources to maintain stable blood sugar is the key to allowing GAG have enough glucose molecules.

Key Processes to Dig Deeper

When we look for the underlying cause, think inflammation, mast cell activation such as #histamine, leukotrienes, and cytokines. Suffers of cystitis have levels of IL-6, five times normal. Mast cells can be further altered by estrogen and corticotrophin releasing hormone (CRH) from the anterior pituitary in the brain. No female dominant condition should be treated without the consideration of hormonal balancing.

The mucosal lining may be damaged or there may be some level of autoimmunity. Just like the thyroid, the bladder may not be the actual problem, but rather it is the victim of an autoimmune condition. Systemic inflammation and an over heightened immune system can wreak havoc on many areas of the body. As well, infection may be a component of interstitial cystitis although no specific pathogen has been identified. Colleagues of mine swear that Lyme disease may be a potential trigger. We also know that a strict non-acidic whole food diet has offered many people relief, so acidity is an important factor as well.

Alkaline Diet

One of the primary irritants to the bladder is toxins from our environment which work themselves into the urine for elimination. Imagine then your bladder wall being irritated and inflamed. The acidic urine will cause pain in the bladder just as lemon does on a small cut on your finger. An alkaline-based diet provides temporary relief while more root level causes are searched for and addressed. We typically move to this diet, combined in some respect with an anti-inflammatory diet, following LEAP therapy which identifies individual food sensitivities. These diets are permanent, rather then are used in the interim to identify the trigger. Sometimes urine can be extra acidic due to a functional potassium deficiency, so a potassium supplement may also be helpful, but listen: a potassium deficiency caused by kidney dysfunction caused by ammonia toxicity caused by digestive dysbiosis is caused by eating too many carbohydrates.

Antibiotic Therapy

Two main bacterias have been associated with interstitial cystitis: enterococcus and micrococcus. Specifically it seems to be that gram positive bacteria is associated, and most traditional antibiotics treat gram negative bacteria. Fugazzatto's research has found that a combination of antibiotics can provide 90 to 95 percent improvement in symptoms, although his research shows that he often used Nystatin as well, which is an anti-fungal drug. Chronic candida therefore, might be correlated with interstitial cystitis.

Fugazzatto's research was back in 1993 though, and now many of the gram-positive bacterias are now antibiotic resistant, such as MRSA. Antibiotic resistant UTIs are very common and lead to recurrent UTIs. Neem leaf, often used for purifying the skin, has anecdotally been helpful for treating interstitial cystitis. Biofilms however, may be better treated using BFB-1 or BFB-2 in combination with an antimicrobial in the capsule form, such as Melia, Morinda, or Golden Thread.

Mast Cell

Elevated mast cells are found in those with interstitial cystitis, as they play an important role in protecting against pathogens and in wound healing. Thus, they are located in the lining of the stomach, intestines, bladder and in the skin. Mast cells gather around wounds to help with healing.

Mast cells contain heparin, histamine, and prostaglandins with heparin being an anti-inflammatory and the other two more inflammatory. Once you have enough heparin in the system, the mast cells decrease their release of heparin and histamine so the blood doesn't become too thin.

Traditionally mast cells are more activated by allergic reactions, such as food allergies, and those with an immune system a bit out of balance, a bit too Th2 dominant will react to all sorts of things, seemingly minor things. You'll find these individuals often have leaky gut or elevated toxins and heavy metals so that their immune systems are reacting to essentially everything. The bladder then can overreact within itself, within the lining with mast cells. Quercetin rutin, and luteolin are known for balancing mast cells and may be an appropriate nutraceutical in these cases.

Interstitial cystitis is tricky. One really has to dig deep for underlying causes for long term relief. If you are willing to look deeper, connect with us.

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