Overview

Interstitial cystitis is a chronic inflammation of the urinary bladder with no known infectious cause. Cause is unknown, probably multifactorial.

Please see conventional, complimentary and alternative medical treatments for important background information regarding the different types of medical treatments discussed on this page. Naturopathic, Complimentary and Alternative treatments that may be considered include:

Diagnosis

Associated Signs/Symptoms:

  • Frequent urination (8 or more times/day) and urinary urgency (90%).
  • Pain relieved by voiding.
  • Nonspecific pelvic pain.
  • Small mucosal disruptions, mild cellular infiltrates, and sub-urothelial infiltrates (90%).
  • Concomitant food or respiratory allergies (40%).
  • Concomitant irritable bowel syndrome (20%).
  • Petechiae or Hunner's ulcers visible upon cystoscopic examination of the distended bladder. Bleeding when distended (20%).
  • Worse during estrogen-dominant portion of menstrual cycle.
  • Autoimmune component suggested by frequent presence of anti-bladder and anti-Tamm-Horsfall (bladder mucus) autoantibodies. Also associated with Sjögren's syndrome.
  • Mast cell and lymphocyte infiltration of the muscularis.
  • Elevated levels of substance-P, possible neuropathy.
  • Possible association with vaginal flora such as Corynebacterium spp. Lactobacillus spp. and the yeast Candida glabrata (Torulopsis glabrata).
  • Deficient levels of nitric oxide in bladder walls may be associated with bladder spasms.
  • Increased incidence after surgery that used silk sutures.
  • Inflammatory process mediated by estrogen receptors: [Risbridger2007] has pointed out the inflammatory effect of stimulating estrogen-receptor-alpha (ER-alpha) in bladder cystitis, and the anti-inflammatory effect of stimulating estrogen-receptor-beta (ER-beta). Both estriol and the naturally occurring substance genistein have been shown to selectively stimulate ER-beta.

Differential Diagnosis

Treatment

Naturopathic, Complimentary and Alternative Treatments

  • Reduce muscle spasm (arginine 1.5g/day for 6 months, kava, calcium channel blocker, acupuncture, hydrotherapy).
  • Identify and remove allergens or dietary irritants (IgG food-allergy test, IgE scratch test for silk allergy, food elimination diet).
  • Heal the mucosa (glycosaminoglycans: oral chondroitin sulfate, glucosamine sulfate, heparin, N-acetyl-D-glucosamine 300-500mg TID)
  • Stabilize mast cells
  • Reduce inflammation (fish oil, bromelain, quercetin)
  • Soothe tissues (demulcents: Zea mays stigmata (cornsilk) tea.
  • Balance immune system (Eleutherococcus senticosus)
  • Antimicrobials (just in case)
  • Homeopathy (Mercurius Solubilis)

Immune System Balancing

[McCulley2018, pg 62] reports that interstitial cystitis may be an autoimmune disorder, and proposes an approach to treating this disease, which should be supervised by a properly trained medical professional. Dr. Weyrich has considerable interest in this topic, but has not treated any cases of interstitial cystitis with Immune System Balancing.

Please see What is Immune System Balancing? for more information.

Low Dose Naltrexone (LDN)

[LdnResearchTrust_conditions] reports that interstitial cystitis is a condition that LDN could help. Dr. Weyrich has been trained in the use of Low Dose Naltrexone (LDN). However, Dr. Weyrich has not treated any cases of interstitial cystitis with LDN.

Please see What is Low Dose Naltrexone? for more information.

Pathophysiology

Hypothyroidism is associated with a thinning of the endothelial lining of the urinary bladder, resulting in irritation of the bladder by its contents [Hertoghe1914], [Starr2005, pg 142].

References