Natural Remedies for Interstitial Cystitis: Say Goodbye to Bladder Pain

How is Interstitial Cystitis Diagnosed?

Interstitial cystitis tends to be a diagnosis of exclusion, meaning it’s identified only after ruling out other possible causes with similar symptoms. This means there is no direct test for IC. It’s critical to differentiate chronic UTI from IC/BPS. A UTI is diagnosed with a urine sample and treated with antibiotics.  

A comprehensive patient history along with testing to rule out infections, nervous system disorders, stones, cancer, endometriosis, pelvic masses, and other structural abnormalities is important. Some of these other conditions are seen with imaging such as an ultrasound or CT scan.

Interstitial Cystitis and Other Conditions 

The majority of the patients I’ve seen with IC/BPS had other chronic health concerns. Studies have shown that autoimmunity and disorders such as allergies, IBS, IBD, chronic fatigue, sleep disorders, chronic migraine and fibromyalgia are more prevalent in the IC/BPS population than in the general population.1,2 The presence of allergies in IC/BPS patients are estimated to be 40-80%.2 It’s likely that IC/BPS shares many of the same underlying inflammatory and immune challenges seen in these other disorders.

Interstitial Cystitis Treatment 

Because there are multiple factors to consider in the underlying cause of interstitial cystitis, there is no “one size fits all approach”.

Conventional Medicine Approach to Interstitial Cystitis Treatment

The American Urological Association (AUA) has treatment guidelines for IC/BPS. These guidelines include:

• Behavioral/Non-pharmacologic Treatments: Education, self-care, behavior modifications, stress management, and physical therapy
• Oral Medications: Pain management, cyclosporine A (an immunosuppressive medication), and other medications
• Intravesical Treatment: Delivery of medication directly to the bladder
• Procedures:
  • Cystoscopy with hydrodistension, which involves inserting a thin scope into your urethra while filling it with water to be able to see the bladder.
  • Treatment of Hunner’s lesions with electrocautery, laser, and/or injections.
  • Botox injections
  • Neurostimulation using a device that sends mild electrical pulses to the nerves in the lower back to decrease pain.
• Major surgery

A Holistic Approach to Interstitial Cystitis Treatment

As a Naturopathic Doctor, I look at multiple factors that contribute to a person’s health. This approach is important as there is not usually only one factor contributing to IC/BPS. 

• Mental and Emotional Health: There is a clear connection between the health of the mind and body. Relaxation techniques and stress management are recognized as an important component of managing IC/BPS symptoms.3
• Sleep: Sleep quality and quantity are important for overall health and healing. Poor sleep patterns and lack of melatonin may play a role in IC/BPS.4
• Diet: Many IC/BPS sufferers find that certain foods and beverages, especially acidic foods can be a trigger. One study showed the most common triggers were citrus, spicy foods, alcoholic beverages, caffeinated coffee/tea, regular/diet sodas, Equal, MSG, vinegar, horseradish, and tomato products.5 Eliminating these foods and then reintroducing them can help identify whether they are problematic for you. Consuming a whole-foods diet while avoiding refined, sugary, and processed foods is important for decreasing inflammation. Severe cases may benefit from an Autoimmune Paleo Diet. I’ve also found food sensitivity testing to be helpful in identifying problematic foods.
• Activity: Exercise and activity that is appropriate for your current level of health can support decreased inflammation and overall health.
• Nutritional Status: Vitamin D is the most common nutrient deficiency I find in practice.  It plays a very important role in immune function and overall health.6 Vitamin D deficiency has also been linked with pelvic floor disorders.7 Other vitamin and mineral deficiencies can contribute to poor health and immune function. 
• Gastrointestinal Health: It is estimated that humans have approximately 2.5-5 lbs of symbiotic bacteria, fungi and viruses in our digestive tract that play a crucial role in our immune function and overall health. Infections or imbalances in these microbes can be a chronic source of inflammation and immune stimulation that can contribute to autoimmunity. In practice, I use advanced DNA-based stool testing to assess for infections, microbial balance, inflammation, gastrointestinal immune function, and digestion.
• Hydration: Some IC/BPS patients may limit fluid intake to decrease frequency of urination. Adequate hydration is important for overall health and helps to dilute irritants and toxins in the urine. Adequate fluid intake is also important for preventing urinary tract infections and constipation which can make symptoms of IC/BPS worse. I’ve also had patients report significant benefit from drinking alkaline water.
• Environmental Exposures: Compounds such as mold, pollen and chemical exposures can lead to allergies and an increase in mast cells and histamine. Several studies have shown a link with elevated mast cells and histamine.8-10 Overall, there is agreement that mast cells play a role in pain syndromes including IC/BPS.9 Given the high number of IC/BPS patients with allergies and other immune challenges, addressing environmental factors is an important treatment factor.
• Structural Integrity: Tight pelvic floor muscles are often a component of IC/BPS.  Various physical therapies including myofascial therapy and acupuncture can be helpful for muscle relaxation and decreased pain.11,12

Additional Naturopathic Strategies and Supplements for Treatment of Interstitial Cystitis

Naturopathic doctors have many tools in their toolbox to address disease. I recommend working with a knowledgeable functional medicine practitioner or naturopathic doctor to ensure you’re taking the products and doses that are right for you. Here are some of the supplements I may use to support people with interstitial cystitis:

• Mast cell stabilizers: Quercetin and buffered vitamin C (non-citrus source)
• Calcium glycrophosphate “Prelief” to buffer acidic pH
• Demulcent herbs to protect and soothe the bladder lining: Althaea officinalis, Zea mays, Avena sativa, Ulmus rubra, Aloe vera
• Essential fatty acids such as fish oil and flaxseed for decreased inflammation
• Anti-spasmodic herbs for pain relief: Viburnum opulus, Piscidia piscipula, Dioscorea villosa
• Perma-Clear by Thorne to support mucosal healing and a healthy gut
• Probiotics for improved GI health and immunity
• Soaking in a Sitz bath or warm epsom salt bath, or using a heating pad or hot water bottle on the pelvic area can alleviate pain

Relief from Interstitial Cystitis/ Bladder Pain Syndrome

I hope your takeaway is that even though IC/BPS is difficult to diagnose, a holistic approach to finding a root cause and treatment can bring relief. When root causes are properly addressed, symptoms resolve.