Interstitial Cystitis – Scottsdale, AZ
Interstitial cystitis is a common condition most frequently found in females that leaves many women with more questions than answers. According to some research it affects up to 6.5% of females although many of those cases go undiagnosed.
The most common medical option to treat interstitial cystitis is to prescribe Elmiron, but that of course comes with many side effects and works for less than 38% of women. Not to mention that we don’t really know why it works. (I will discuss this in part 2.)
Symptoms of Interstitial Cystitis?
The classic symptoms are an urgent need to urinate, a frequent need to urinate and pain above the pubic region. The bladder is located right above/behind the pubic bone in the pelvic area.
We know that in some/most individuals the bladder wall becomes irritated and can become scarred or stiff. Small ulcerations and pinpoint bleeding are present in 90% of patients with interstitial cystitis. (IC) There is also an un-ulcerated version of IC, but its etiology is likely the same.
If you don’t have IC, then a little pain and going to the bathroom more often may not sound too bad, but some patients urinate up to 60 times per day!! This is a seriously debilitating condition.
What we don’t know
Mostly what we don’t know is if there is one specific cause of IC. Like most other chronic conditions, conventional medicine wants one pill to fix all the symptoms, but this is rarely the case. The old “pill-for-an-ill” model is not suited for addressing today’s modern health conditions. It is the model that revolutionized the treatment of infections but that has epically failed in the treatment of modern conditions and the treatment of chronic disease. And in case you don’t think that matters, 80% of primary care visits are due to chronic conditions.
What we do know
As always, it is more important to look at processes rather than symptoms when trying to dig to the root and get real answers. I have made an abbreviated list of some of the key processes that are found in those with interstitial cystitis/painful bladder syndrome.
- Inflammation – Inflammation is the key feature of IC and PBS.
- Mast Cell Activation – Mast cells are immune cells that contain potent chemicals to kill invaders. Things like histamine, leukotrienes and cytokines are present in IC. In many IC patients for example, IL-6 is up to 5 times normal levels.
- Mucosal Lining Damage – The damage of the mucosal lining is part of the presentation of IC. Most believe that it is one of the reasons the condition becomes painful. Other mucosal barriers in the body include the lungs and the gastrointestinal tract.
- Autoimmunity – Just like the thyroid, the bladder is usually not 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.
- Infection – IC presents like an infection although no specific pathogen has been identified. This is the main reason why its cause is “unknown”. But, the key to understanding this is that we are limited by our current knowledge of microorganisms as well as our detection of those organisms. Lyme disease for example still has poor testing and is often undiagnosed for years. One researching physician has claimed that he discovered a malaria-like organism in IC patients. As antibiotics have proven to be useless, this means one of two things; it is either not a bacteria or it is an antibiotic resistant bacteria. (I will discuss this more in detail in part 2)
- Hormones – 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.
- Elmiron – We do know that Elmiron works in about 38% of patients. They say that the reason is unkown, but there are 2 main factors that may play a role. First Elmiron is said to coat the wall of the bladder, creating a protective layer. Second, Elmiron acts as an anticoagulant and fibrinolytic effect, which can have big implications in the treatment of biofilms. The above mentioned malaria like organism is a biofilm forming organism.
- Acidity – We know that many people have success by eating a strict non-acidic whole food diet.
All 7 of these things we know are variable in presentation. This means if you suffer from IC, you may have only one or two OR you could have the whole list. If you have fallen into the disease delusion and believe that a condition is caused by one single thing and that a single pill can resolve any concern, you will not succeed with IC. It requires a multi-factorial approach to be treated.
If you look at the above list, just because we know a lot of contributing factors doesn’t mean that treating it is a breeze. Treating systemic autoimmune disease can be challenging enough alone, but adding infection in the bladder, mucosal lining damage, etc. makes it even more complex. That being said, I don’t think it is something that a complex, multifactorial approach won’t benefit. It simply means that we need to have a clinical approach that treats root level problems in order to treat critical underlying factors so that the bladder can get the relief it desperately needs.
In part 2 I will cover the treatment and additional information we know from 1-7.