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Q
Painful Bladder Problem?
I've just been diagnosed with interstitial cystitis. Any suggestions that would help me heal as naturally as possible?
A
Answer (Published 8/30/2005)

Interstitial cystitis (IC), also called irritable bladder syndrome, is a chronic inflammatory bladder condition that causes bladder pain, a feeling of urinary urgency, the frequent need to urinate, pain and pressure in the lower abdomen, and pain during sexual intercourse. Women are affected much more frequently than men. No one knows what causes IC, and patients are often misdiagnosed as having cystitis, a urinary infection that often requires treatment with antibiotics.

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Although there is no single treatment for IC that works for everyone, you may be able to ease or relieve your symptoms with the following self-help measures:

  • Avoid foods that can irritate the bladder. These include citrus fruits, aged cheeses, nuts, cured, processed or smoked meats and fish plus coffee, tea, carbonated beverages and alcoholic drinks, black and red pepper, and other spices. You can find a full list of foods to avoid on the Web site of the Interstitial Cystitis Association (ICA) at www.ichelp.org/TreatmentAndSelfHelp/ICAndDiet.html - but I encourage you to experiment to find out the particular irritants that you react to by leaving one food out of your diet at a time, then adding it back in and noting any correlation with symptoms.
  • Try stress reduction techniques such as biofeedback, pelvic floor relaxation exercises, self-hypnosis, guided imagery and visualization.
  • Do some gentle stretching or yoga to relax muscles.
  • Experiment with osteopathic manipulation and trigger point therapy, especially focusing on the muscles of the low back, buttocks and inner thigh.
  • Keep a "bladder diary" of how frequently you urinate and what seems to trigger the urge.
  • Ask your doctor about bladder retraining. This can enable you to space out the frequency of urination, which may help ease the pain.
  • Educate yourself about IC via the ICA or other resources.

Your physician may prescribe a number of different treatments but here, too, not every medication or procedure helps everyone with IC so finding the one that works best for you may require some trial and error. Research is ongoing to find new and better approaches. A national study just launched will test whether the antidepressant amitriptyline (Elavil) helps when combined with bladder retraining and avoidance of irritating foods and drink.

Researchers at 10 medical centers are recruiting adults newly diagnosed with IC. If you're interested in participating, check http://www.nih.gov/news/pr/feb2005/niddk-17.htm to see if a center near you is involved.

Recent research suggests that IC patients may be able to get immediate relief with a combination of heparin, lidocaine, and bicarbonate instilled into the bladder. The treatment, developed by a physician at the University of California at San Diego, was reported in the January 2005 issue of the journal Urology.

Andrew Weil, M.D.

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