Interstitial Cystitis - Commonly Mistaken for UTI
Bladder infections are common.
I have many patients - all women - who call frequently with the typical symptoms of pain with urination, increased frequency and urgency of urination. It is no wonder that this is not more common, considering that there is only about an inch between the inside of the bladder and the outside world and only a few inches from an area that passes daily the most common cause—e. coli bacteria from the stool.
But when "bladder infections" become a regular thing, women should be suspicious of an under-diagnosed, underlying problem: interstitial cystitis.
This blog will look at interstitial cystitis, highlighting its treatment with diet.
What is Interstitial Cystitis?
Interstitial cystitis (IC) is a chronic inflammatory infection of the bladder. It is believed that people with IC have a defect in the lining of the bladder. When this becomes “leaky” it allows the toxic substances in urine to inflame tissues and nerves. This inflammation causes swelling, dysfunction of the tissue and confused signals from the bladder to the brain that the bladder is full when it is not. It produces symptoms of:
- Pain during urination.
- Frequent urination.
- Urgency to urinate.
Occasionally the condition can cause:
- Pelvic pain.
- Pain during sexual intercourse.
Duration:Symptoms can be constant or wax and wan.
Demographics: Though the problem has been described in men and children, it is almost exclusively a problem of women.
- Being a woman.
- Regular consumption of carbonated beverages.
- Regular consumption of caffeinated beverages.
- Diet rich in Vitamin C.
IC or UTI?
The trickiest thing about IC flares is that they look exactly like a urinary tract infection. While bacteria is not involved, exams of the urine can show white blood cells which are an indication of an infection. Further, antibiotics can sometimes help the situation - anti-inflammatory effect, placebo… who knows? While the norm is for a culture of the urine to be free of bacteria, this is not to say that a person with IC can’t get an infection.
All of this, along with the other chronic problems of pelvic pain and pain with sexual relations lead to an extremely frustrating problem.
Often, during these times, when I bring up the possibility of interstitial cystitis, women express relief to potentially have something at least to hold on to with hope for management of the problem.
While diagnosing IC depends largely on the absence of infection in the presence of the symptoms described above, further confirmatory testing is often done.
Infusing saline and another solution with potassium can often confirm IC. While a person with a normal bladder will not notice a difference between the two solutions, a person with IC will experience pain when the bladder is exposed to potassium. A scope into the bladder is also usually done to rule out any abnormalities of the bladder’s anatomy, polyps or tumors.
Interstinal Cystitis Treatment
No definitive treatment has been the end-all-be-all for this chronic problem.
- Medications can help some, but leave others suffering from side effects.
- Procedures such as those that stretch the bladder with infused fluid or instillation of chemicals to desensitize the bladder can be painful in and of themselves and need to be done on a regular basis.
- Surgery is considered a last resort.
Luckily, simply restricting certain foods from the diet is often a quite effective method of treatment!
Control of IC through diet involves avoiding bladder irritants. The most irritating components of a diet can be summed up by the “four C’s.”
- Carbonated beverages
- Caffeine (coffee, soda, chocolate, energy drinks)
- Citrus (fruits and foods with citric acid)
- Vitamin C-rich foods (not just fruit- broccoli, tomatoes, brussels sprouts)
Many of my patients have noticed a dramatic difference when they get serious about dropping bladder irritant foods - more even than with medication and procedures. Even better - with dietary restrictions, there are no side effects.
For some who are leery about getting tested for IC, I recommend a therapeutic trial of the diet to give a better idea about diagnosis. A number of books are available which better outline food choices and give recipe ideas.
Natural Treatment for IC Bladder Problems
As with many problems, various factors can exacerbate the issue.
- If you smoke, consider stopping. Nicotine is a stimulant and affects nerves, including those of the bladder. Further, smoking is the leading cause of bladder cancer.
- Work to reduce stress in your life. I refer to stress as “the universal magnifying glass” that seems to make all of our problems bigger and more noticeable.
Interstitial cystitis is a chronic inflammatory condition of the bladder which can imitate chronic urinary tract infections. It is almost exclusively seen in adult women. Though many treatment options exist, none is definitive. Avoiding bladder irritants in the diet shows promise in controlling the problem in a more natural way.