INTERSTITIAL CYSTITIS
Interstitial cystitis is a relatively common affliction that affects mainly women. Symptoms include pelvic pain, urinary frequency, and a constant sensation of needing to empty the bladder. The pain can be mild to severe and symptoms tend to flare up and then disappear. Menstruation and sexual intercourse often aggravate symptoms.
The exact cause of interstitial cystitis (IC) is unknown but two current theories are thought to provide clues to cause. The bladder permeability hypothesis states that urine chemicals penetrate the bladder lining and cause irritation. Glycosaminoglycans (GAG) are constituents of the bladder lining that have been found to be low in IC. GAG supplementation with Elmiron, a prescription drug, shows reduction in symptoms. Other GAG treatments include heparin, hyaluronic acid (Cystostat), chondroitin sulfate and glucosamine.
In some patients with IC, certain foods will cause a flare up of symptoms. The most common culprits are coffee, alcohol, chocolate, citrus fruits, carbonated drinks and tomatoes. Acid foods and food high in potassium are suspect as well. A trial of elimination of these foods is worth trying for 3 to 4 weeks. An over the counter supplement called calcium glycerophosphate (brand name Prelief) has shown marked reduction in symptoms of IC when it is eaten at the same time as acidic foods.
Vitamin A lowers inflammation, increases tissue integrity and normalizes secretion defenses of the bladder lining. A safe daily dose of 5,000 to 10,000 units of Vitamin A is worth trying.
Arginine is an amino acid that helps regulate levels of nitric oxide. Supplementation with arginine has shown evidence of lowering IC symptoms. A twice daily dose of 500 milligrams can be tried.
Kava is a south Pacific herb that has the ability to reduce bladder spasms. In IC, elevation of potassium levels is associated with increased symptoms. Kava helps to lower potassium and may therefore lower symptoms. Kava is also known to lower anxiety, which is an aggravating factor in IC. There may be risk of liver damage when using kava. This appears to be from using a different part of the plant to prepare the extract. The traditional use of using only the root of the plant appears very safe. Avoid preparations that use other parts of the plant.
Other anti-inflammatory supplements that may be useful are quercitin, Oregon grape, and corn silk.
Daniel Blodgett MD