September is Interstitial Cystitis (IC) Awareness Month. As the month draws to an end, I want to take this time to shed light on a bladder disease that affects millions of Americans as well as several of my close friends. Unfortunately, it isn’t as easy to remedy as a common cold, but there are some natural things that can help.
What is Interstitial Cystitis?
IC is a bladder disease characterized by chronic pelvic pain, a persistent and urgent need to urinate, (often throughout the day and night and sometimes more than 50 times a day), pain or discomfort while the bladder fills and relief after urinating, and pain during sexual intercourse.
IC symptoms may come in flares, with periods of relief for some people and for others it may rage constantly. Often times, symptoms of IC mimic classic urinary tract infection (UTI) symptoms but there is no sign of bacteria or infection and antibiotics do little to nothing to alleviate the pain. IC affects men and women but is much more common in women.
Because IC does not have a cure and is a chronic pain disease, successful treatment is typically limited to reducing the symptoms of frequency, urgency, and pain. When those symptoms are reduced IC patients are able to live more comfortable lives.
Much of this is trial and error for IC sufferers. What works for one doesn’t always work for another, and often a person must try many options before finding something that works. Also, what works during one flare may not be effective during another, so it’s good to have a toolbox of possible remedies.
This video explains IC, what it does to the bladder and how it affects the lives of those who suffer from it.
Types of Interstitial Cystitis Flares
There are typically 3 types of interstitial cystitis flares: bladder wall flares, pelvic floor flares, and muscle flares.
Bladder wall flares are most often characterized by a feeling of ground glass or razor blades scraping the bladder. During these flares the bladder has often been irritated by a food/drink sensitivity and becomes more inflamed than usual.
Pelvic floor flares can be a product of sexual intercourse, long periods of sitting, or something seemingly as simple as riding a bike. They are more of a burning feeling in the urethra, vaginal area, or any part of the pelvic floor. They can also feel like something is falling out of or being pushed into your vagina or urethra.
A muscle flare is typically when the bladder muscle goes into spasms and will often cause a severe aching feeling in the bladder. The pelvic floor muscles can also become tight, spasm, and ache.
Because conventional medical therapies have not been shown to offer much long term relief for IC patients, sufferers often turn to alternative means to treat their ongoing pain. These therapies include heat/cold therapy, physical therapy, diet changes, regulating hormones, water intake, reducing stress, and supplements such as marshmallow root and aloe vera pills.
Heat/Cold Therapy
Sometimes heat/cold therapy are the most effective treatment to relieve the pain of a interstitial cystitis flare. Depending on the type of flare, heat may be more effective, or cold, or even a combination of both.
Bladder wall flares react well to heat as do muscle flares. The easiest thing to use is a simple heating pad or hot water bottle over the abdomen when the bladder is in spasm. The heat helps the tight and spamming muscles to relax and soothes the bladder wall.
If treating a pelvic floor flare with heat, it may be helpful to use a longer lasting portable heat pad (with a protective layer over it) inside pants or underwear.
Numbing the area, especially during a pelvic floor flare, is very effective. With extreme urethra burning, a frozen water bottle (with a layer of protection over it) placed against the urethra provides quite a bit of relief. The cold helps to reduce inflammation.
It is important not to leave either the cold or hot on too long, alternating or removing evert 20 minutes or so.
Pressure/Support Therapy
The Mama Strut is a promising new product for IC patients. It wasn’t designed to treat interstitial cystitis but rather was invented to help women heal in the post-partum period after childbirth but seems to have the potential to be quite effective in helping many other pain/healing issues including IC.
The Mama Strut has several compartments where hot or cold packs can be placed on the back, abdomen, and perineum…Perfect for IC flare pain! It’s a bit pricey, but for some women would be well worth the cost to be able to place hot/cold packs where needed and also be able to move around instead of needing to lie down during flares with ice or heat.
The Mama Strut is also less bulky than other similar products so you can easily and discreetly wear your clothes over it. This video shows how it works.
Physical Therapy
Many IC patients find that their pelvic floor muscles are very tight. Physical therapists work on releasing those tight muscles and the tender trigger points by using techniques such as deep tissue massage (also called “myofascial release”), trigger point release therapy, and nerve releases.
Biofeedback is also used by some therapist by placing probes into the vagina or anus (or electrodes on the body in these areas). These probes or electrodes show on a computer screen how tight your pelvic floor muscles are. The readings from these can help you to learn how to relax your muscles.
Often times interstitial cystitis patients don’t even realize how tight their pelvic floor muscles are until they see it on the computer screen using biofeedback. They have become so used to living with these tight muscles and now need help learning how to relax them.
When most people (especially women) think of pelvic floor exercises they think of Kegels. This is the opposite of what you want to learn to do for IC. Doing Kegels teaches your body to tighten your pelvic floor muscles. IC patients need to learn to relax their pelvic floor muscles and working with a physical therapist they can learn how to do this using certain exercises on a regular basis.
Many physical therapists use transcutaneous electrical nerve stimulation (TENS) therapy to treat IC. This article explains how it works.
In TENS therapy, mild electrical stimulation is applied to the lower back or pubic area. These pulses may increase blood flow and strengthen bladder wall muscles. The electrical stimulation may also help block pain.
TENS units can be used outside of the physical therapy office by patients once they are shown how to use them and can be purchased for a reasonable price. They can provide daily relief from symptoms. Some patients find so much relief from the TENS therapy that they have a similar device, called Interstim, surgically implanted in their lower backs so that they have constant electrical stimulation to treat urgency-frequency syndrome as well as urinary retention when other treatments have failed.
Many physical therapists also teach bladder retraining exercises so to help reduce urinary urgency and frequency as well as learning to more completely empty the bladder. This is often done by systematically spacing out the frequency of urination in order to train your bladder to go longer and longer between urinations.
For IC, it’s important to find a physical therapist who specializes in pelvic pain issues or women’s health. The American Physical Therapy Association’s website can help find a PT who specializes in IC (choose “women’s health”) and so can the International Pelvic Pain Society’s website.
Interstitial Cystitis Diet
One of the most popular methods of treating a UTI is drinking pure cranberry juice. This treatment can actually prove detrimental to IC sufferers. Cranberry juice is very acidic and acidic foods can often inflame the bladder.
Some common acidic bladder irritants are coffee, diet soda, alcohol, cranberry or other acidic fruit juices, tomatoes, chocolate, and lemons. Many people are able to pinpoint which foods, if any, cause flares to worsen but by trying an elimination diet.
Some IC sufferers take a product called Prelief when they know they will be eating an item containing an acidic bladder irritant.
The active ingredient in Prelief is calcium glycerophosphate, a dietary mineral that combines calcium and phosphorus in a 1:1 ratio. When it is added to acidic foods, the mineral acts as a base agent, actually bringing the pH of the food toward a neutral level. (1)
Other IC sufferers find that an anti-inflammatory diet is helpful as IC is an inflammatory disease. Often times this is a wheat or gluten free, low sugar diet with little to no processed foods.
Marshmallow Root
Elmiron is a popular pharmaceutical drug used to treat IC. It is thought that it acts to coat the bladder wall and offer protection to IC patients.
Marshmallow root is used to naturally act in a similar manner as Elmiron, but without the possible side effects of pharmaceutical drugs. The marshmallow root can be taken in capsule form or prepared as a tea.
Aloe Vera
Many OB/GYN’s are now recommending the use of aloe pills to their patients to help keep IC flares at bay.
Freeze-dried Aloe Vera Capsules have been shown in clinical trials to effectively reduce urinary frequency, burning, and pain that are a part of many bladder disorders, but especially interstitial cystitis/painful bladder syndrome (IC/PBS).
It is theorized that the aloe plant helps IC patients in several ways. When processed correctly, the powder maintains its high levels of the glycosaminoglycans (GAG). The first lining of the bladder destroyed by IC is a GAG layer. It is possible that aloe vera is working much like Elmiron, but with no side effects from a man-made drug. The aloe plant is also a natural anti-inflammatory, antibiotic, analgesic, and anti-microbial agent but only when used in its super-strength form.(2)
IC patients should use caution when consuming liquid aloe vera juice. It is often preserved using citric acid which can be an irritant to the bladder.
Regulating Hormones
For many women interstitial cystitis pain can flare with changes in hormones. Some women find that their IC flares are the worst around the time before ovulation and then subside after ovulation. Other women find that the time from ovulation to the beginning of their menstrual cycle to be the worst.
Pregnancy will sometimes relieve the pain of IC until the third trimester. It’s also not uncommon for women to have a big flare at some point during their post-natal period as their hormones are in major flux.
Working to balance hormones can help ease the symptoms of IC, Essential oils can also be used to regulate hormones as well as acting as pain relievers and anti-spasmodics.
Natural progesterone creams such as Progest can also be helpful in balancing hormones. I plan to write an in depth article on this in the future (stay tuned). (3)
Water Intake
Water intake gets a bit tricky for an IC sufferer. It is important to drink at least 6-8 glasses of water per day to stay hydrated, staving off constipation, and keeping urine from becoming too acidic. The problem is that many IC sufferers worry about their frequency and that drinking too much water will make them have to urinate more often which can cause more pain.
Finding the right amount of water intake can be a balancing act. Sipping water throughout the day seems to be the best option to stay hydrated and still keep urgency/frequency to a minimum.
During a flare, some interstitial cystitis patients opt for alkaline water to make sure that their urine isn’t too acidic. Another trick to balancing out the acidity in the urine is to drink ½-1 tsp. of baking soda mixed with a full glass of water (Some caution is advised if you have high blood pressure. If this is the case, check with your healthcare provider).
Reducing Stress
Stress can trigger inflammation in the body and IC is an inflammatory disease. It is important find ways to relax and de-stress, which can help decrease inflammation. (Easier said than done for someone in constant pain!)
Simple steps like taking time to meditate and relax can help. Help pelvic floor muscles relax by laying in an inverted position on the floor with legs up on a chair or ottoman for 10-15 minutes daily while working on relaxation techniques (listening to relaxing music, meditating, or using guided relaxation).
An Epsom salt bath can help to relax pelvic floor muscles as well as the bladder muscle. A baking soda bath used as an external soothing agent is another great way to reduce bladder pain and aid in muscle relaxation.
This article was medically reviewed by Dr. Michelle Sands, ND. She is double board certified in Integrative Medicine and Naturopathic Medicine and is also a Board-Certified Holistic Nutritionist, and competitive endurance athlete. As always, this is not personal medical advice and we recommend that you talk with your doctor.
Do you suffer from Interstitial Cystitis, reoccurring UTI’s or pelvic pain? What natural remedies have you found helpful?
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