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Home > Articles > Treatment For Interstitial Cystitis

Interstitial cystitis or IC affects over 600,000 people in the UK, who are told that there is no cure and they must live with it. It affects both women and men. Patients that leading London Consultant Medical Herbalist Deborah Grant meets have often been on an exhausting route visiting GPs, urologists and gynaecologists with little success. They feel that the orthodox treatment seems to be purely symptomatic and unable to address the underlying cause of this very debilitating and painful condition.
Treatment For Interstitial Cystitis


What is Interstitial Cystitis?

IC is a very uncomfortable and stressful disorder, which is characterized by chronic urinary urgency (feeling the need to urinate immediately) and frequency (frequent urination) with or without pelvic pain. Symptoms may vary among individuals and may even vary with time in the same individual. Many people have to live life around their bladder because of the unpleasant symptoms. The term "cystitis" refers to any inflammation of the bladder. In contrast to bacterial cystitis, which results from an infection in the bladder, no infectious organism has been identified in people with IC.

IC is diagnosed when the symptoms occur without evidence for another cause of the symptoms.

About 90 percent of patients with this condition are women and the average age of onset is 40, though people of any age can be affected. Although it has not been considered a hereditary disorder, multiple cases have occurred among some families, prompting further research into a genetic link.

Women with this condition are more likely to have had frequent urinary tract infections and to have had previous gynaecological surgery than women without IC. Certain chronic conditions have been described as occurring more frequently in people with IC than in the general population:

  • Systemic lupus erythematosus (Lupus or SLE)
  • Irritable bowel syndrome (IBS)
  • Allergies
  • Endometriosis
  • Vulvodynia (chronic discomfort in the vulvar area)
  • Soreness at the end of the penis
  • Fibromyalgia

The condition has been classified into two forms, ulcerative and non-ulcerative, depending on the presence or absence of ulcerations in the bladder lining. Star-shaped ulcerations in the bladder wall are known as Hunner's ulcers. The ulcerative (classic type) of interstitial cystitis is found in less than 10% of cases. Scarring and stiffening of the bladder wall may occur as a result of the long term inflammation, leading to a decrease in bladder capacity. Areas of pinpoint bleeding may be seen on the bladder wall (See picture above, left. On the right is a healthy bladder).


What is the cause of IC?

Orthodox medical science does not know exactly what causes this condition. Most researchers believe that it represents a spectrum of disorders rather than one single disease. One area of research has focused on the layer that coats the lining of the bladder called the glycocalyx. This consists mainly of substances called mucins and glycosaminoglycans (GAGs). This layer normally protects the bladder wall from toxic effects of urine. Researchers have found that this protective layer of the bladder is "leaky" in about 70% of interstitial cystitis patients. There is a hypothesis that this may allow substances in urine to pass into the bladder wall where they might trigger IC.

Potassium is one substance that may be involved in damage to the bladder wall. Researchers have isolated a substance known as antiproliferative factor (APF) that appears to block the normal growth of cells that make up the lining of the bladder. APF has been identified almost exclusively in the urine of people suffering with IC. Research is underway to clarify the potential role of APF in the development of IC.

Other theories about the cause of IC are that it is a form of autoimmune disorder or that infection with an unidentified organism may be producing the damage to the bladder and the accompanying symptoms.


What are the signs and symptoms of IC?

The symptoms  vary greatly from one person to another but have some similarities to those of a urinary tract infection. They include:

  • Decreased bladder capacity
  • An urgent need to urinate frequently day and night
  • Feelings of pressure, pain, and tenderness around the bladder, pelvis, and perineum (the area between the anus and vagina or anus and scrotum) which may increase as the bladder fills and decrease as it empties
  • Painful sexual intercourse (dyspareunia)
  • Discomfort or pain in the penis and scrotum

In women, symptoms usually worsen around the time of their periods. Stress may also worsen the symptoms. The symptoms usually have a slow onset, and urinary frequency is the most common early symptom. As IC progresses over a few years, cycles of pain (flares) and remissions occur. Pain may be mild or so severe as to be debilitating. Symptoms can vary from day to day.


How is IC diagnosed?

Because the symptoms of IC are similar to those of other disorders of the urinary system and because there is no definitive test to identify it, doctors must exclude other conditions before making a diagnosis of IC. Among the disorders to be excluded are urinary tract or vaginal infections, bladder cancer, bladder inflammation or infection caused by radiation to the abdomen, eosinophilic and tuberculous cystitis, kidney stones, endometriosis, neurological disorders, sexually transmitted diseases, urinary tract infection with small numbers of bacteria, and, in men, chronic bacterial and non-bacterial prostatitis. Medical tests that help identify other conditions include a urinalysis, urine culture, cystoscopy, biopsy of the bladder wall and, in men, laboratory examination of prostatic secretions.


The Herbal Treatment For IC


The Herbal treatment for IC does not work for everyone but some patients have experienced the benefits of this approach. Everyone is so different and therefore may react differently to Herbal Medicine. The aim of the treatment is not only to alleviate the symptoms but to find any underlying issues, which may be fueling the IC. By taking a very detailed history, Deborah can better understand the pathology of each patient's IC and thereby address the underlying issues. Every patient's experience of IC is different and must be treated accordingly rather than with a one-size-fits-all approach. Deborah treats the whole person and not just the symptoms. Read testimonial here.

Many patients travel hundreds of miles in the UK and others come from Europe to see Deborah and, where distance is involved, she is happy to do follow up consultations by telephone at the follow up consultation rate to save the patient the time, cost and the discomfort of traveling.

Patients should look to spend around £40 per week on their prescription.

IC is indeed a very complex and debilitating condition. The chronic inflammation in the bladder and its repair is the most challenging part of the body to treat as it is always in constant use. The complexity of this illness dictates that treatment is given in stages, addressing both the underlying weaknesses in the body and the symptoms. The treatment for IC takes both trust and dedication to achieving a good clinical outcome.

Patients are put on the kind of low carbohydrate diet, that the human body is designed for. This diet takes off excess weight but does not make patients underweight, if carried out properly. Without a doubt, it is very difficult to change the dietary habits that we have become so entrenched in but the majority of patients are happy to work hard to achieve the necessary changes and they then reap the benefits.    
It is very much team work with the patient working with Deborah to get through the various stages of treatment, which address underlying issues and strengthen body systems. Deborah formulates a personalised herbal prescription for each patient during the treatment for IC. 

The stress and depression that this condition often causes is also treated, which again usually leads to less pain and better control of symptoms. Patients report that they feel calmer, with their mood better than before. At this stage in the treatment patients may see an improvement in their sleep. Some report that they are sleeping deeper and so have more energy. For others it can take longer to feel comfortable at night.

Every patient responds differently to the herbal treatment for IC. Some patients may react relatively quickly to the treatment, whilst others may take much longer. It is therefore impossible to estimate how long treatment will take. It can often take around at least two years to rebalance the body. Patients do suffer setbacks from time to time and this may be brought on by stressful situations in their life. When this happens, the herbal prescription can be modified to give the patient more support. Patients report that this flexibility in the treatment is extremely beneficial and they say that they feel so much better than they ever did on the orthodox treatment.

There are no quick fixes with this natural approach to treatment for ICs. Some patients have reported pain reduction of 75% after one year of treatment and 85% after 15 months. If you would like to try this natural approach to treatment for IC, call for an appointment.

Deborah is happy to receive your case history and test results by This e-mail address is being protected from spambots. You need JavaScript enabled to view it a week before your appointment. You may also email Deborah, if you have any questions before making an appointment. 


Read testimonials here


What is the orthodox treatment of IC?

 Orthodox medication

The principal type of oral medication is Elmiron, which is chemically similar to the substance that lines the bladder. It is believed that Elmiron assists in the repair of the bladder. Even after therapy has begun, patients may still experience symptoms for some time because the sensory nerves in the bladder have been hyperactive, and it takes time for the nerves to return to their normal state of activation. Doctors recommend giving up to one year of this treatment in mild IC and two years in severe IC before deciding if the drug is effective or not. Between one-third and two-thirds of patients will improve after three months of treatment.

Other oral medications that may be used to treat IC along with Elmiron include antidepressants, aspirin and ibuprofen (both of which may make symptoms worse in some patients).

Bladder Distension

Bladder distension is sometimes is used for therapy of IC. It helps reduce symptoms in approximately 20-30% of people with IC. When it is effective, the relief of symptoms persists for three to six months after the procedure.

Bladder Instillation (Intravesical therapy)

This procedure may also be called a bladder wash or bath. During a bladder instillation, the bladder is filled with a solution that is held for varying periods of time, from a few seconds to 15 minutes, before being drained through a narrow tube called a catheter.

In severe cases of IC, intravesical solutions may be administered along with Elmiron to provide relief until the oral medication has had time to take effect. Other drugs that have been used for bladder instillations include dimethyl sulfoxide (DMSO, RIMSO-50), heparin, sodium bicarbonate, and hydrocortisone (a steroid). Treatments are given every week or two for 6 to 8 weeks, and repeated as needed depending on symptoms. Most people with IC who respond to DMSO notice an improvement in symptoms 3 or 4 weeks after the first 6 to 8-week cycle of treatments.

Other Surgical Procedures for IC

In severe cases of IC that do not respond well to oral medications or to bladder distension or instillation, more invasive surgical procedures may be attempted. A procedure known as sacral neuromodulation has been shown to be effective in controlling symptoms in some people with interstitial cystitis. The term "neuromodulation" refers to an alteration of the nervous system. In sacral neuromodulation, a device is implanted that allows for electrical impulses to stimulate the nerves in the sacral (lower back) area. Sacral neuromodulation is believed to work by inhibiting the hyperactive signals from the sensory nerves within the bladder wall. For sacral neuromodulation, a wire from an electrical impulse generator is implanted in the sacral region of the spinal column. If there is relief of symptoms, the impulse generator can be implanted beneath the skin in the region of the buttocks. A remote control programmer allows the patient to adjust the impulse frequency and power to provide optimal relief of symptoms.

Therapies that also have been used include transcutaneous electrical nerve stimulation (TENS), a form of neuromodulation that does not involve surgical placement of wires or an impulse generator. With TENS, mild electric pulses enter the body for minutes to hours two or more times a day either through wires placed on the surface of the lower back or the suprapubic region, between the navel and the pubic hair, or through special devices inserted into the vagina in women or into the rectum in men. It is believed that the electric pulses may increase blood flow to the bladder, strengthen pelvic muscles that help control the bladder, and trigger the release of hormones that block pain. TENS is generally more effective in reducing pain than in reducing urinary frequency.

Other surgical procedures that may rarely be performed to treat severe IC include peripheral denervation (disrupting the nerves to the bladder wall), bladder augmentation to increase bladder capacity, and cystectomy (bladder removal) with diversion, or re-routing, of urine flow.

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