How Diet Impacts A Difficult to Diagnose Bladder Problem
guest post by Dr. Olivia A. Joseph, Doctor of Chiropractic
How ironic that what is best known about interstitial cystitis (IC), a bladder condition affecting nearly one million men and women in this country, is that it is so frequently unrecognized.
Symptoms of IC are many and varied and often mimic other disorders, which is why many times doctors fail to identify it properly and instead treat the patient for something else. This was what "Wendy," a 40-year-old woman, experienced when she sought medical help to address the bladder pain, frequent urination and sharp lower abdominal and pelvic pain she had recently developed.
The doctors diagnosed her condition as a urinary tract infection, a common misdiagnosis of IC. Accordingly, Wendy took repeated courses of antibiotics, but to her dismay, none of them improved her condition. After a year of frustration with no relief of her painful symptoms and with the risk of side effects from the antibiotics, Wendy consulted Mark Stengler, ND, who successfully identified the true underlying problem.
Dr. Stengler says that he began to suspect IC when Wendy described her symptoms and told him that antibiotics had had no impact. To explore this possibility, he sent her to a urologist for a diagnostic test called a cystoscopy with hydrodistention. This test requires the patient to have general or local anesthesia so that the urologist can distend the bladder by filling it beyond its normal capacity with water or other liquids. Distention is occasionally performed with gas. By distending the bladder in this manner, the doctor can insert a scope, which allows an examination of the bladder lining (the epithelium) to see if there are tiny hemorrhages called glomerulations. These are present in 95% of IC cases. A second test is also available called a potassium sensitivity test that sometimes also helps determine what treatments will work to improve a particular patient's bladder lining. However, this test can be painful and is still experimental with an accuracy rate of 75% or less. Unfortunately, high-resolution ultrasound is not yet capable of identifying the hemorrhages.
When the result of Wendy's test came back, it confirmed the diagnosis -- she did indeed have IC. This condition is chronic and there is no cure at this point and treatments vary from case to case. Symptoms, in addition to pain in the pelvic area, the bladder and the lower abdomen, can include a nearly constant and urgent need to urinate although the volume is small... pain in the perineum (the area between the vagina or scrotum and the anus)... pain during sex and in women in the vulva, in men the prostate. Other disorders that have some of these symptoms and which doctors must consider when looking for a diagnosis include kidney stones, sexually transmitted diseases, vaginal infections and several more. Symptoms generally get worse in the first 12 to 18 months of IC and then level off, though patients may find their symptoms flare and then abate for a period of remission.
Dr. Stengler says that IC is believed to be an inflammatory condition of the bladder epithelium that worsens symptomatically by hormone imbalance, food sensitivities and stress. He advises everyone with IC to avoid the following foods because they seem to have an inflammatory effect on the bladder and can aggravate IC...
- citrus fruits and juices
- coffee and other caffeinated beverages
- spicy foods
- carbonated beverages
- cranberry juice
In addition to the above list, Dr. Stengler tests patients for individual food allergies/sensitivities if he suspects they are present. In Wendy's case, the test showed that she was sensitive to dairy and so he had her eliminate that as well. She also increased her vegetable and water intake, which helped reduce an overly acidic environment in her bladder. To reduce the spasmodic pain she had, Dr. Stengler put Wendy on a protocol of homeopathic Magnesia Phosphorica 6x. In a month's time, Wendy's bladder pain was greatly reduced and by staying with the protocol, she is able to control this condition.
It can also be helpful to address inflammation in general, says Dr. Stengler. You can take the following with an important caveat -- introduce these separately and only one every one to two weeks. IC is sensitive and symptoms flare easily to some substances. Should any of the following bother you, it will be possible to identify it immediately and avoid it from then on...
- Omega-3s (fish oil) -- 1,000 mg combined EPA and DHA
- Quercetin -- 500 mg, two to three times daily
- Marshmallow root -- 250 to 300 mg twice daily
- Corn silk -- 250 to 300 mg twice daily
- Vitamin E -- 400 IU once a day
Talk to your doctor before taking omega-3s if you are on blood-thinning medications.
Dr. Stengler also prescribes homeopathic and herbal remedies to reduce inflammation as we saw with Wendy. There is a wide range of these and patients have highly individual responses to them. Consequently, he says that IC patients must work with a doctor educated in these types of treatments to establish what protocol is suitable for them. Once patients have appropriate remedies, they improve within a month or so and remain better so long as they remain on their protocol. Some patients do find that the necessary changes in diet will cause a brief flare in symptoms, however.
While there is no common cure, fortunately, IC is a condition that responds very well to natural treatments, says Dr. Stengler. Given that many doctors miss it and prescribe a series of unnecessary antibiotics, it is well worth the time and effort to find an appropriate medical professional who can help you find the treatment that will make living with IC a much more comfortable experience.