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What is interstitial cystitis/ bladder pain syndrome/ painful bladder syndrome? 

the presence of chronic suprapubic pain to bladder filling accompanied by other urinary symptoms, such as frequency, urgency, discomfort with filling, and relief with emptying of the bladder in the absence of infections or other pathology - Ali et.al. 2018

The trouble with syndromes is that they are often viewed within the blinkered perspective of the reductionist model of the body. This means that when they say ‘or other pathology’ they most likely mean pathology relating to the urinary system, when in fact PBS might be caused by a pathology in other areas of the body like the immune system, digestive system or reproductive system. Naturally if the underlying cause of the symptoms is another problem entirely then it is that first problem which needs to be treated most importantly. But, nevertheless the advice given below is likely to help with symptom management, and that’s always welcome when pain is involved!

Although interstitial cystitis (IC), bladder pain syndrome (BPS) and painful bladder syndrome (PBS) is generally seen as different words for the same condition Birder (2019) believes IC to have inflammation where the others don’t. I personally feel this is splitting hairs. Because this is a relatively new diagnosis it is still evolving and not everyone in the medical community agrees on its definition, treatment or why it occurs. That’s to be expected with anything called a syndrome, it simply means ‘collection of symptoms’. Although it’s a condition worth diagnosing it seems, from my research at least, to really be a sign of some other underlying problem (some suggestions of this are listed below). 

Although interstitial cystitis (IC), bladder pain syndrome (BPS) and painful bladder syndrome (PBS) is generally seen as different words for the same condition Birder (2019) believes IC to have inflammation where the others don’t. I personally feel this is splitting hairs. Because this is a relatively new diagnosis it is still evolving and not everyone in the medical community agrees on its definition, treatment or why it occurs. That’s to be expected with anything called a syndrome, it simply means ‘collection of symptoms’. Although it’s a condition worth diagnosing it seems, from my research at least, to really be a sign of some other underlying problem (some suggestions of this are listed below). 

SYMPTOMS OF INTERSTITIAL CYSTITIS, BLADDER PAIN SYNDROME AND PAINFUL BLADDER SYNDROME INCLUDE:

  • Sharp pain when urinating
  • Urgent need to go frequently
  • Need to go urgently
  • These symptoms will have recurred for over 6 months 

As a bladder infection can be very serious if left untreated it’s crucial that you rule this out before treating as IC/BPS/PBS. Most who have found this blog have probably already been diagnosed with one and that’s who I’ve written the article for. 

Get rid of Cystitis for good with our Cystitis Tea

A WARNING ABOUT MISDIAGNOSIS

Bladder infections should never be ignored as they can travel to the kidney and cause so much trouble it can do damage to the kidneys and you can even lose function in them. Taking pain killers and getting on with your day as normal is not enough. It's important when you treat your own cystitis that you understand a few signs which should always be referred to the doctors:

Red flags in bladder infections

  • Blood in the urine
  • A fever
  • Low back pain
  • Vomiting

ASSOCIATED ILLNESSES (WHICH MAY BE THE CAUSE)

  • Endometriosis
  • IBS
  • Fibromyalgia
  • Rheumatoid arthritis
  • Even asthma

Changes to the urothelium or epithelial sensor/barrier functions, neurogenic inflammation, possibly autoimmune involvement and may sometimes cross-talk between different pelvic viscera particularly in endometriosis and IBS (Birder, 2019).

DIET AND LIFESTYLE CHANGES

These are simple steps you can take to reduce the chances of you getting an infection in the first place.

  • Minimise stress (stress has a big role to play Birder, 2019). Our product Rested Resilience combats long term stress.
  • Caffeine or sugar might exacerbate the problem so be wary.
  • When the problem is accompanied by IBS you might find wheat or dairy exacerbate symptoms so best keep it to a minimum.
  • Kegel exercises may help those who have incomplete bladder emptying.

HOME REMEDIES

Treating an acute flare-up of symptoms has some similarities to treating an infection but as there is no need for an anti-bacterial element its more simple.

  • Apple cider vinegar. This will change the pH of the bladder making it less hospitable for bugs. Add a tablespoon to a pint of warm water and drink twice a day.
  • Bicarbonate of soda. This does the same as the apple cider vinegar. Have a teaspoon in a pint of warm water twice a day. (I normally aim to drink a pint per hour and switch between all these remedies as the day goes on so I get the best of them all)
  • Flat leaf parsley tea. This is a lovely anti-inflammatory and it immediately relieves the pain. Use a couple teaspoons of fresh herb from the supermarket and pour on a mug of boiling water. Infuse for 5 mind before drinking.
  • Cranberry juice concentrate. Everyone should have this in their house as the shelf life is enormous so you can have it just in case of infections. It contains D-mannose which stops the bacteria from attaching to the wall of bladder, allowing you to flush it out.

TRADITIONAL HERBS

These herbs can be combined any which way you like but I would recommend using at least one from each category. There are many more herbs under each category but I have chosen the most commonly found wild ones or the ones most strongly associated with the urinary system. 

  • Soothing (demulcent): Marigold (Calendula off.), Marshmallow root (Althea off. rad.), Couch Grass (Agropyron repens). Marigold and marshmallow is also in our Soothe + Comfort tea. 
  • Diuretic: Horsetail (Equisetum arvense), Marshmallow leaf (Althea off. fol.), Nettle leaf (Urtica dioica), Dandelion leaf (Taraxacum off.). Nettle and marshmallow can be found in our Soothe + Comfort tea. 
  • Relaxants: Chamomile (Chamomilla recutita), Lemonbalm (Melissa officinalis), Hawthorn (Crataegus spp.), Passion flower (Passiflora incarnate). Both hawthorn and passionflower are in our Premenstrual Peace. Chamomile can be found in our Soothe + Comfort tea. 
  • Adaptogens: Ashwagandha (Withania somnifera) found in our Rested Resilience, Liquorice (Glycyrrhiza glabra) found in our Premenstrual Peace drops. 

I try to use herbs which are easy to grow and find in the UK so I don't usually use Buchu, Uva ursi or Cornsilk though they are the usual favourites. The diuretics will help you pee with less pain. They are often anti-inflammatory too and will soothe the passage of urine. The soothing herbs will calm the painful sensations too. The relaxants help to minimise the (potentially) underlying stress in that moment. Whereas, adaptogens will help with long-term stress. You can take our stress test to see which you need most or take some of each every day to prevent occurrences!

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EMOTIONAL CAUSES OF INTERSTITIAL CYSTITIS

It’s said that bladder infections are due to feelings of being pissed off or angry. But I’m not so sure if this is the case with the chronic pain of interstitial cystitis/BPS/PBS. Books such as The Molecules of Emotions and The Body Keeps the Score would certainly argue that syndromes such as this are most likely linked to some unexpressed emotion. Aside from that, I’m not sure how much help I can be in this article on emotion. Suffice to say it’s something to be aware of as each individual will no doubt differ.

The research shows that stress, more generally, is linked with flare-ups of this syndrome (Birder, 2019). That was certainly the case with my patients when I saw them. That’s why I’ve highlighted the importance of relaxants and adaptogens in this article. It’s also why I’ve included relaxing chamomile an uplifting jasmine in our bladder soothing tea blend Soothe + Comfort. 

Disclaimer: this information is for educational purposes only and should not be used without advice from your medical practitioner especially if you are already taking any medicines. 

References

Ali, A., Ali, N. S., Malik, M. B., Sayyed, Z., & Ahmad, M. Q., 2018. An Overview of the Pathology and Emerging Treatment Approaches for Interstitial Cystitis/Bladder Pain Syndrome. Cureus, 10(9), e3321.

Birder, Lori A, 2019. Pathophysiology of interstitial cystitis. International journal of urology, 26(1), pp.12–15.