Managing Interstitial Cystitis and Bladder Pain Syndrome symptoms: tools and avenues to consider
As a re-cap from my initial blog on Interstitial Cystitis and Bladder Pain Syndrome (IC/BPS), these conditions (of exclusion) are complex and multifactorial; one reason they are so hard to manage and live with. Overall the conditions are characterised by inflammation of the bladder’s lining.
Sufferers often complain of symptom ‘flares’, whilst some women will experience symptom intensity in a pattern with their monthly cycle. Everyone’s experience is unique to them, including how the condition developed in the first place (in many this is unknown).
Medical options are varied in type and effectiveness, options include pain management, instillations to support the bladder lining, anti depressants due to the mental burden, anti histamines and physical therapy.
I will introduce a few concepts below that I would be focusing on when looking at supporting clients with IC/BPS.
Physical floor therapy
In nearly all sufferers of IC/BPS there is some degree of pelvic floor dysfunction. Pelvic floor muscles can become tight (hypertonic) when there is ongoing tension. This tightness can contribute to symptoms.
I recommend seeing a specially trained pelvic health physio in person for an examination and treatment. This website only includes physios trained in women’s pelvic health: https://thepogp.co.uk/patients/physiotherapists/
Microbiome health
The microbiome environments of the body are instrumental to health in the areas they reside. Some people report UTIs around the time their IC/BPS started, so its not uncommon for sufferers to have experienced an imbalanced bladder microbiome previously, and in some cases inflammatory microbes may still be present, but at low levels they may not be detected by standard urine tests.
Getting back to basics - microbes from the anus and vagina can ‘translocate’ to the bladder via the urethra; this is more common in women given we have shorter urethras.
Ensuring the vagina isn't harbouring a reservoir of inflammatory microbes is sensible in cases of ongoing bladder symptoms. The vaginal microbiome is a key predictor of bladder microbiome health, given these two structures are so close together.
Our vaginal microbiome test can specifically report if inflammatory microbes are present or not. In cases where they are, we recommend rebalancing the vaginal microbiome to avoid reinfection of inflammatory microbes into the bladder.
Inflammation in the gut can drive inflammation throughout the body. Any signs of gut microbiome problems such as bloating, flatulence, pain, diarrhoea, constipation should be addressed.
Overall, the best way to look after our microbiome sites is by eating a diet of whole foods, with very little processed foods and sugar. Beneficial bacteria thrive off plant foods: vegetables, fruits, lentils, beans and legumes. Making healthy swaps from milk chocolate to dark chocolate, flavoured yogurt to plain yogurt and berries, biscuits to nuts and seeds, or alcohol to kombucha are smart moves for your microbiome too.
Systemic inflammation control
IC and BPS are characterised by inflammation. Any interventions to reduce inflammation will be beneficial for all round health.
An anti inflammatory diet is helpful, including oily fish twice weekly, plenty of berries, turmeric, ginger, olive oil and plant foods. Where safe to do so, supplementation with omega 3 can be considered. Moderate exercise and stress management are beneficial too.
Bladder lining integrity
One area of research has focused on dysfunction of the bladder lining, called the glycocalyx, for driving IC and BPS symptoms.
High strength aloe vera, produced exclusively by Desert Harvest (the CEO was an IC sufferer herself), can help to soothe, coat and support healing of this bladder lining. The properties of the aloe vera plant include being anti-bacterial, anti-fungal, anti-inflammatory and analgesic (pain numbing).
We have a number of IC patients providing feedback on how helpful this product has been for symptom management.
Hormone considerations
About 90 percent of patients with this condition are women and the average age of onset is 40, although people of any age can be affected.
Considering the bladder is lined with oestrogen receptors, the drop in this hormone will have a major impact on this organ during menopause: from reducing tissue integrity and strength to altering the protective microbial environment.
Therefore, in women with these conditions, I would urge them to consider their hormones: what are they doing and do they need hormone replacement therapy at any point. This requires discussion with a specialist in context of wider health.
Nervous system support
The bladder has a rich network of nerves. In IC/BPS, inflammation from bladder lining damage, immune activation and mast cell activity can cause these nerves to become overactive and hypersensitive, sending pain signals to the brain, even when the bladder is empty.
In those suffering from IC and BPS, adopting interventions to calm the nervous system may be beneficial: from yoga or meditation, taking magnesium glycinate and / or B vitamins, reducing our stress response, or seeing a pain expert for tailored advice are some options.
Exclusion diets.
Unless these very specifically help you, and are limited to a very small number of foods e.g. coffee, spices, I don’t recommend exclusion diets. Our gut microbiome needs variety and diversity of microbes, and a varied diet of plant foods supports this.
It can become unhelpful and negatively impact health to exclude a large number of health promoting foods in the diet.
Summary
With these complex conditions, lifestyle and diet interventions should be considered, alongside medical interventions too.
I hope the above has been useful. If you have any specific questions about our products please email us at hello@pelvicrelief.co.uk.
