Interstitial cystitis is a chronic syndrome that is characterized by the classic symptoms of bladder pain, nocturia, and frequency that last several months. Different hypotheses exist about the etiology and pathogenesis. Since there is no pathognomonic marker, diagnosis of interstitial cystitis is a combination of typical patient history and exclusion of differential diagnoses. Cystoscopy and biopsies are not specific; however, they can provide useful information on extent and aid in treatment choice. Interstitial cystitis is more common than previously thought and is often diagnosed only when pain, frequency, and urgency become continuous and severe. Physicians should keep the diagnosis of interstitial cystitis in mind for all patients presenting with pelvic pain or urinary symptoms. Negative urine cultures are characteristic of interstitial cystitis.

Causes
The three main proposed etiologies are bladder urothelial dysfunction, bladder inflammation (possible neurogenic), and neuropathic pain.

Interstitial cystitis symptom
Problems include excessive urgency and frequency of urination, and chronic pelvic pain. A common interstitial cystitis symptom is suprapubic pain which is basically pain above the pubic bone where the bladder is located. Many women have the interstitial cystitis symptom of dyspareunia which is pain during intercourse. Interstitial cystitis occurs primarily in females including adolescents and its diagnosis is still one of exclusion. It is now recognized as a serious medical condition associated with significant disability.

Interstitial cystitis natural supplements
As the articles below suggest, it may be worthwhile to try garlic, parsley, probiotics, cranberry, chondroitin sulfate and quercetin supplements. Try them alone one at a time for 2 to 4 weeks and then combine them. If you notice any benefits or side effects, please contact me so I can inform others who read this page.

Case Rep Med. 2014. Efficient and cost-effective alternative treatment for recurrent urinary tract infections and interstitial cystitis in women: a two-case report. Urinary tract infections (UTIs) are among the most common bacterial infections affecting women. UTIs are primarily caused by Escherichia coli, which increases the likelihood of a recurrent infection. We encountered two cases of recurrent UTIs (rUTIs) with a positive E. coli culture, not improving with antibiotics due to the development of antibiotic resistance. An alternative therapeutic regimen based on parsley and garlic, L-arginine, probiotics, and cranberry tablets has been given. This regimen showed a significant health improvement and symptoms relief without recurrence for more than 12 months. In conclusion, the case supports the concept of using alternative medicine in treating rUTI and as a prophylaxis or in patients who had developed antibiotic resistance.

Intravesical chondroitin may relieve interstitial cystitis, along with hyaluronic acid
The results of a small study suggest that intravesical chondroitin sulphate is a safe and effective treatment for some patients with interstitial cystitis. Chondroitin sulphate is a glycosaminoglycan that makes up a mucus layer of the bladder. Dr. J. Curtis Nickel, from Queen's University, Kingston, Ontario, Canada assessed the outcomes of 53 patients who received intravesical infusions of chondroitin, weekly for 6 weeks and then monthly for 16 weeks. The subjects had moderately severe interstitial cystitis for an average of 9 years. By 24 weeks the response rate was 60%. BJU Int 2009.

The aims of this study were to evaluate the efficacy and tolerability of intravesical instillations of high-molecular-weight hyaluronic acid (HA) 1.6% and chondroitin sulfate (CS) 2.0% in patients with refractory painful bladder syndrome/interstitial cystitis (PBS/IC) and to observe their impact on Quality of Life. Twenty-three women were enrolled. They received bladder instillations with HA and CS weekly for 20 weeks and then monthly for 3 months. Mean follow-up after completion of therapy was 5 months. We observed a significant improvement in urinary symptoms on voiding diaries and Visual Analogue Scale for frequency, urgency, and pain. The O'Leary-Sant Interstitial Cystitis Symptom Index and Interstitial Cystitis Problem Index resulted in a significant improvement in both scores. The Pelvic Pain and Urgency/Frequency Symptom Scale only showed significant improvement in the symptom score. Int Urogynecol J Pelvic Floor Dysfunct. 2008. A combined intravesical therapy with hyaluronic acid and chondroitin for refractory painful bladder syndrome/interstitial cystitis. Urogynecology Department, S. Carlo-IDI Hospital, Rome, Italy.

Interstitial cystitis: bladder pain and beyond.
Expert Opin Pharmacother. 2008; Theoharides TC, Whitmore K, Stanford E, Moldwin R. Tufts University School of Medicine, Department of Pharmacology and Experimental Therapeutics, Experimental Therapeutics 136 Harrison Avenue, Boston, MA, USA.
The aim of this paper was to review the pathogenesis and treatment of interstitial cystitis with emphasis on new pathogenetic trends and therapeutic modalities. About 713 mostly original papers were reviewed in Medline from 1990 to August. 2008. Increasing evidence of co-morbid diseases, neurogenic inflammation and the effect of stress are promising as new targets for pathophysiology. No new effective treatments have emerged. Oral pentosanpolysulfate, amitriptyline, hydroxyzine and quercetin, as well as intravesical heparin / bicarbonate / lidocaine solutions, are still used with variable success. Interstitial cystitis contributes substantially to chronic pelvic pain and to poor quality of life. Oral or intravesical administration of solutions containing sodium hyaluronate, chondroitin sulfate and quercetin to both reduce bladder inflammation and 'replenish' the glycosaminoglycan layer should be tried.

Treatment of refractory interstitial cystitis / painful bladder syndrome with CystoProtek -- an oral multi-agent natural supplement.
Can J Urol. 2008. Theoharides TC, Kempuraj D, Vakali S. Department of Pharmacology and Experimental Therapeutics, Tufts University School of Medicine and Tufts Medical Center, Boston, Massachusetts, USA.
Interstitial cystitis/Painful bladder syndrome (IC/PBS) is a chronic bladder condition of unknown etiology and pathogenesis. However, there is evidence of bladder surface mucosal and glycosaminoglycans (GAG) dysfunction in IC/PBS and GAG replacement therapy has been used to treat the condition. The results of an open label, uncontrolled study of a dietary supplement designed to improve GAG mucopolysaccharides integrity (glucosamine sulfate, sodium hyaluronate and chondroitin sulfate) and reduce bladder wall inflammation (quercetin, rutin) are presented herein. Two hundred fifty two IC/PBS patients (25 men, 227 women; 18-69 years old), who had failed other treatments, took four CystoProtek capsules /day (mg/capsule: glucosamine sulfate, 120; chondroitin sulfate, 150; hyaluronate sodium, 10; quercetin, 150; rutin, 20). Symptoms were evaluated using a visual analogue scale (VAS) (severity range from 1-10) before and after treatment (< 6, 6-12 or > 12 months). The women were divided into two severity groups--a more severe A group with a baseline mean VAS score greater than or equal to 5 and a less severe B group with a mean score < 5. Male patients had a mean VAS score  which fell 51 percent after 12 months of treatment. The women experienced a 48% reduction in the mean VAS score.  Dietary supplements targeting the bladder GAGs (chondroitin, glucosamine, hyaluronate) and bladder inflammation (quercetin, rutin) are useful in the treatment of refractory IC/PBS. Prospective randomized trials of such supplements are warranted in both treatment refractory and treatment naïve patients.

Ther Adv Urol. 2016. Managing chronic bladder diseases with the administration of exogenous glycosaminoglycans: an update on the evidence. Although the pathophysiology of acute chronic cystitis and other 'sensory' disorders, i.e. painful bladder syndrome (PBS) or interstitial cystitis (IC), often remains multifactorial, there is a wide consensus that such clinical conditions may arise from a primary defective urothelium lining or from damaged glycosaminoglycans (GAGs). A 'cascade' of events starting from GAG injury, which fails to heal, may lead to chronic bladder epithelial damage and neurogenic inflammation. To restore the GAG layer is becoming the main aim of new therapies for the treatment of chronic cystitis and PBS/IC. Preliminary experiences with GAG replenishment for different pathological conditions involving the lower urinary tract have been reported. There is a range of commercially available intravesical formulations of these components, alone or in combination. Literature evidence shows that exogenous intravesical hyaluronic acid markedly reduces recurrences of urinary tract infections (UTIs). Patients treated with exogenous GAGs have fewer UTI recurrences, a longer time to recurrence and a greater improvement in quality of life. Exogenous intravesical GAGs have been used for the treatment of PBS/IC. Despite the limitations of most of the studies, findings confirmed the role of combination therapy with hyaluronic acid and chondroitin sulfate as a safe and effective option for the treatment of PBS/IC. To prevent and/or treat radiotherapy and chemotherapy induced cystitis, GAG replenishment therapy has been used showing preliminary encouraging results. The safety profile of exogenous GAGs has been reported to be very favourable, without adverse events of particular significance.

Interstitial cystitis treatment
 Despite decades of basic and clinical research, IC/BPS remains difficult to treat. A variety of treatments are used, each aimed towards one etiology. For example, glycosaminoglycans are thought to improve the urothelial permeability barrier, anti-inflammatory agents are used to decrease general inflammation, and mast cell stabilizers and/or antagonists of mast cell products are used in the treatment of neurogenic inflammation.

Taiwan J Obstet Gynecol. 2012. Treatment of interstitial cystitis in women. Interstitial cystitis (IC) has been described as a chronic debilitating sterile inflammatory multifactorial bladder syndrome of unknown etiology. IC is characterized by bladder pain (or suprapubic pain) associated with urgency, urinary frequency, and nocturia. Because the pathogenesis of IC remains unclear, it is still an enigma and represents a diagnostic and therapeutic challenge. The diagnosis of IC remains unclear and is based on exclusion of other diseases. Consequently, IC has usually been underdiagnosed, and the consensus on best available treatment for the disease is lacking. The current goal for the treatment of IC is usually symptomatic relief, and treatment protocols are based on empiricism. Multiple forms of therapy are available, and most patients can be managed conservatively. Nevertheless, the efficacy of most treatments is short term.

Cystitis symptom
These usually refers to various symptoms known to a patient, but the phrase cystitis signs may refer to those signs only noticeable by a doctor. These cystitis symptoms include urinary pain, urinary burning, urgency, bladder pain, lower abdominal pain, fever, dark or bloody urine, cloudy or smelly urine. When there is a lot of blood in the urine it is called hemorrhagic cystitis. Chronic cystitis refers to difficult to treat cystitis that returns frequently even when treated with antibiotics. Acute cystitis refers to a sudden onset of cystitis often limited and easily treated with antibiotics.

Interstitial Cystitis natural treatment emails
Hello Dr. Sahelian, I have interstitial cystitis and i was just wondering why nobody has even try to have a doctor talk about this on a program like Dateline. I would think that it's time that it gets out into the public and many those who do have it and don't know it, after seeing a program on television about it, would then go to their doctor and give them some insight about it. Alot of doctors don't even know what Interstitial Cystitis is. It's a real condition that does give you bladder pain and bladder pressure. It's not something in your head that alot of doctors think and they put you on antidepression pills. I am trying the Ultimate Urinary Cleanse now. My doctor put me on Terazasin, 5 mg. and it worked for about two weeks and now it doesn't help at all. Thank you for taking the time in reading my e-mail Dr. Sahelian. It's good to know your out there helping people with the natural way. I feel it's the best way to.

Q. Do you have any natural products that would help with interstitial cystitis?
   A. Sorry, I have not come across extensive studies regarding an effective treatment of interstitial cystitis with oral natural supplements. Would chondroitin supplements help taken orally? Perhaps, but I don't know.

Q. I have been reading of the benefits of forskolin and wanted to ask you about its effectiveness in treating interstitial cystitis symptoms. I have had Interstitial cystitis for 9 years and have tried many treatments. Reading about this product sounded hopeful, but the writings say has not been tested as of yet, on humans.
   A. A Medline search in March 2009 using the keywords interstitial cystitis forskolin did not reveal any studies.

I am a retired board certified Family Practice physician who has developed Celiac disease. As part of the disease I have interstitial cystitis which is very painful and limits what I can do. I have found marshmallow root tea, and an old medication urised does give some help along with careful diet.

My wife has IC and through a little research we found out that if she eats boiled yuca her burning lessens or goes away.

 I was diagnosed with interstitial cystitis about 5 years ago. My doctor gave me some medication to take for the condition. It toke away the bladder pain but added severe abdominal pain, and some other issue's. I felt worse and couldn't hardly get far from home with having problems. Felt very trapped. After some research I found a web site where some people had tried some herbs and thought I would give it a try. I take quercetin and glucosamine with msm daily. It took about 2-3 months before the pain was completely gone. I have done this for about 4 years now. I have no bladder pain and live a normal life.

 I have been supplementing with P-5-P and Slippery Elm for approximately 2 years. I was diagnosed with Interstitial Cystitis and my local homeopathic center suggested I give it a try. It was a miracle for me. I stopped having pain and discomfort simply by ingesting a 50 mg P-5-P and a 400 mg Slippery Elm supplement each evening before bed. I live in the Northeast and we had terrible weather here this winter 2014, plus I became ill with a serious cold / upper respiratory infection, so I could not get to the store to buy more P-5-P. I stopped it for about 3 weeks, all the pain and discomfort came back. I was wondering have you done any work with Interstitial Cystitis? I am currently taking the P-5-P and Slippery Elm 2X a day. I see a little improvement, but still not well.

Natural Cystitis Prevention or Treatment
Drink plenty of fluids, especially after intercourse.
Cranberry herbal extract has been studied, along with cranberry juice, for cystitis prevention.
Eyebright herb, for more information regarding this supplement.
D-Mannose nutrient
Uva Ursi herb and extract or bearberry plant

Medical Cystitis Treatment
Antibiotic therapy for 3 days is similar to prolonged therapy in achieving symptomatic cure for cystitis, while the prolonged treatment is more effective in obtaining bacteriological cure.