September is Interstitial Cystitis month and before the month gets away from us completely, I wanted to talk about this little known syndrome that was my constant companion for the last several years. While the mechanisms behind IC aren’t always clear, it is becoming widely considered to be the work of misbehaving mast cells, as IC is frequently a comorbid condition to all known mast cell activation disorders.
IC is also among the conditions that were found to be driven by duplicate tryptase genes in a familial study sponsored by the NIH, now known as hereditary alpha tryptasemia syndrome (HATS). With ever mounting evidence that HATS is a mast cell activation disorder in and of itself, it will be interesting to see what the future classification of this syndrome looks like.
The current estimate is that 1 to 4 million men and 3 to 8 million women have symptoms of IC. Interstitial Cystitis is marked by bladder pain and irritation, urgency and the need to urinate frequently. Basically, it feels like having a Urinary tract infection 24/7. For most sufferers, it begins with the need to urinate somewhat more frequently, which can lead to feelings of urgency. As this urgency builds, it can become painful. Sometimes this urgency never ceases, and the bladder signals the need to urinate as soon as it is emptied (Urology Care).
I’m not sure when I developed interstitial cystitis, but I know it’s been over a decade since I first noticed that my trips to the bathroom were becoming at first more frequent and then more urgent, interfering with my job and other aspects of my life. Then a few years ago, I developed what I thought was a bladder infection, but when I got tested at the doctor’s office, I was told it was negative. When I asked what I was supposed to do about the burning pain in my bladder, I got the usual shrug which indicated that I should just live with it like I do everything else. The pain never really went away after that. It just got duller or sharper.
I didn’t realize how dangerous it could be to have a bladder in constant distress until I started urinating blood. Apparently my next bladder infection went unnoticed and quickly became a serious kidney infection. After that, the bladder irritation was so severe that it felt like I had to pee as soon as I lifted my bottom from the toilet. I lived in constant agony. When I finally found a new GP, I asked for a referral to a Urogynecologist to get to the bottom of my pee-pee problems.
Since there was some weakness in my pelvic floor, the urogynecologist wanted to start with pelvic floor therapy and prescribed oxybutynin for me to help get the bladder spasms under control during my rehabilitation. In two days, the angry hive of bees in my bladder fell silent. I was in therapy for three months. My pelvic floor showed marked improvement in testing and I was thrilled to see great improvements in the bedroom and the bathroom. As soon as I went off of the medication, however, the pain and burning returned. So did the incontinence in some instances. It was as if I’d changed nothing.
By this time, I had strongly begun to suspect the culprit was MCAS and IC, so I made an appointment with an immunologist and began to read up on these conditions. The low histamine diet is a popular intervention for IC and MCAS, so it was a first line defense for me. I also decided to try quercetin, not only for my IC, but for a multitude of other symptoms I’d begun suffering with since the onset of spring and pollen. Within two weeks of starting quercetin, my IC pain and incontinence were completely resolved, almost as if they had never existed in the first place.
More than likely my interstitial cystitis is here to stay, so I’m incredibly grateful to have found some effective treatments for it so I don’t have to think too much about it anymore. For some, the pain of interstitial cystitis is only part time instead of the constant onslaught I experience. Regardless, it is a disabling syndrome that causes interruptions in sleep, work, relationships, and leading a healthy life. We have to do a better job of getting to a diagnosis earlier and getting relief for patients sooner, even if that means just trying out a mast cell stabilizer to see if it works. I’m sure someone will come tell me why that’s a phenomenally bad idea, but right now, I fail to see why once infection has been ruled out. After all, I’m not sure I would even have this diagnosis yet if we didn’t know what effectively took care of it and what didn’t. That’s my two cents. Take it with all the salt you’d like!