In the practice of medicine no disease is really the same as someone else’s disease They all have their nuances of differences And this is true of IC
No IC bladder pain syndrome is the same from one individual to another Some have more anxiety and frequency while others have more burning and spasm Some have other skin and eye conditions associated with their IC Some are fortunate enough to have a few nonbacterial “UTIs” and then things seem to rectify themselves and they never have symptoms again
Others are debilitated with symptoms and cannot function So what’s the definition of chronic IC
The reason that it’s difficult to assess the true prevalence of IC in a given population is that symptoms of the condition can vary widely Some may have very localized symptoms to the bladder/pelvis and may dissipate over time for one reason or another
Some may struggle with symptoms and then with modifications to diet or using suggested remedies by friends or physicians the symptoms again gradually dissipate over time
These populations of patients are not counted typically in the IC longitudinal surveys And then there are the men and children affected by the same voiding and pelvic dysfunction that has not as yet been labeled as IC So you can see that the prevalence of IC may far be underestimated
But then who’s left? Typically in studies the people with chronic symptoms congregate to form study populations So what’s chronic IC?
Admittedly due to the lateness of detection typically patients have progressed far enough along in their symptom complex that chronicity is part of the picture Importantly the earlier a clinician can intervene with nutritional information and lifestyle the more likely that the IC will not go onto chronic debilitating disease
Chronic Debilitating IC Definition: Bladder and/or pelvic pain for greater than 3 years that is constant and that has persisted and increased in intensity and has urologically and gynecologically been shown to have no obvious cause(eg tumor,cancer, bladder stone, ureteral disease)
Now this time frame is arguable but you get the picture that there has to be enough time to establish a pattern of chronicity This of course is almost always(unless there is relentless pain) punctuated with acute flares
It’s always nice to know where you are on the spectrum of any disease But even more valuable is to give you an appreciation of what to expect in getting better
Getting better? Wait, this disease is treatable but not curable Currently what “treatable” means is that another groping bandaid is applied to try to manage the symptoms Having trouble? Try a shortstay in the outpatient surgical unit for a bladder fulguration Or perhaps low dose Valium
So if one’s open to getting better with IC then you should want to know what to expect
As you know disease is not created overnight The imbalance that creates the disease in the body takes time But slowly but surely the symptoms become full blown and relief is required So here are 5 things that you should understand and be willing to do if you want to manage your IC effectively
1 Patience and being in it for the long haul So if you really get this then you realize that it will take time to reverse the imbalance that created the disease in the first place What’s the time frame? For every year of imbalance it will take 2 months for the disease course to reverse itself For example, if you’ve been having problems with symptoms since 1999 then that’s at least 14 years of imbalance exposure which would mean 28 months or +2 years of work Interestingly most people with IC are an impatient bunch “I don’t have time to wait for healing to occur I’ve got things to do, places to go, and people to see” If you know that about yourself then you have the chance for being more patient about results There is no magic pill with this disease!
2 Choose a healing discipline that can deliver Obviously the matter science approach with it bandaid approach isn’t working(interstim, bladder distentions, pharmaceuticals) The energy science approach can affect change but it takes time Of clinical significance is the now recognized association of fibromyalgia and chronic fatigue syndrome with chronic IC(1) As IC progresses in its chronic state it’s apparent that patients get sicker It is at this stage of the disease that the matter science approach to healing comes to a complete standstill in terms of options It is at this point that the energy science model of healing can take over due to its understanding of the origin of disease
3 Realize that with chronic disease there is universally a bowel component to the problem The matter science approach is to micromanage the bladder symptoms when the origin of the disease is at the gut level Strange as it may sound, IC management requires that the clinician become a bowel health doctor Otherwise there will be no success IBS is estimated to be present in the IC population as high as 80%(2) (personally I believe it’s probably 100%..it’s just that the 20% don’t have symptoms severe enough for them to be diagnosed as IBS) Acid indigestion(GERD) is estimated to be in the range of at least 50%( but again probably higher) Prelief anyone?4 Understand a multifaceted approach to disease There are many causes that brought about the symptom complex of IC So realize that it will take many different avenues of treatment So it’s not just one drug(elmiron) or one procedure(interstim) but a multiplicity of interventions from a therapeutic standpoint to bring about change in symptoms
5 Toxicity Realize that part of the process of healing is detoxification that comes along with the balancing process that occurs with the clearance of symptoms As a matter of fact the reason that the qualities that produce IC cannot be eliminated from the pelvis is that the toxic load in the pelvis holds them there So detoxification is mandatory if you are to get relief But what is detoxification in the mainstream press is not anything close to what real detox is
(1)J Urol. 2010 Oct;184(4):1358-63. doi: 10.1016/j.juro.2010.06.005. Epub 2010 Aug 17
All the best in healing To Health as a Skill Dr Bill
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Interstitial cystitis(IC) is a chronic disease with an unknown cause from the currently practiced matter or molecular science medical discipline And the treatments are random due to this reason
From an energy science medical view IC is a painful pelvic syndrome not necessarily localized to the bladder due to the failure of the body to eliminate the hot and mobile qualities from the pelvis usually due to toxic load also localized in the pelvis This disease as in all diseases according to the energy science tradition originates in the gut and hence the foundational approach for treatment must include a shift in nutrition
So it makes sense that you would remove the hot and mobile qualities from the foods ingested if you want to make any headway in the management of IC The mobile quality is found in many foods in different forms but one of the obvious foods is carbonated drinks Air is mobile and gas containing foods have air in them; in carbonated drinks the air is carbon dioxide
The mobile quality is directly responsible for the urinary frequency and urgency associated with the abnormal voiding pattern of IC and the overactive bladder syndrome(OAB) But it doesn’t stop at IC because these same qualities are involved in chronic prostatitis, fibromyalgia, vulvodynia, IBS and GERD
But there is also the burning sensation associated with IC and the hot quality is responsible for this physical sensation in the pelvis The OAB does not have much of this quality so urinary frequency and urgency with or without incontinence predominate as symptoms
It’s not quite intuitive how carbonated drinks produce the hot quality Usually the drink is taken over ice anyway(ice is not a good idea anyway from a digestive point of view) so where’s the hot quality come from?
Anything that’s acidic in the body contains the hot quality There is heat associated with digestion and when you digest food with the stomach acid and the enzymes to break down food you are using the hot quality
It turns out that all the favorite carbonated drinks carry orthophosphoric acid This is now a much publicized ingredient to Coca Cola The drink is so acidic that it is used as a pesticide, a commercial grade cleaner for car batteries, engines, and removing rust from surfaces If you leave a penny in a glass of coke over a week, the penny will dissolve into solution!
The upshot of our discussion today is that carbonated drinks for anyone is problematic but for you with IC it will provoke your symptoms and can instigate a painful pelvic or bladder flare And then you can add chronic prostatitis, fibromyalgia, vulvodynia, IBS and GERD because all of these seemingly unrelated diseases are associated with the hot and mobile qualities If you want you can add as a waste basket term CPPS or chronic pelvic pain syndrome
This is the tip of the iceberg when it comes to energy science food recommendations for IC The matter science nutrition makes their recommendations based on anecdotal experience so in essence guess work is involved when it comes to recommendations
The energy science nutritional approach is different It asks for no consumer feedback, does not equivocate, and produces the list grounded in a deep science of an understanding of the workings of Nature herself The body obeys the laws of Nature and physics I make no claims that energy science cures everything including IC Energy work is not a quick fix but with diligence discipline and assuming a different lifestyle, you can bring harmony to the body and resolve IC
Have an awesome week Love Dr Bill
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The body is simultaneously an energy and matter field based on your perspective
The bladder pain that is seen in IC flares can be viewed as either a molecular problem(matter science) or an imbalance in energy patterns in the urinary tract The predominant theory of the matter or molecular science is that the glycosoaminoglycan(GAG) layer becomes disrupted and allows urine irritants to infiltrate the bladder wall leading to the painful flares of IC
The energy science of Ayurveda completely concurs that there is disruption due to acidic loading but notes it as an imbalance of too much of the hot quality(inflammation or high Pitta) rather than naming a molecule at fault The urinary frequency, urgency with or without incontinece due to the mobile quality of high Vata Since the energy science is a qualitative one there is no evaluation of molecules as in the matter science discipline
The endoscopic photos above show variations of crystalline formations on the renal papillae as a prodrome of stone disease of any form or size
I have long contended in my urological practice that the vast majority of patients with stone disease have a GAG layer disruption in the kidney that predisposes them to stone disease And I have suggested to them that they use aloe vera gel and a Pitta pacifying nutritional format or one used at foodsheal.com after taking the questionnaire
In this month’s International Urogynecology Journal a group from Taipei reported on a study of a population of patients of painful bladder syndrome and controlling for other associated diseases such as IBS, fibromyalgia, chronic fatigue syndrome, chronic pelvic pain(CPPS). depression, and chronic pelvic pain found that those with prior stone disease were at higher risk for developing PBS or IC
There has been one other study suggesting an association but this is the first population based study to show the association between the chance of forming stones and suffering from IC or PBS
From the above discussion the GAG layer is secreted by all cellular tubes that communicate with the outside So the respiratory tree, the GI tract, and the urinary tract linings all produce GAG layers
So it would make complete sense that deficient GAG layer in the urinary tract would not have to be necessarily located just singularly involving the bladder but could involve the kidney GAG layer as well If this occurs the faulty papillary GAG layer in the kidney would not be slimy/smooth enough to prevent papillary crystals to form to serve as a nidus for continued stone growth
If the hot quality of Pitta can break down the GAG layer in the bladder it can certainly do the same thing in the kidney leading to stone formation
So it comes as no surprise that nutritional format reducing the Pitta energy pattern foods used is a solution not only for IC but also for stone disease as well This would reduce those foods that are inflammatory and bring the hot quality in those patients who are predisposed to either stone disease or IC
The use of aloe would begin to help restructure the deficient GAG layer and making it whole again would be the solution to preventing stones in the future
What you are witnessing here is the unique interplay between the energy science and matter science disciplines where both support each other in a holistic way
Of course it goes without saying that IC and a person with stone disease should be treated in the same way as the problem is from an energy science view Pitta and Vata imbalances in the urinary tract
All the best To Health as a Skill Love DrBill
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It’s estimated that 50 to as high as 70% of people experiencing IC have spontaneous resolution of bladder pain symptoms or after a period of time go away entirely or move to a more manageable symptom complex. This is typified in the accompanying bell curve graph which shows to the left of the line those that have resolved completely or have manageable symptoms and those to the right who have repeated flares for an extended period of time.
This latter debilitated group of patients(CPPS) suffer not only unrelenting flares but lose marriages, relationships, and jobs leaving them on disability, helpless and with little positive outlook. I believe the urologist is equally frustrated with these tormented souls as the pharma tools that they have are often inadequate for the job. This is primarily because the origin of disease by the matter science is not understood and hence the pharma used is not targeted therapy.
Anyone with chronic interstitial cystitis(IC) with numerous trips to the urologist has experienced cystoscopy and catheterizations necessary to instill medicinal agents such as DMSO or medications such as heparin and steroid. Some patients who have severe frequency and urgency are taught to by some urologists to do self administered intermittent catheterization thinking that decreasing residuals might help these lower tract irritative symptoms.
The energy science of Ayurveda has used catheterization for 1000’s of years and it is called basti. There are many different forms of basti dependent on what locale of the body’s anatomy the healer wishes to treat. Basti is used for various disease states from eye disorders to low back pain to constipation.
Basti helps to target the specific imbalanced organ in this case the bladder but can also be used for vulvodynia or vaginal pain which I blogged about in the past using topically administered herbs placed by hand or tampon.
Recently in the past 12 years there has been growing interest in the cancer literature on “targeted therapy” which has been used to describe cancer treating molecules that specifically “target” specific cancer cell processes that arrest cancer growth. This avoids the broad chemotherapy effects that can be hard on treated patients.
I have described in previous posts that the origin of disease is understood from an energy science perspective to be an imbalance in qualities. When herbs are used they specifically “target” the imbalance in the organs that are symptomatic, in this case the bladder or vagina.
What herbs target the bladder lining and can be used safely for topical intravesical use? Let’s list them.
Aloe vera gel This time honored herb reduces the hot of inflammation and so is excellent when the Pitta energy pattern is causing the burning in the pelvic cavity as well as on urination or vaginal burning.
Cumin Coriander Fennel These three herbs are medicinal to the urinary tract since all are cooling to the bladder mucosa. Taken orally as a tea or making a decoction to deliver other herbs to the bladder mucosa can be therapeutically effective.
Goksura(aka Caltrops) This herb is an antiinflammatory and targets the urinary tract and can be effective in reducing stone formation hence suggesting that it is important in GAG layer function. It is also a nervine and shows the broad effects that happen to be characteristic of herbs in general. It is one of the roots in dashamula below.
Guduchi This is a commonly used herb for high Pitta conditions because it’s a rejuvenative for Pitta but has the unique quality of heating hence useful in toxic conditions which is often the case when there is longstanding IC.
Dashamula This is a combination of 1o roots all with specific properties hence the name which means 10 roots. Whenever there is Pitta in the tissue the tissue there is Vata as well and this herb is helpful in clearing the Vata energy pattern from the bladder wall.
Shatavari This herb is tissue building and great for high Pitta conditions. As I have said earlier it should not be used if there is a condition called polycystic ovarian syndrome.
Neem This is a commonly used antiinflammatory and great for high Vata conditions and debility.
If you know how to self cath then this type of therapy under guidance as to which herbs to use is fairly easy.
If you can’t cath then accessing your friendly urologist to help with the instillation of the tea can be done. The instillation schedule varies according to the clearance of symptoms but usually would be daily for at least 8 days while doing other therapies.
I have found basti as targeted therapy to be immensely rewarding for chronic IC over the years. Try it, you’ll like it!
To Health as a Skill DB
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When confronted with a chronic disease two questions usually come up 1 Why is this happening to me? 2 How can I get relief from these miserable symptoms that are plaguing me day in and day out? The first question will be difficult to answer based on the current model of healing and is based on theory
And the second question is more to the point of “allow me to get comfortable so I can at least function” This question also has loads of responses doing online searches because you are empathetic to the other’s suffering and want to alleviate it if you can What would life be like without this chronic pain? What would I be able to do that I can’t do now?
The FDA approval for the surgical use of Medtronic’s InterStim is for the OAB syndrome not IC And the urinary frequency/ urgency and urge incontinence is improved by the device in about 50-70% of cases as reported in 2009 but usually doesn’t eliminate completely the voiding difficulty so as to give normal bladder function The use of the device has carried over into the IC patient group because of the desperate needs of the IC patient to at least control the voiding problem aside from the associated pain
This is to say, the IC pain complex will not be taken care of by the device As always there are anecdotal reports of pain cessation but this is not what the device is designed for
There will always be a surgical or mechanical alternative to chronic pain or for that matter any problem Weight loss surgery, pancreatic islet cell transplant for diabetes, and for the OAB InterStim has become a surgical option in the management of IC If you pass a 2 week trial period then a permanent stimulating neuromodulator can be placed in a subcutaneous pocket overlying the right gluteal region
The bladder is innervated by the sacral nerve roots S2-3 By placing needles that emit a low grade electrical current to the nerves going to the bladder, the nerves sending signals from the bladder that urination needs to occur(resulting in frequency, nocturia, and urgency) get overridden by the nerve stimulator The result is a reduction in the bothersome voiding pattern of OAB but not the pain complex
Complications range from 10-25% and related to the mechanical aspects of the procedure such as infection and dislodgement of the wires due to falling or jarring can occur particularly if the needles are not well seated At times such stimulation can bring on chronic pain from the placement compounding the problem rather than making it better
Surgery is a part of the energy science of Ayurveda discipline It clearly recognizes that surgery can be the best option in certain patients But it also brings to the table a rich understanding of the origin of disease and therefore uses the surgical option in a more refined way When adding the matter science technological approach to disease this can lead to a very effective holistic medical system
With this being said the use of a mechanical device should not be offered unless there has been an adequate trial of nutrition using energy science guidelines Over the last 10 years I have personally witnessed OAB symptoms resolve using this kind of nutritional approach
As discussed in my upcoming book, IC Bladder Pain Syndrome, the OAB separates itself from the disease label of IC due to the pain component You see the OAB problem is a Vata disturbance of bladder function whereas the IC disease label is a Vata AND Pitta disturbance of the bladder leading to not only the OAB symptoms(Vata) but the Pitta energy pattern presence leading to the sharp shearing pain of IC that can be episodic and recognized as the flare
Using a surgical approach is an option Using a nutritional approach is an option But if the latter has not been given an adequate trial then that leaves the former as the only viable option
So my suggestion is to not act too hastily and give the energy science approach a really good trial before you open yourself up to the potential problems associated with surgery And if you elect to have the implant know that the pain may not be affected
All the best To Health as a Skill Love DB
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Interstitial cystitis(IC) bladder pain with flares can be amplified by the routine use of nuts of any kind and this includes their butters!! Peanut butter, almond butter, cashew butter
Unlike the matter science(MS) nutritional information that fatty acids are good and bad, the energy science(ES) of Ayurveda states that all nuts are inflammatory due to these molecular fatty acids regardless of the “good or bad nature of them” The reason for this is that the post digestive(small bowel) effect is heating therefore inflammation provoking
The sweet taste of many foods covers the acidic nature of the foods itself and this is true of the nut category This is why the ES nutritional information trumps the MS guesswork around nutrition and is why the anecdotal information of the MS nutritional realm is at times confusing hence flares and then no flares What gives? This also explains why various other inflammatory conditions are interrelated with IC such as fibromyalgia, IBS, chronic fatigue syndrome(CFS), GERD, prostatitis(did you know that PSA is a marker for inflammation?), and CPPS(chronic pelvic pain syndrome)
As an aside this sweet taste of nuts in general make them a great choice for building tissue since the sweet taste is anabolic
Sorry to blow your day if you crave the mixed nuts but there is certainly a favorite guideline of mine and that is “There are no hard guidelines in the ES realms” Know that if you use the foods that are provoking that you increase the likelihood of a flare That use of inflammatory foods will keep you up at the ceiling of the curve below rather than allowing your mindbody to do the rebalancing as the curve progresses to the right(BTW the ascent from the left shows how we gradually get sick over decades by our own choices(Oh shoot, you didn’t have to say that did you?)
Journey to Balance
Soaked and peeled almonds(this is very important! or you can use slivered almonds from the bulk section of the grocery store if they have one ) are very helpful for their nutritive benefit but also for their cooling effect Turns out that the skin of the almond holds enzymes that in and of themselves are inflammatory Almonds are not actually nuts but in the end who cares
Charole(actually seeds like sunflower) is another nut choice It’s a very small nut found in very few stores in the US(I know because Ive looked; let me know if you have a source that you would share with the community) and is heating but due to the size and its energetics is acceptable and does not provoke Pitta(more about this energy pattern in future blog posts)
And of course coconut because it’s COOLING! The general energy science principle is this: Plants that grow in hot climates are there for a very specific reason Their job is to make the environment cold(well cooler) and so Momma Nature is always taking care of balancing herself
What about nut milks? Almond Breeze is made from blanched and peeled almonds so a great drink Coconut milk also is a very nutritious drink and both these “nut” milks make great date shakes More about that in the future
Here are three options for substitution without provoking inflammation or the Pitta energy pattern in the physiology
Use the above three recommendations and make your own nut butters from the slivered almonds
Sunflower seeds can be used by anyone anywhere anytime Sooo.. sunflower butter sold at Trader Joe’s is an excellent proprietary product and the best tasting sunflower butter on the planet Have tasted many and this by far is the closest to peanut butter with a nice sweet taste Mmm good!
Give yourself “permission” to have a few nuts every once and a while if the craving is too great The ES reminds us that food cravings are a result of imbalanced digestion so the faster we can improve our digestion the better it will be
Interested in a free ES consultation with me? Just tap on this link
Or sign up to join our growing ES IC community!
Well enough for now Until next time To Health as a Skill Love DrBill
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read moreLast time we talked about a long list of Ayurvedic lifestyles that will enhance immunity Here’s a shortlist of trace metals that are important in immunity which is the only way we individually will improve our immunologic response when infected by a viral load such as COVID 19 Nasal breathing Many of us breathe through the mouth The simple transition to nasal breathing can enhance nitric oxide which improves immunologic response among other things Neti use can improve immunity directly and indirectly Because it clears ...
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