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Mail on Sunday – YOU Magazine
11th October 2009
Bladder to better: relief for severe cystitis
By Sarah Stacey
According to some experts, virtually every woman will suffer at least one bout of bacterial cystitis at some point. It’s uncomfortable but relatively easy to treat with antibiotics and lifestyle measures, unlike interstitial cystitis, the more severe (but less common) form of the condition, known medically as painful bladder syndrome/interstitial cystitis (PBS/IC).
Sufferers say the pain is constant and excruciating. There were times when Sara, a 29-year-old from Wiltshire, felt like crashing her car. ‘I didn’t want to kill myself, I just wanted to get away from the pain. It felt like a scalpel going up and down my urethra. Plus I had to urinate so often I could never move far from a loo.’
PBS/IC can affect anyone, but women between 30 and 50 are the most usual group of patients seen by Mr Zaki Almallah, consultant urologist at Birmingham & Solihull Bladder Clinic (thebladderclinic.co.uk).
In America, three to six per cent of women are said to be affected, but Mr Almallah says it’s almost impossible to quantify as so many patients are either not diagnosed or their condition is put down to other causes. ‘There’s a collective denial of PBS/IC by the medical profession because it’s a long-winded process to diagnose, and difficult to cure. It’s poorly recognised and poorly treated.’
It occurs due to a type of inflammation in the bladder, affecting part of the lining called the GAG (glycosaminoglycan) layer. ‘When that becomes defective, it allows toxins from the urine, particularly potassium, to filtrate through to the nerve endings, triggering pain,’ says Mr Almallah.
But the exact cause of PBS/IC is not known, mainly due to lack of research funding. ‘It’s probably a combination of genetic susceptibility [PBS/IC can run in families] and some sort of infection, probably atypical bacteria, which triggers the cascade of inflammation.’
In some cases, such as Sara’s, the infection starts with bacterial cystitis. ‘At 16, I started having to go to the loo very often, and getting a burning sensation. I was prescribed antibiotics, which became less effective.
The symptoms got worse and I ended up taking a course of antibiotics about every two weeks.’ This went on until three years ago, when Sara’s mother found the Cystitis and Overactive Bladder Foundation website (cobfoundation.org) which listed her symptoms under PBS/IC.
Sara also read Solving the Interstitial Cystitis Puzzle: A Guide To Natural Healing by Amrit K Willis, which suggested alkalinising urine by cutting out acidic foods, including tomatoes, citrus fruit, wine – and cranberry juice: ‘I used to drink masses because it’s standard advice for bacterial cystitis, but I didn’t know the acidity would exacerbate IC.’
Her GP, who agreed with her self-diagnosis, prescribed a painkiller and Sara can now live a ‘relatively normal’ life.
Recently, a treatment called a ‘bladder instillation’ has helped many patients. Compounds such as heparin, hyaluronic acid and chondroitin sulphate are inserted into the bladder to help heal the lining. ‘Up to 80 per cent of patients respond after a course, which usually lasts six weeks. Some may achieve remission, others may need a second course, or sometimes regular maintenance courses,’ says Mr Almallah.
A non-acidic diet is ‘very important’ and various complementary therapies may help, including acupuncture, herbs, hypnotherapy and stress-reduction techniques. He is also happy for patients to try d-mannose, a natural extract which is anti-inflammatory.
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