Thursday, August 22, 2013

Mast Cells, Interstitial Cystitis, and Is Diet Alone Enough to Treat Bladder Symptoms?

Mast Cells and Interstitial Cystitis
Hi Everyone! I originally wrote this in response to a crazy thread on a popular Interstitial Cystitis Facebook page. The group asked whether people used antihistamines as a part of their treatment, but the discussion turned into a debate about whether it is ok to use medications at all, or if a person can control IC strictly through "natural" means. The fact that people were judging each other's use of medication or not had me wishing there was a "dislike' button to use on Facebook!

Please think about what you post, my friends. These narrow-minded, judgmental views can really hurt patients who are trying desperately to get better. It is never helpful to "shame" another patient into doing something or not doing something, and often confuses an already confused person. 

As a registered dietitian nutritionist who treats interstitial cystitis patients, I know it is a rare patient who can manage their symptoms only with diet. Using the IC Diet to determine personal food triggers is a HUGE help with symptoms, and around 90% of patients feel some relief when they take out the worst offenders. Indeed, we find that other treatments work better when IC patients manage their diet. Think about it! You wouldn't take sandpaper to a scraped knee three times a day, or soak a cut finger in lemon juice three times a day, why would you eat bladder buster foods three times a day when you are trying to heal it?

Now, while I believe the interstitial cystitis diet is an essential part of the treatment plan for IC patients, I never want to discourage patients from combining it with other treatments. As an example, many IC patients have an excess of mast cells in the bladder lining and when those cells are irritated, either by some allergic response or even stress, they release histamine (you may have heard of degranulation) and this can increase IC symptoms. If you doubt that stress can cause this, think about the fact that some people get hives when they are under stress. Yep, same mechanism involved. Hives are degranulating mast cells too.

So, YES, taking an antihistamine can help control this process, and Atarax or Vistaril (Hydroxyzine compounds) or sometimes other antihistamines like diphenhydramine (Benedryl) or certinzine (Zertec) can greatly help IC patients. In addition, they often have the effect of reducing anxiety and helping a person sleep, again, contributing to the well-being of a sleep-deprived anxious bladder patient.

I have taken hydroxyzine for years, and I have had some other nice side effects! First of all, with my IC better controlled, I can eat a  much wider variety of foods than I could without it. That helps me create a healthier body than I could if I had to continue to restrict the types of foods I eat. I also used to have horrible allergies in the fall and the hydroxyzine that I take for my IC is enough to control that. In addition, I am allergic to cats, and I can now live with my two furry babies. So all around, although I understand the motivation of some people wanting to take the "natural" route, the quality of my life is immensely better with the drug than without.

As with anything you read on this blog, I am not dispensing medical advice. I ALWAYS ALWAYS want you to talk to your physician to determine the best treatments for you. Antihistamines, both prescription and over the counter versions, can have serious side effects or interact with other drugs you may be taking. Always err on the side of caution and work with your doctor.

Finally, Here is an article that explains things in a little more depth: Interstitial Cystitis and Mast Cells

Author, Speaker, Patient Advocate

Helping Yourself Is the First Step to Getting Well

For step by step guidance for creating your own personal interstitial cystitis meal plan, see: Confident Choices®: Customizing the Interstitial Cystitis Diet.

For some basic, family-style, IC bladder-friendly recipes, see: Confident Choices®: A Cookbook for Interstitial Cystitis and Overactive Bladder

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