Q. I frequently have a burning sensation in my bladder, especially when I urinate. I’ve been told that I may have something called “interstitial cystitis.” Can you explain what this is, how it’s treated, and what alternatives there are to drugs?

Interstitial cystitis (IC) is a chronic inflammatory condition of the bladder. Symptoms of the condition include pelvic pain and frequent, urgent, painful urination. Although the symptoms resemble those of a bladder infection, people who have IC don’t show any bacteria in their urine cultures. The cause of IC is unknown, but it may be due to genetics, an autoimmune condition, or an unidentified infectious agent. It has been found that people with IC have a defect in the protective layer of the bladder wall known as the GAG (glycosaminoglycan) layer.

In the United States, 700,000 people have IC, and 90% of them are women. A diagnosis of IC is made after an urologist has done an exam, called a cystoscopy, which shows tiny hemorrhages on the bladder wall in people with IC. Other tests to assess for IC include a biopsy, and a potassium chloride sensitivity test which reveals deficiencies in the GAG layer.

The conventional Western approach to treating IC includes the prescription drug Elmiron to help rebuild the GAG layer, local medication such as DMSO, and chronic pain medications.

Complementary treatments for IC include techniques to decrease bladder spasms, increase control over the bladder, and decrease bladder pain sensation. These treatments consist of physical therapy of the pelvic floor, bladder retraining, biofeedback, stress reduction, and dietary changes.

There are a number of naturopathic and traditional Chinese medicine treatments for IC. Avoiding food allergies and food intolerances is paramount to the success of IC therapy. Herbal teas, such as marshmallow tea and corn silk tea, help coat and sooth the mucous membranes of the bladder and urethra. N-acetyl-glucosamine (NAG) helps decrease pain in the bladder by rebuilding the GAG layer.

Homeopathic medicines can also be useful in treating symptoms of intolerable urgency to urinate, and pain with or after urination. The most commonly prescribed remedies include cantharis, apis, and sarsasparilla.

In Chinese medicine, the approach to treating IC is to work with the body’s Qi, or vital force. Acupuncture and Chinese herbal medicines can be quite effective in alleviating spasms and decreasing the pain associated with IC by increasing the flow of Qi, nourishing yin and yang (two aspects of Qi), and treating the underlying cause of the disorder.

By using multiple approaches to treatment, many of my patients with IC have experienced remarkable improvement in their symptoms and their quality of life, often without taking drugs.