150 patients in the Illinois MCPP have interstitial cystitis (IC), according to the 2018 annual report recently published by the Illinois Department of Public Health. 2.7% of American women and 1.3% of American men suffer from this painful condition. This post will discuss the symptoms, possible causes and treatments of interstitial cystitis.
What is Interstitial Cystitis?
Also called painful bladder syndrome, it is typically chronic and long-lasting. Unlike other bladder disorders, there is no infection associated with it. There is no known cure for the disease. While its causes remain unknown, possibilities include autoimmunity, an allergic reaction, genetics, and a defect in the protective lining of the bladder, allowing the toxins in the urine to irritate and inflame the bladder wall. The onset of symptoms is most common for women in their 30s.
Symptoms vary from person to person. They may also vary over time triggered by menstruation, long periods of sitting, stress, exercise and sexual activity. They range from symptom-free to severe. Symptoms may worsen with the onset of a urinary tract infection. They include:
- Discomfort, pressure, and tenderness in the pelvic area
- Intense pain in the bladder with a sudden need to urinate
- Frequent urination with burning and pain
- Blood in the urine
- Feeling like your bladder is never empty
- Pain or discomfort while the bladder fills and relief after urination
- Disturbed sleep
- Pain during sexual intercourse
Convention treatments include NSAIDs (Nonsteroidal anti-inflammatory drug), antihistamines, antidepressants and pentosan polysulfate sodium which is a blood thinner. These all come with side effects including increased risk for stomach ulcers, bleeding, increased likelihood of bruising, rash and vision problems. Other therapies include nerve stimulation, bladder training, and stretching.
Can Cannabis Reduce The Symptoms of Interstitial Cystitis?
There have been very few human studies of cannabis use on patients with interstitial cystitis. Some have used synthetic cannabis derivatives instead of the cannabis plant. Even in such cases, many subjects experienced a reduction in symptoms, although there were side effects with the synthetic product that would not have occurred with natural cannabis. There have been a few animal studies which I have cited below.
A 2013 study by Wang, Wang, and Bjorling, using mice, appeared in the American Journal of Physiology-Regulatory, Integrative and Comparative Physiology. These findings supported the assumption that cannabis can reduce bladder inflammation and frequent urination due to expressing the cannabinoid receptors, CB1, and CB2, located in the bladder of mice and humans. THC has been proven to interact with CB2 receptors in the endocannabinoid system (ECS). Further research by this team found that activating CB2 receptors with cannabinoids reduced the severity of bladder inflammation.
A 2014 animal study by Wang, Wang, and Bjorling, appeared in The Journal of Urology. The results indicated that the mice treated with cannabinoids showed a reduction in bladder swelling and frequency of urination.
Another animal study by cystitis & Fernando, 1996 and Fulhase, et al. 2014, in the British Journal of Pharmacology, demonstrated the relationship between CB1 receptors and bladder function. Cannabinoids retarded bladder contractions in mice brought on electrically.
A 2006 study by Freeman, et al, treated MS patients with occurrences of urge incontinence with cannabis. This was a random, placebo-controlled trial. The results, which appeared in the International Urogynecology Journal and Pelvic Floor Dysfunction, supported a reduction in such episodes. This suggests that cannabis use would be beneficial for those with bladder dysfunction diseases.
Jill Osbourne, founder, and president of Interstitial Cystitis Network created an online survey to gather information about the experiences of IC patients who used cannabis. There were 118 participants, of which 80 reported to have used cannabis in the past 6 months to control their symptoms. 97% used the delivery method of smoking.
- 18.2% were completely symptom-free
- 63.6% reported a 50% reduction in their symptoms
- 14.8% reported a 25% reduction in their symptoms
- 31.8% pain-free
- 55.7% reported 50% reduction
- 3.4% reported no pain reduction
Muscle Tension & Spasms
- 31.3% muscle tension free
- 43.4% reported 50% reduction
- 12% reported no muscle tension reduction
Frequency & Urgency
- 56% improvement in frequency
- 52% improvement with urgency
- 78.2% improvement in sleep quality
- 27.6% slept through the night
- 50.6% only had to get up once or twice during the night
Many participants reported a significant reduction in anxiety, nausea, stomach cramps, bowel problems and flares with cannabis usage. Human studies are clearly needed to substantiate anecdotal evidence that cannabis relieves many symptoms associated with interstitial cystitis.
Sources: herb.com, Does Cannabis Help Cystitis, The Painful Bladder Syndrome? Anna Wilcox, January 6, 2017
medicalmarijuanainc.com, Interstitial Cystitis-Medical Marijuana Research Overview, November, 2015
ic-network.com, Is It Time To Consider Medical Marijuana For Bladder & Pelvic Pain? Jill Osbourne, November, 2013