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Interstitial Cystitis (IC) is an excruciating chronic condition that is characterised by irritation of, or damage to, the bladder wall. According to NHS Digital, there were 330,000 admissions to hospital, indicating patient complaints of urinary-related problems associated with IC.
IC is a condition that is often discussed along with Painful Bladder Syndrome (PBS), because the two conditions share similar symptoms. These include:
The main difference is that IC patients have cystoscopic (lesion or ulcer-like) areas on the bladder wall in addition to the PBS symptoms.
PBS is diagnosed when a patient experiences persistent or recurrent pain in the urinary bladder region and at least one other symptom. Some examples include increased pain when the bladder is fuller, and more urinary frequency at specific times of the day or night.
There is no known cause. IC is typically associated with negative cognitive, behavioural, or emotional consequences attributed to symptoms affecting the lower urinary tract as well as sexual dysfunction.
This specific bladder pain disorder impacts more women than men. About 14 million UK residents live with IC. Many patients describe IC’s negative impact on quality of life. Fatigue, anxiety, and depression can accompany the pain. IC may flare up due to stress, hormone changes, diet, and other factors.
Interstitial cystitis symptoms are different for each patient, but the most common symptoms include the following:
Conventional therapies include orally administered pain medication, physical therapy, nerve stimulation, bladder distention, and (in rare cases) surgery.
Tablets or capsules may be used to treat people with BPS (interstitial cystitis). These include over-the-counter painkillers such as paracetamol, nerve pain medication, nonsteroidal anti-inflammatory drugs, and even certain antidepressants.
Other treatment components may include biofeedback, diet-based therapies, herbal remedies, massage, and meditation practices. Complementary and alternative medicine therapies are increasingly incorporating plant-based medicine including CBD oil into their way of life.
CBD oil is the extracted compound cannabidiol in a carrier oil to facilitate absorption via sublingual or digestive routes. CBD oil is produced in varying strengths, and sometimes additional terpenes or flavors are added to the oil.
CBD oil is an extract of the hemp (or cannabis) plant, which contains high levels of cannabidiol (CBD). CBD oil can come in many forms, but there are three main types: full-spectrum, broad-spectrum, and isolate.
Here in the UK, CBD products containing less than 0.2% THC are legal for over-the-counter sale, meaning that anyone can legally buy CBD oil without a prescription. One pertinent point to be aware of is that over-the-counter CBD options are subject to less stringent regulatory oversight than medicinal, prescribable, CBD options.
Another interesting point, or theory (to be more precise), to be aware of is the "entourage effect”.
What is the entourage effect?
Simply put, the entourage effect refers to the synergistic effect of the various compounds found in cannabis, specifically the cannabinoids, terpenes, and even possibly the flavonoids. When these compounds are offered together in a single CBD oil, they may work together to enhance the therapeutic benefits of CBD. Certain terpenes have also been found to offer health benefits on their own, but when combined with CBD, these benefits may be synergistically enhanced.
CBD oil has been shown to potentially help with many health concerns, especially symptom reduction. CBD (and all medical cannabis products) should be seen as one small part of a holistic treatment regime and never as some kind of "magic cure-all". Recent research has shown that CBD oil is generally safe and potentially effective for managing pain, anxiety, and many other complaints.
To understand how cannabinoids (CBD included) have the ability to modulte certain bodily functions, including pain levels, we need to look at the body's own endocannabinoid system (ECS).
This is a complex network of receptors (CB1 and CB2), neurotransmitters (endocannabinoids), and enzymes that help the body maintain homeostasis or balance. This system is interconnected with various other physiological pathways and plays an important role in many bodily processes. It has been shown to essentially work as the “master regulator” of the body's entire system.
CBD and other cannabinoids fit into these receptors like a key in a lock, activating them to produce various effects. CBD can bind with CB1 and CB2 receptors, but the exact mechanism of action is complex due to the extensive number of pathways involved in this type of reaction. It has also been shown to reduce the rate of enzymatic breakdown of our own endocannabinoid, Anandamide (AEA). This allows AEA to persist in the system for longer, amplifying its effects.
It is thought that CBD may help reduce the inflammation and pain associated with IC and PBS. In addition, it may also reduce the pain associated with bladder spasms, which are common symptoms of both conditions. CBD's anti-inflammatory and pain-reducing properties have been investigated in numerous studies.
While the research directly relating to CBD and its effectiveness in reducing the symptoms of interstitial cystitis is somewhat lacking, there is one study that we can reference.
“Cannabidiol as a Promising Therapeutic Option in IC/BPS: In Vitro Evaluation of Its Protective Effects against Inflammation and Oxidative Stress”, which was published in March 2023, looked into the potential effect of CBD in alleviating the symptoms of interstitial cystitis. If found that CBD treatment of urothelial cells significantly decreased TNFα-upregulated mRNA, which in turn resulted in the huge potential for the reduction of symptoms.
And although there may not be a bunch of specific IC/CBD research to pull from, the more general research into CBD and its ability to act as an anti-inflammatory and pain reliever is widely available.
CBD has been shown to reduce the levels of pro-inflammatory cytokines, and also inhibits T cell proliferation. What does this mean, exactly? Well, that CBD has beneficial pharmacological effects, including anti-inflammatory and antioxidant properties, and has therapeutic potential for many diseases associated with oxidative stress.
Another showed that topical CBD reduces inflammation and pain-related behaviours, and one more study looked into CBD effects on TRPV1 Signaling Pathways, with a specific focus on pain reduction.
Sleep problems and anxiety are common issues that go hand in hand with many health complaints, and this is true for sufferers of interstitial cystitis. The pain and the need to urinate can have a devastating effect on sleep patterns, which often leads to anxiety surrounding the idea of sleep. “Cannabidiol in Anxiety and Sleep: A Large Case Series” offers great insight into how effective CBD is in potentially alleviating much of this anxiety, while also acting as a powerful sleep aid.
All of this evidence points to the potential of CBD as a therapeutic agent in the reduction of IC symptoms. With more research being conducted all the time, hopefully we will have a clearer understanding of the exact mechanisms behind the health potential of CBD, but for now, it’s safe to say that it holds great potential.
Many medical professionals anticipate that CBD will be a predominant role in future chronic bladder pain treatments.
There is a multitude of ways that CBD oil can be administered. From topical creams, to sublingual (under the tongue) drops, and even in a wide range of pre-dosed edibles, the world of CBD is certainly an interesting one.
But, before you make any decisions regarding your treatment plan, we heavily recommend seeking the advice of a doctor that is both registered to, and experienced in prescribing medicinal cannabis.
Sure, you could just head out to your closest health food store and grab a bottle of CBD oil, but for the best chance at symptomatic reduction of interstitial cystitis, it’s best to have an understanding of all the potential options available to you.
As we mentioned above, the consumer CBD market, while regulated, is less so than the medicinal sector. The products prescribed by doctors are subject to rigorous testing, and the dosages are much more accurately prescribed.
When it comes to CBD dosing for treating interstitial cystitis, there is unfortunately no definitive answer. Every person’s body works differently, and everyone responds to different dosages in varying ways. Again, a doctor will be able to best guide you in dosing CBD oil.
Side effects of CBD administration such as dizziness, nausea and grogginess can be at least somewhat common, but most patients report that they are mild and easily resolved when use is tapered or stopped.
It is also possible that CBD oil and some medications will interact negatively, so consult your prescribing physician about dosing concerns and potential interactions, especially if you are taking prescribe pharmaceuticals.
Emerging data points to the safety and efficacy of CBD oil to manage interstitial cystitis symptoms. As with most medicinal cannabis research, thanks to the almost century-long prohibition on marijuana, there is still much to be learned. The best way to ensure the safety of your CBD oil use for IC treatment is to consult with a doctor who is knowledgeable in medicinal cannabis and has experience with treating IC patients.
If you like to know more about the potential of medicinal cannabis, we are here to help.
It is important to seek medical advice before starting any new treatments. The patient advisors at Releaf are available to provide expert advice and support. Alternatively, click here to book a consultation with one of our specialist doctors.
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