Irritable Bladder Syndrome

Over 400 million people in the United States experience bladder discomfort, and about 90% of them are women. While bladder pain can feel overwhelming, it's important to remember that there are many causes, solutions, and ways to support healing. Understanding your body is the first step toward reclaiming comfort and control.

 

 

Common Causes of Bladder Pain

 

Urinary Tract Infections (UTIs)

 

UTIs are a well-known cause of bladder pain. They can cause bladder muscle spasms and a burning sensation when urinating. They are often bacterial, but sometimes infections can be viral or fungal, and standard urine tests may not detect them.

 

 

Interstitial Cystitis (IC)

 

IC is bladder inflammation without an infection. Seven hundred thousand to one million people of all ages in the United States have Interstitial Cystitis. People with IC may notice stiff areas, scarring, or small bleeding patches on the bladder wall. Up to 10% of IC patients may also have Hunner's ulcers, which can increase discomfort. Because the bladder becomes sensitive to stretching, pain often occurs when it's full. Think of it like stretching scar tissue. It's uncomfortable, but manageable with the right approach.

 

Causes of IC or Bladder Pain Syndrome (BPS) are as follows:

 

  • Allergies
  • Autoimmune disease, including Sugar Disease
  • Defects in the lining of the bladder wall
  • Bladder trauma (surgery, rape, injury)
  • Abnormal substances in the urine
  • Unusual infections that are not looked for in standard tests (viruses, fungi, strep)
  • Bladder Cancer or radiation to the pelvic area (IC doesn't typically lead to Cancer)
  • Nerve problems (inflammation, hypersensitivity), such as Pudendal Neuralgia (see below)
  • Pelvic Floor Dysfunction
  • Drugs or chemicals that affect the bladder
  • Constipation (a full rectum can press on the bladder, creating pressure and discomfort. The nerves connecting the bowel and bladder can trigger bladder pain)
  • Sjogren's Syndrome
  • Shingles and other viruses (see below)
  • Bladder overextension (not being able to go for hours on end)
  • Some say arginine makes IC worse (it's the amino acid that feeds the herpes virus, by the way), while those who do not live with herpes often say arginine helps to relieve IC. DO NOT consume large amounts of arginine if you live with HSV.

 

Related conditions are migraines, endometriosis, IBS, vulvodynia, asthma, panic attacks, and sensitive skin. Those with IC are 100 times more likely to have IBS and 30 times more likely to have systemic Lupus. They are also at higher risk for Chronic Fatigue and Fibromyalgia syndromes. Interestingly, herpes viruses are implicated in IBS, CFS, and FS.

 

 

Intertial Cystitis FAQ:

 

  • Normal repair to the bladder doesn't occur in IC, allowing particles to leak into the bladder wall and cause pain. The cells of those with IC produce a protein called APF (antiproliferative factor), which prevents the bladder from healing. APF isn't present in those without IC. 

 

  •  Some studies reveal that there's no relationship between IC and gluten.

 

  • Some say dietary changes substantially help, while others say they don't. This could be due to not following the proper diet for the correct "cause" of IC. For example, an anti-yeast diet for Candida can help with IC caused by a fungus, but not IC caused by a bacterium, such as Streptococcus (Strep). Strep can take up residence in scar tissue in the bladder. 

 

  • Pain memory can be a cause of IC. Repeated inflammation increases the sensitivity of nerves leading to the bladder and pelvic area, eventually causing the pain to become chronic.

 

 

Viral Cystitis

 

Certain viruses, such as Epstein-Barr (mono) and Varicella-Zoster (shingles), can also contribute to bladder pain or dysfunction. HSV-2 (genital herpes) can also affect the bladder. Viral bladder infections exist, though they're rarely tested in standard UTI screenings.

 

 

Irritable Bladder Syndrome (including Overactive Bladder)

 

Irritable Bladder Syndrome can cause a range of symptoms:

 

  • Bladder pressure or pelvic discomfort
  • Frequent urges to urinate with little output
  • Incontinence with laughing, sneezing, or exercise
  • Urine retention or accidental leakage
  • Pain is described as burning, pricking, cramping, or shooting sensations

 

This condition can result from infections, nerve irritation, constipation, hormonal changes, diet, or stress, among other factors. Importantly, each case is unique, and understanding your triggers is key to managing symptoms.

How Infections May Hide

 

Bacteria, viruses, and fungi can sometimes hide behind biofilms, protective layers that make them invisible to standard urine tests. This means that even negative tests don't always rule out infection. E. coli is often blamed, but it accounts for only 28% of UTIs, and other microbes can be involved. Many, such as herpes viruses, hide under biofilms. 

 

 

Other Factors That Influence Bladder Health

Hormonal Imbalances

 

Low estrogen, for example, can thin the urethra and vaginal walls, making infections more likely. Balancing hormones can be empowering for bladder comfort.

 

 

Diet & Sensitivities

 

Some foods, beverages, and substances may irritate the bladder, including:

 

  • High-histamine foods (such as aged cheeses, soured and fermented products, and certain teas)
  • Oxalates (found in foods such as spinach, nuts, beans, and chocolate)
  •  Acidic foods (such as oranges, tomatoes, cranberry juice)
  • Caffeine, alcohol, and carbonated drinks
  • Artificial sweeteners and processed foods

 

Here's a more detailed list of foods that can irritate the bladder:

 

  • Dairy: Aged cheese, sour cream, yogurt, kefir
  • Vegetables: Fava beans, lima beans, onions, tofu, soybeans, mushrooms (some people are okay with white mushrooms and mushroom extracts), and store-bought tomatoes.
  • Fruits: Apples (sour), apricots, avocados, bananas, cantaloupes, citrus fruits, cranberries (use supplements instead), grapes, nectarines, peaches, pineapples, plums, pomegranates, rhubarb, strawberries, acidic fruit juices, bananas (bother some people and not others)
  • Grains: Fermented foods (sourdough, fermented rye bread, kombucha, kefir)
  • Meats & Fish: Aged, canned, cured, processed, or smoked meats and fish. Food containing nitrates or nitrites, such as anchovies, caviar, chicken livers, corned beef, and meats.
  • Nuts: Most nuts. Almonds, cashews, and pine nuts are okay. Peanuts are fine for some people and not others.
  • Beverages: Alcohol, carbonated beverages, coffee, and some tea. Fruit juices, especially citrus or cranberry juice.
  • Seasonings/Condiments: Mayonnaise, ketchup, mustard, salsa, soy sauce, and miso. Salad dressing and vinegar, including balsamic and flavored vinegars. Spicy foods, which include those from Chinese, Indian, Mexican, and Thai cuisines.
  • Preservatives & Additives: Benzol alcohol, citric acid, monosodium glutamate (MSG), artificial sweeteners, such as aspartame (Nutrasweet) and saccharine. Foods containing preservatives, synthetic ingredients, and colors.
  • Miscellaneous: Dark chocolate, tobacco, caffeine, junk foods, yeast, sugar, hot spices, gluten, diet pills, and recreational drugs. Cold and allergy medications containing ephedrine or pseudoephedrine. Specific vitamin C, B-complex, and multivitamins (certain brands or manufacturers). Vitamin A, D, E, calcium, and magnesium are okay. 
  • Interestingly, honey can actually support bladder health for some people, due to its antiviral and antibacterial properties, but reactions vary by individual. If you're going to use honey, make sure it's not mass-produced, as it may contain pesticides and corn syrup (both can irritate the bladder). Instead, purchase Manuka honey or raw, organic honey from local markets.

 

 

Stress and Psychological Factors

 

Chronic stress may weaken the bladder's defenses, contributing to pain through the body's chemical processes. Being "pissed off" all of the time (angry, bitter, resentful, fearful) adversely changes body chemistry. Mind-body practices, gentle exercise, and self-care can help restore balance and calm in the body, including the bladder.

 

 

Nerve or Muscle Issues

 

Tension, injury, childbirth, or surgery can cause muscle tightness or nerve irritation in the pelvic floor or lower back —a condition known as Pelvic Floor Dysfunction —that can lead to bladder discomfort and, when nerves are affected, pain. Targeted exercises, stretching, massage, and physical therapy can bring relief. A chiropractor can help alleviate issues caused by pinched nerves. However, for tight muscles, seeing a massage therapist is a better option.

 

 

Supportive Practices for Bladder Health

 

Hydration

 

Drink plain, pure water to flush the bladder and dilute irritants. Avoid sugary or caffeinated beverages, as they can worsen symptoms.

 

 

Bathroom Habits

 

  • Go when you feel the urge, but avoid "hovering" at every tiny urge.
  • Take your time emptying your bladder fully. Gentle shifts in position can help. A tip for older women: Give your labia a gentle tug to open the vaginal "lips" and improve urine flow.

 

 

Diet, Herbs & Supplements

     

    • Selenium works to keep the Herpes Simplex Virus dormant. If you suffer from recurrent outbreaks, consider taking 55-100 mcg of this essential mineral daily (no more than 200 mcg).

     

    • If your bladder problem isn't pain but overactivity (having to "pee" way too often), pear juice, aloe vera juice, and nuts (almonds, cashews, and peanuts) can calm the bladder. However, nuts are high in arginine and feed the herpes virus, so if your bladder pain is related to herpes, avoid foods high in arginine or take a lysine supplement to offset arginine.

     

    • Oxytrol (patches) for an overactive bladder is also an over-the-counter product you may want to try. Please read the fine print for instructions and potential side effects.

     

    • Bromelain (an enzyme found in pineapple) is a potent anti-inflammatory that helps prevent bladder irritation.

     

    • Pumpkin seed extract helps strengthen the pelvic floor muscles and the control of muscles that regulate urine flow. Taking the extract in conjunction with performing pelvic floor exercises can help accelerate the healing process.

     

    • Oregano, garlic, and sage work against HSV-1, stomach flu, Murine Norovirus (MNV), and Respiratory Syncytial Virus (RSV). Oregano tea can help flush out harmful bacteria from the urinary tract, including the bladder. However, you'll have to use twice as much Oregano tea as other teas for this purpose (8 one-cup servings daily for 3-4 days using one teaspoon of oregano per cup). This is fine viral advice, but you need to know that aromatic herbs may irritate an already sensitive bladder. 

     

    • Lemon balm, rosemary, fennel, and holy basil are known to combat all herpes viruses, which can cause Viral Cystitis. Of these, lemon balm is the number one choice. The other three may be too aromatic for a sensitive bladder.

     

    • Pipsissewa (Chimaphila umbellata) leaf tea breaks down kidney stones, disinfects the urinary tract, and heals urinary tract and bladder infections. The active ingredient is hydroquinone, which also helps fight upper respiratory infections. It works as a diuretic similarly to uva ursi, but contains fewer tannins, making it more suitable for prolonged use. You can use pipsissewa for Rheumatoid Arthritis and Gout. For tea, use one teaspoon of dried herb to 8 ounces of near-boiling water. Steep for 2-4 minutes. If you like, you can add milk and raw honey to taste. Pipsissewa tincture is also available. Individuals with iron deficiency and poor nutrient absorption should avoid using this herb. Long-term use (more than a week or two) can cause side effects such as Tinnitus, vomiting, confusion, and seizures. It's unknown whether this herb is safe for pregnant or nursing women, so it is best to avoid it in these cases.

     

    • According to Dr. Axe, Lactoferrin helps fight bacteria, viruses, and other microbes by boosting immunity. For immune support, take 100-600 mg daily on an empty stomach. It can also be used to support iron absorption, treat anemia, and help with acne. No side effects and no signs of toxicity have been reported. N-acetylcysteine and morinda citrifolia (Noni/Indian Mulberry) are beneficial for bladder healing. These ingredients, along with lactoferrin, are formulated in a product called Ausilium NAC, although I don't believe it's available in the United States. In my opinion, lactoferrin is the best ingredient of the three for bladder health. Lactoferrin is an ingredient in a Uqora product, but not in the dosage Dr. Axe suggests.

     

     

    What To Do Specifically for Bladder Pain

     

    • Parsley is antibacterial, antiviral, and a diuretic. It's also a diuretic, helping to flush out the bladder. Almost everyone can drink 3-4 cups of parsley tea daily without experiencing any side effects. Take three days off every seven days. To make parsley tea, add one teaspoon of dried herb to 1 cup (8 ounces) of near-boiling water. Steep for 5-7 minutes and sip. If you are taking diuretics, pregnant, or nursing, please don't use parsley. 

     

    • Quercetin is a natural antihistamine and antioxidant that helps manage histamine in the body. If your bladder pain is due to histamine breaking down in the bladder (excruciating), quercetin is your go-to supplement. You can learn more about Quercetin under Histamine Intolerance or Supplements for HSV.

     

    • PEA (Palmitoylethanolamide) is natural in some foods and in the human body. It is highly anti-inflammatory and reduces pain. It also helps to rebuild the bladder lining, preventing acids and toxins from irritating it. This is extremely important for those with Interstitial Cystitis (bladder pain with negative test results), where the bladder lining either doesn't heal or heals very slowly. PEA can be taken at high doses with no known side effects or toxicity. Taking 600 mg daily for 2-3 months is entirely safe for adults. 00 mg daily for maintenance thereafter has been suggested, while others suggest taking a short break. It's questionable how PEA might react with drugs and during pregnancy. Click here for more information. 

     

    • Fennel is antibacterial, antiviral against all herpes viruses, and anti-inflammatory.   must be crushed or ground before using in tea or food. You can combine parsley and fennel to make tea. se ne teaspoon of dried herb to 8 ounces of near-boiling water. 

     

    • D-Mannose is a type of sugar found in fruit. Like cranberry supplements, it can help ease bladder pain by preventing harmful, pain-causing bacteria from adhering to the bladder wall or urinary tract, or flushing them out once they do. Numerous studies indicate that D-Mannose is effective, if not superior, to antibiotics for bladder and urinary tract infections, and can also alleviate symptoms of Interstitial Cystitis (pain with no infection) with little to no side effects. Mild  digestion, bloating, stomach discomfort, soft stools, and slight bladder irritation, which can mimic a bladder infection, may occur when used for preventive measures. Switching to a different brand may help alleviate the issue. Taking  Mannose is safe even when taking Diabetes medication. It doesn't interfere with antibiotics or urine tests. Studies vary on dosage, so I designed a plan on what I thought would be appropriate, and my urologist agreed. Take 1.5 t spoons daily for 3 days, then 3/4 teaspoon for 10 days. You'll want to take it in divided doses. Take 1/2 teaspoon in 1 cup of water, three times a day, for three days, and 1/4 teaspoon in 1 cup of water, three times a day, for ten days. Precautions:  Mannose is derived from birch tree juice, cranberries, pineapple, or corn, so your bladder might become sensitive if you have allergies to any of these. Don't take D-Mannose if you have SIBO, as it could worsen your symptoms. If you are trying to get pregnant, D-Mannose can bind to sperm and knock it out of the ballpark, making it harder to fertilize an egg. And anyone with genetic disorders, MPI-CDG or PMM2-CDG, might suffer Diabetic-like symptoms when taking D-Mannose. Also, taking too high a dosage of D-Mannose (or taking it for too long) may cause Depression. However, symptoms quickly dissipate once you stop taking it (within a couple of days).

     

    • Aloe vera supplements can help reduce inflammation in the body and the bladder, and thereby reduce pain. It contains some D-Mannose. Aloe vera contains glucomannan, a fermentable fiber that supports the growth of some healthy bacteria. However, fermented products are one of the things to be wary of when it comes to bladder pain.

     

    • Raw honey (Algerian or Manuka honey is best) contains antiviral and antibacterial properties. It can help to combat harmful bacteria, such as E. coli, and viruses, while also soothing the digestive system, detoxifying the bloodstream, and reducing bladder inflammation. O NOT use mass-produced honey, which may contain chemicals or corn syrup, which can cause bladder irritation in some people. And, don't boil your honey. It becomes acidic. 

     

    •  Nephrocalcinosis, such as calcium, magnesium (malate or citrate), zinc, and, specifically, potassium citrate, buffers the effects of acidic wastes and toxicities that may affect the bladder and cause pain. Be sure to eat foods rich in minerals or take supplements.

     

    • Place an ice pack on your lower spine and tailbone. Major nerves that lead to your bladder stem reside in this area, as does the Herpes Simplex Virus when you live with HSV-2. You can also try placing an ice pack over your bladder or between your legs (touching between the vagina and anus or between the testicles and anus) for 20 minutes, then rest for 20 minutes (or alternate with a heating pad). Repeat up to 4 times, and break for 1 hour.

     

    • Drinking 1/4 teaspoon of baking soda in two cups of warm water in the morning and again in the evening can help balance the pH of the bladder.

     

    • Cranberry supplements can help the bladder by reducing the likelihood that certain bacteria will adhere to the bladder wall. o not substitute whole cranberries, cranberry juice, or dried cranberries for this remedy. Cranberries are mildly acidic. If you notice worsening symptoms with cranberry supplements, discontinue use.

     

    • Vitamin C (non-acidic) is antiviral and immune-modulating. Foods and supplements containing citric or ascorbic acid can irritate the bladder, especially when it is inflamed or raw. When choosing a vitamin C supplement, ensure it's ascorbate and includes bioflavonoids. Esther C is suitable. 

     

    • Cornsil has been used to remedy bladder infections and relieve pain. They are best used as tea, rather than capsules, for bladder issues.

     

    • Do all you can to reduce Histamine Intolerance. Certain foods and products, such as deodorants, air fresheners, and cleaning products, can increase your histamine load, potentially leading to increased inflammation in the body and bladder pain.

     

    • Prebiotics and probiotics can help replenish and support the growth of beneficial bacteria in the gut, vagina, and bladder. However, it's essential to take the right ones, as some probiotics can raise histamine levels. Histamine released in the bladder causes pain.

     

     

    Exercise and Physical Care

     

    • If you have bladder dysfunction, DO NOT perform Kegel exercises, which firm and tighten the bladder. Instead, to strengthen pelvic floor muscles and improve bladder control, perform gentle stretching, walking, yoga, and posture adjustments to reduce tension that impacts bladder nerves.

     

    • Consider supportive shoes (avoid heels) and avoid tight clothing to reduce strain on your body.

     

    • Don't sit in one position for too long without getting up to stretch for a few minutes. 

     

     

    Mind-Body Practices

     

    Stress management, relaxation, and mindfulness can reduce inflammation and improve bladder comfort. Emotional awareness, forgiveness, and letting go of anger can support overall wellness.

    When to Seek Medical Guidance

     

    • Persistent or severe pain, obvious blood in your urine, or the inability to urinate (pee)
    • Suspected infections, hormonal imbalances, or autoimmune conditions
    • Bladder dysfunction related to nerves or past trauma

     

    Your doctor may recommend treatments like GAG layer injections.   Glycosaminoglycan (GAG) injection consists of a clear, colorless liquid that temporarily replaces the bladder lining. It primarily consists of sodium hyaluronate, a naturally occurring glycosaminoglycan found in the bladder lining. This layer is deficient in painful bladder conditions and may provide the bladder wall with a protective coating against bladder irritants in the urine. Prescription medications, herbal therapies, or lifestyle adjustments may also be discussed. Oregon grape root is an anti-inflammatory and antibacterial that naturopaths often use to treat UTIs.

     

    However, it's crucial to know that while doctors treat bacterial infections with prescription antibiotics, they may sometimes cause more harm than good. I'm not saying they can't be helpful in emergencies, but they don't work against biofilm communities, and antibiotics don't kill viruses or fungi. Furthermore,  while antibiotics may help treat first-time infections when caught early on (unless the wrong antibiotic is used), they won't affect biofilms. Moreover, biofilms tend to become resistant to any antibiotic taken, and they can pass this resistance to their offspring. Additionally, using low-dose suppression therapy (administering a smaller dose over a more extended period) can promote greater drug resistance and increase infection risks.

     

    Doctors often prescribe an antidepressant for Irritable Bladder Syndrome (and Irritable Bowel Syndrome). Here's why. Anxiety and Depression can cause hormonal changes that adversely affect the bladder and cause pain. Reducing stress reduces the chances of hormone cascading, thereby reducing inflammation and pain. Antidepressants also contain analgesic properties.

     

     

    NSAIDS

     

    • Over-the-counter pain medications, such as acetaminophen (Tylenol), may help to ease the pain associated with bladder pain. However, Tylenol disrupts gut bacteria and can cause constipation, which is associated with bladder pain. Take Tylenol as directed to avoid liver problems.

     

    • Aspirin can be used to relieve pain and reduce inflammation. However, children under 18 should not use Aspirin as it can cause Reye's Syndrome, which can be deadly in children with fever. spirin can also cause Pruritus (all-over itch). Ibuprofen is anti-inflammatory but has many side effects, including stomach and liver problems, and the threat of making COVID-19 symptoms worse.

     

    Always work with your healthcare provider to find the safest, most effective solutions tailored to you.

    A Message of Hope

     

    Bladder discomfort is common and manageable. With the proper knowledge, self-care, and professional support, you can regain comfort, strengthen your bladder, and improve your quality of life.

     

    Empower yourself with information, gentle practices, and holistic care. Your body is resilient, and relief is possible.

     

     

    Also see Herbal Antibiotics and Herbal Adaptogens & Antivirals.