Managing Cystitis and Irritable Bowel Syndrome (IBS) with Naturopathy

People with irritable bowel syndrome (IBS) often develop cystitis. Why and how can disruptions to the intestinal flora lead to issues with the vaginal flora? What is the role of a naturopath in such cases? These are the questions Sandra Marianacci will answer in this article.

Intestinal microbiota and cystitis

The microbiota is composed of microorganisms (bacteria, viruses, parasites and non-pathogenic fungi) that live in a specific environment. There are a range of different microbiota in the body (in the mouth, ENT area, skin, vagina and gut).

In this article we discuss the intestinal microbiota, more commonly known by the general public as intestinal flora.

Imbalance to the intestinal flora can cause certain disorders including the urogenital infections that are the subject of our research.

Vaginal flora is closely linked to the intestinal microbiota. As mentioned in the article on “cystitis and probiotics”, these bacteria are essential to protect the mucous membranes and allow the body to function properly. The human microbiota is composed of several trillion microorganisms, mainly located in the gut. Each individual has their own microbiota, which is a sort of unique fingerprint. It is composed primarily of a multitude of lactobacillus and bifidobacteria species.

Inflammatory bowel disease and bowel irritation, what is the link to cystitis?

The most common inflammatory bowel diseases are Crohn’s disease or ulcerative colitis (which differs from irritable bowel syndrome). The main common symptoms associated with these conditions are abdominal pain, constipation, diarrhoea and bloating.

All of these conditions affecting the gut play a major role in chronic cystitis (recurrent cystitis).

Focus on irritable bowel syndrome and cystitis

Our intestinal microbiota is made up of billions of bacteria which, in a healthy body, live in symbiosis: i.e. they coexist harmoniously. These bacteria are all essential for developing a healthy immune system, ensuring high levels of absorption from nutrients and intestinal well-being. Irritable bowel, also called irritable bowel syndrome (IBS) can manifest in several ways:

• Constipation-predominant (IBS-C)
• Diarrhoea-predominant (IBS-D)
• Alternating between constipation-diarrhoea (SII-M or mixed)

It occurs in the form of a flare up, for example after a period of intense stress, with anxiety, fatigue, or following a poor diet, etc.

It has also been shown that patients with irritable bowel syndrome are more prone to bladder irritability.

This condition creates an intestinal dysbiosis, i.e. naturally present “bad bacteria” will predominate the “good bacteria”. And this imbalance will cause constipation, diarrhoea, bloating and wind, and, ultimately, hyper-permeability of the intestinal barrier. This is the barrier that filters food entering the bloodstream: it allows nutrients, vitamins and minerals to pass through it but prevents the entry of bacteria and toxins. When toxins in the body pass through this barrier, they end up in the bloodstream and can then travel through the body to the bladder and cause cystitis. In such cases, chronic bowel irritation will trigger an overactive and irritable bladder. Repeated irritable bowel syndrome flare ups lead to an accumulation of toxins in the body, which then spread to the bladder, which is an organ adjacent to the bowel. This is called interstitial cystitis.

Cystitis, irritable bowel and constipation

Irritable bowel syndrome, also known as functional colopathy, is a chronic bowel disease. “Spastic colopathy”, the old name for this condition, is still sometimes used in the literature. It is a fairly common condition; its characteristic symptoms are mainly abdominal discomfort, diarrhoea, constipation, or an alternation of the two.

What is constipation?

When should you consider that you are constipated? It should be restated that each case is unique and that what is normal for one person may not be for someone else. Some people have two bowel movements a day, while others only every other day. Medically, constipation is described when the situation is accompanied by the following features:

• Less than three bowel movements a week
• Hard stools
• Difficulty in passing stools.

When suffering from irritable bowel syndrome, it is not uncommon to have episodes of constipation. Although, of course, being constipated is not always synonymous of a serious and chronic condition and anyone can be affected by constipation.

It is also worth knowing that poor bowel movements can have a direct effect on the occurrence of cystitis and lead to recurrent cystitis, which is why constipation is an issue to be taken into consideration.

Stagnant stools favour the growth of bacteria in the anal margin. Such bacteria can potentially colonise the bladder and cause cystitis. Ideally, stools should be passed regularly to avoid stagnation and thus prevent an excessive absorption of toxins.

Cystitis, irritable bowel syndrome and naturopathic medicine, what approach?

If you suffer from irritable bowel syndrome (functional colopathy), receiving naturopathic support in addition to your medical care may be advisable. A naturopath will help you reduce the hyperpermeability of your bowel by looking at areas such as your lifestyle and more specifically your diet. He or she will also provide emotional support, which is often an overlooked area; they can help you manage your stress, and learn to reduce or eliminate your anxiety.

A “healthy” microbiota is closely related to your eating habits. For example, the micro-fungi responsible for candidiasis (or fungal infections) are extremely fond of sugary products (soft drinks, refined cereals, chocolate). And, to make matters worse, this type of unhealthy eating habits provide the favourite food source of the pathogenic bacteria that cause cystitis.

The role of a Naturopath is to gain an understanding of how you function and study your eating habits to determine the reasons why you have adopted certain habits. For example, cravings for sugary food are not always trivial and can be explained in several ways. Stress can make you eat to compensate and sugar cravings can mask intestinal candidiasis or a hormonal imbalance.

The aim is to identify the original cause and solve the problem by attacking it at the root, and not by merely acting on a superficial level by alleviating the symptoms.

In a future article will discover some of the good basic habits to adopt for a healthy bowel.

#StoryTime: “Naturopathy is life”!

Élodie, aged 42, an active woman in the prime of her life, and an executive in a well-known consulting firm. She is under constant pressure and her company is extremely demanding in terms of her performance: waiting on her clients hand and foot is essential.

To be at the top of her game, Élodie has a very healthy lifestyle: she is very sporty and enjoys cycling and running. She tries to make sure her diet is as healthy as possible given her busy lifestyle.

For several months, she has not felt her usual self and has been feeling sluggish. She has stomach cramps, bloating, and even - more embarrassingly - sometimes wind, which in her working environment is a real problem. She is losing her grip and her self-confidence as taken a serious hit.

She has seen her general practitioner several times who advised her to consult a gastroenterologist. He prescribed a colonoscopy which was normal.

However, as a result of the various symptoms and tests carried out, the doctors diagnosed that she had irritable bowel syndrome.

Élodie is disconcerted, she feels like she is doing everything right, and yet this has happened. Episodes of diarrhoea or constipation occur repeatedly, without her being able to understand what triggers them.

When taking to a colleague about her problem, the colleague suggested she should see a naturopathic doctor who has now significantly improved her quality of life.

She is intolerant to gluten, oilseeds and some legumes meaning her diet is rather restricted. The naturopath suggested that she first work on her intestinal barrier and recommended that she should take glutamine for two months. Glutamine is one of the amino acids that make up proteins. Among other things, it provides energy to intestinal cells, improves digestion and reduces the risk of intestinal problems, especially before a sports session. At the same time, her naturopath advised her to use foot reflexology to manage her stress.

After a few weeks of taking glutamine and undergoing foot reflexology, Élodie noticed a marked improvement and was delighted with the naturopath. She felt that her stress levels had dropped and a new form of balance was being established in her life. She then realised that she had forgotten to set aside a little time to take care of herself. Her digestion has improved significantly and she has far fewer episodes of digestive problems.

Also, to reduce low-level inflammation – i.e. the inflammatory reactions that are a feature of a gradual weight gain that clog up the body, the naturopath suggested nutritional supplements and an anti-inflammatory diet. The latter, recommended by the naturopath, includes small oily fish and flaxseed among other things.

Then, with the help of probiotics (without Fodmaps = fermentable Oligosaccharides Disaccharides Monosaccharides and Polyols, to avoid fermentation), she strengthened her microbiota.

Since then, her pain has disappeared. She now feels more independent as the naturopath has taught her to listen to her body and to know it better. Élodie knows when her body needs a course of glutamine or probiotics and has learned to recognise when she needs them. She is extremely grateful for her colleague’s advice and also having followed the recommendations of her naturopath.

Reminder:

• Elodie’s case is an actual and specific case, which applies only to this situation and to a particular individual cared for by a doctor and a naturopath.
• Naturopathy, as stated in the article, provides support for a medical treatment, which is essential.
• A naturopath will always tailor their care to a specific individual.