Painful bladder syndrome/interstitial cystitis: Current concepts and role of nutraceuticals

Chronic pelvic pain syndrome (CPPS) affects approximately 1 of 60 adults in the United States and is associated with significant disability and poor quality of life. Painful bladder syndrome/interstitial cystitis (PBS/IC) has emerged as a major cause of CPPS along with irritable bowel syndrome (IBS), endometriosis, and chronic prostatitis (CP). PBS/IC is a heterogeneous clinical syndrome occurring mostly in women, with some evidence suggesting it may have similar features to CP. PBS/IC is characterized by severe pelvic and perineal pain, as well as urgency and frequency of urination in the absence of a bacterial infection or bladder cancer. PBS/IC is associated with other comorbid conditions, such as allergies/asthma and fibromyalgia, that are worsened by stress. Neurogenic inflammation leading to neuropathic pain has been increasingly implicated in PBS/IC. There are no curative treatments. Management of PBS/IC should address younger, newly diagnosed patients. This could be accomplished with unique nutraceutical formulations containing natural bladder lining rebuilding and antiinflammatory molecules, such as chondroitin sulfate, sodium hyaluronate, and quercetin.