A urologist and allergist from Louisville, Kentucky got together to explore a possible link between allergies and Interstitial Cystitis with the hopes of possibly being able to provide a more effective treatment for IC. They found out that they were sending patients to each other. Dr. John Hubbard, urologist, was sending patients with seasonal allergies to Dr. C. Steven Smith, the allergist. Dr. Smith was sendind his allergy patients with IC symptoms to Dr. Hubbard. The allergy treatment Dr. Smith was using was helping the IC symptoms and sometimes with dramatic results. Their research was published in the ICA Update. According to Barbara Gordon, executive director of the ICA:
“Until now, the evidence linking IC and allergies has been circumstantial. Epidemiologic studies show the prevalence of allergies in IC patients to be higher than in people in general. Anti-allergy medications seem to ease IC symptoms, especially when patients have seasonal allergies. And during allergy seasons, doctors report an upswing in IC-related calls and patient visits.”
Allergist Dr. Smith says that not only are seasonal allergies a problem for IC patients but also a problem are food allergies. Smith estimates that approximately 35% – 40% of his allergy patients with IC have food allergies. These are confirmed by elimination diets and skin prick allergy tests. IC symptoms in these patients improve when they remove the allergic food(s) from their diet. According to Heather Lange, ARNP, the nurse practitioner who works with urologist Hubbard’s IC patients:
“We’ve been able to identify a lot of food allergies that IC patients didn’t even know they had.”
Dr. Smith said that while the effect on Interstitial Cystitis of treating environmental allergies with shots or medications is “less obvious”, it still appears to be beneficial. He says that about 1/2 to 1/3 of his patients with IC suffer from diagnosed environmental allergies and/or symptoms of hay fever, recurrent ear infections, asthma, or chronic hives.
Together Dr. Hubbard & Dr. Smith are working on a formal study between allergies and IC & they are hoping to gain interest from other researchers as well. One of their main goals in this study is to find a marker that will help urologists decide which of their patients will benefit from allergy testing and treatment. Dr. Hubbard uses cystoscopy and hydrodistention to diagnose Interstitial Cystitis but he takes the procedure a little further. He also takes a biopsy specimen to look for mast cells. He says that when mast cells reach a certain density, the patients respond better to allergy testing and treatment.
Dr. Smith says that not every patient responds to the treatments but for the high number of patients who do benefit, it is well worth the effort. Smith says:
“It’s one of the most rewarding patient care experiences I have ever had.”
There doesn’t seem to be a consensus as to whether IC is autoimmune or allergic. Perhaps both are possible etiologies – and in general autoimmunity and allergies may be closely related. Low dose naltrexone tends to be helpful for both kinds of problems.
I have Ic and allergies. Dr Smith tested me about 10 yrs ago with 8 food allergies. I could not find bread without wheat at that time but there is a little more now but it is usually expensive and taste hard and terrible. any recommendations. Don’t like almond milk but drink it some. How much is naltrexzone to use for Ic. What % does it help. Is it an antidepressant?