L-Arginine
Nobody knows what causes IC. One school of thought believes that there may be a deficient blood supply to the IC bladder and that this may account for the clinical features (pain with a full bladder, relief of pain by voiding, a small capacity bladder, the tendency to get infections etc.) as well as the cystoscopic (glomerulations and haemorrhages) and experimental findings (leaky bladder wall) we associate with the condition. For this reason recent reports on the apparent beneficial effects of L-arginine in IC are quite exciting.
L-arginine is simply an amino acid, one of the building bricks that make protein molecules. The key to L-arginine's action lies in a tiny molecule, nitric oxide. Arginine is metabolised or broken down by an enzyme called nitric oxide synthesase in all body cells and nitric oxide is released. This little molecule causes several interesting changes at tissue level, the most important of which is to increase blood flow through the tissues. It also helps smooth muscle cells to relax, possibly allowing organs like the bladder to increase their capacity to store larger volumes.
Studies in animals have shown that L-arginine prevents damage to tissues whose blood supply has been compromised by either disease or experiment. These include heart, kidney, skin, retina of the eye and intestine. It prevents ischaemic damage by increasing nitric oxide levels in the diseased tissue and thereby increasing tissue blood flow. You may be interested to know that Viagra, the new impotence treatment, also works by producing high levels of nitric oxide in the penis thereby greatly increasing penile blood flow.
A group of scientists at Yale University found that female patients with IC had very low levels of nitric oxide in their urine compared to that of either control subjects or patients with urinary infections. By taking large amounts of L-arginine these workers showed that the amount of nitric oxide in the urine of IC patients increased and that their symptoms of pain and frequency improved. This is presumably because the bladder's blood supply is being improved by increased levels of nitric oxide within its tissues.
The recommended dose of L-arginine is 1.5 grams per day. It is not a drug as such and therefore does not require a prescription. It can be obtained in most health-food shops and some pharmacies and it can also be taken in conjunction with standard medical treatments for IC. As well as helping with your IC, L-arginine may also confer additional benefits, in particular by preventing and even reversing atherosclerosis (hardening of the arteries).
Paul Irwin MCh, FRCSI(Urol) - A Wee Ray of Hope, Spring 1999