When this protective layer is damaged, it may cause the cells to leak, and exposes the small blood vessels in the bladder wall to urine, causing them to become overgrown. In addition, the urine can trigger nerve networks that are present in the deeper layers. As a result, burning, pain and frequent urination can result.
Dr. Gillespie discovered that IC was the result of a myriad of different factors, which resulted in damage to the lining and cells of the bladder.
Dr. Gillespie postulated that certain antibiotics might, if no bacteria were present, end up attacking the bladder tissue itself. This could damage the all important protective layer of the bladder as well as the deeper layers, and cause the body to form antibodies to the altered bladder tissue.
In fact, Dr. Gillespie did biopsies of bladder tissues in women with IC and found that in one group of women the immune defence system of the body had been activated. A certain antibody pattern was found in bladder tissues if the woman had used nitrofurantoin, and another distinct pattern was found if erythromycin or tetracycline has been used. A third pattern was found if a combination of these drugs was used.
And as in other auto-immune diseases, where antibodies are formed against the body's own tissues, antibody formation can cause symptoms in a woman's joints, lungs and bowels.
In fact, as Dr. Kristene Whitmore, Associate Professor of Urology at the University of Pennsylvania, points out in her excellent book,OVERCOMING BLADDER DISORDERS, "Although it is a singular disease in many respects, interstitial cystitis has some striking similarities with certain other {auto-immune} diseases... such as lupus erythematosus, rheumatoid arthritis, asthma, allergic rhinitis (nasal congestion due to allergies) and polyarteritis (inflammation of the smaller arteries)."
Another piece of the puzzle fell into place when Dr. Gillespie realized that many of the foods that bothered her patients with IC contained tryptophan, tyramine or tyrosine. These substances are amino acids which are the building blocks of proteins. They stimulate the production of serotonin and norepinephrine.
Serotonin and norepinephrine are made in the brain from food and transmit messages between nerves. Recently these neurotransmitters were discovered to be present in the bladder and the gut.
Increased serotonin production could account for the electric shocks that some women experience. Increased serotonin and norepinephrine could also cause referred pain to the urethra and the clitoris.
Serotonin could cause blood vessels in the bladder to narrow and go into spasm, resulting in the throbbing bladder pain or "migraine" of the bladder that some women experience.
Over the counter cold medicines, some cough syrups and diet pills make IC worse because they increase the production of norepinephrine.
IC can be caused by the Epstein Barr virus or other viruses. Some women with IC may also have chronic fatigue and immune system dysfunction (CFIDS). Fibromyalgia, now recognized as part of CFIDS, has also been associated with IC.
Viruses can be activated in the bladder by many factors, including a group of chemicals known as the phorbol esters. This group of chemicals is found in paints, lacquers, solvents, industrial chemicals, and in certain glues and polishes used by manicurists.
Dr. Paul Fugazzoto is a microbiologist who has worked in the field over 50 years. He maintains that IC is caused by bacteria not found by the currently used methods of culturing urine specimens. By using different culturing techniques, he has found two predominant bacteria he believes are responsible for IC. The bacteria are known as enterococcus and gaffyka.
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