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Chronic Prostatitis: When antibiotics and pain meds aren’t enough

Chronic Prostatitis Dr. Eric Viegas Naturopathic Medicine Ottawa

Chronic Prostatitis: When antibiotics and pain meds aren’t enough

 

Dr. Eric Viegas, ND

 

Chronic Prostatitis is an inflammation of the prostate gland and commonly affects young males who have had a previous viral or bacterial infection. It is estimated that about half of all males will be diagnosed with some form of prostatitis during their lifetime. About 90% of these men fall into the category of chronic prostatitis (CP). CP can be caused by a history of sexually transmitted infections and E. Coli, but also occurs without the presence of bacteria or viruses. The most commonly reported symptom in CP is continuous or spasmodic pain that is described as “dull” or “aching”. Pain occurs either in the perineum, penis, scrotum, or low back. Urological issues like incomplete emptying of your bladder, obstructed flow, pain on urination & ejaculation, and sexual dysfunction add to what is usually an already high level of psychological stress.

 

Chronic nonbacterial prostatitis (CnbP), CP without the presence of an infection, is a multifactorial condition; psychological stress, lack of physical activity, food sensitivity, allergies, autoimmunity, and neuromuscular dysfunction are theories of possible triggers in the development of CnbP. After a thorough assessment to rule out other possible diseases, doctors will often prescribe antibiotic and pain relief therapy. Unfortunately, non-bacterial prostatitis has a tendency to recur after antibiotic therapy, and pain medications carry risks of gastrointestinal bleeding if used long-term.

 

Interstitial Cystitis (IC) shares symptom overlap with CPPS. People with IC develop pain, irritation, and urinary problems without the presence of an infection. Unfortunately, both IC and CPPS are treated with antibiotics for symptom relief, but antibiotics are not recommended as a primary therapy; nor should they be used if a person has failed to respond to antibiotics in the past. Men diagnosed with CP and CnbP may have IC; in which case, they fall into the category of Chronic Pelvic Pain Syndrome (CPPS).

 

Quercetin, a bioflavonoid I mentioned in my seasonal allergies post, is an excellent anti-inflammatory nutrient and mast cell inhibitor. Mast cells release histamine in your body, and have been found in high concentrations in the bladders of people with IC. A combination of quercetin, nettle root, pygeum, and curcumin may benefit people who suffer from IC and CP. A quality of life increase, and a decrease in symptoms of CP were reported by men with CPPS after a month long trial of Nettle, Pygeum, Curcumin, and Quercetin with antibiotics. Cernilton, a blend of rye pollens, has been used in the past to successfully treat urinary problems in men with benign prostatic hyperplasia (BPH); an enlargement of the prostate. BPH is similar to CP in that there is usually obstructive and inflammatory problems in the prostate and urinary ducts. Cernilton may benefit men who suffer from CPPS and CP by improving urinary symptoms, pain, and quality of life. A healthy inner bladder wall is lined by a protective substance known as glycosaminoglycans. The use of the glycosaminoglycans glucosamine, chondroitin, and sodium hyaluronate may help with symptoms of IC.

 

Men with CPPS do not have to suffer in silence. There are alternatives to commonly prescribed medications that can significantly improve urinary symptoms and quality of life. For more information on which nutrients and therapies are right for you, speak to your naturopathic doctor.

 

References:

  1. McGowan C., Krieger J. Prostatitis, Epididymitis, and Orchitis. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases 2015; Updated Edition 112: 1381-1387.
  2. Matsui, Hirofumi et al. “The Pathophysiology of Non-Steroidal Anti-Inflammatory Drug (NSAID)-Induced Mucosal Injuries in Stomach and Small Intestine.” Journal of Clinical Biochemistry and Nutrition 48.2 (2011): 107–111.
  3. Forrest JB, Schmidt S. Interstitial cystitis, chronic nonbacterial prostatitis and chronic pelvic pain syndrome in men: a common and frequently identical clinical entity. J Urol. 2004;172(6, pt 2):2561-2562.
  4. Katske F., Shoskes DA., Sender M., et al. Treatment of interstitial cystitis with a quercetin supplement. Tech Urol 2001; 7: 44-46.
  5. Cai T, Mazzoli S, Bechi A, Addonisio P, Mondaini N, Pagliai RC, Bartoletti R. Serenoa repens associated with Urtica dioica (ProstaMEV) and curcumin and quercitin (FlogMEV) extracts are able to improve the efficacy of prulifloxacin in bacterial prostatitis patients: results from a prospective randomised study. Int J Antimicrob Agents 2009; 33(6):549-53.
  6. MacDonald R1, Ishani A, Rutks I, Wilt TJ. A systematic review of Cernilton for the treatment of benign prostatic hyperplasia. BJU Int. 2000; 85(7):836-41.
  7. Wagenlehner FM1, Schneider H, Ludwig M, Schnitker J, Brähler E, Weidner W. A pollen extract (Cernilton) in patients with inflammatory chronic prostatitis-chronic pelvic pain syndrome: a multicentre, randomised, prospective, double-blind, placebo-controlled phase 3 study. Eur Urol. 2009 Sep; 56(3): 544-551.
  8. Theoharides TC. Treatment approaches for painful bladder syndrome/interstitial cystitis. Drugs 2007; 67: 215-235.

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