Q. I frequently have a burning sensation in my bladder, especially when I urinate. I've been told that I may have something called interstitial cystitis. Can you explain what this is, how it's treated and what alternatives there are to drugs?

A. Interstitial cystitis is a chronic inflammatory condition of the bladder. Symptoms of the condition include pelvic pain and frequent, urgent, painful urination. Although the symptoms resemble those of a bladder infection, people who have interstitial cystitis don't show any bacteria in their urine cultures. The cause is unknown, but it may be due to genetics, an autoimmune condition, or an unidentified infectious agent. It has been found that people with interstitial cystitis have a defect in the protective layer of the bladder wall known as the GAG (glycosaminoglycan) layer.

In the United States, some 700,000 people have interstitial cystitis, and 90 percent of them are women. An interstitial cystitis diagnosis is made after a urologist has done an exam, called a cystoscopy, and finds tiny hemorrhages on the bladder wall. Other tests to assess for interstitial cystitis include a biopsy, and a potassium chloride sensitivity test, which reveals deficiencies in the GAG layer.

The conventional Western approach to treating interstitial cystitis includes the prescription drug Elmiron to help rebuild the GAG layer, local medication and chronic pain medications.

Complementary treatments for interstitial cystitis include techniques to decrease bladder spasms, increase control over the bladder and decrease bladder pain sensation. These treatments consist of physical therapy of the pelvic floor, bladder retraining, biofeedback, stress reduction, and dietary changes.

There are a number of naturopathic and traditional Chinese medicine treatments for interstitial cystitis. Avoiding food allergies and food intolerances is paramount to the success of therapy. Herbal teas, such as marshmallow tea and corn silk tea, help coat and sooth the mucous membranes of the bladder and urethra. N-acetyl-glucosamine helps decrease pain in the bladder by rebuilding the GAG layer.

Homeopathic medicines can also be useful in treating symptoms of intolerable urgency to urinate, and pain with or after urination. The most commonly prescribed remedies include cantharis, apis and sarsaparilla.

In Chinese medicine, the approach to treating interstitial cystitis is to work with the body's qi, or vital force. Acupuncture and Chinese herbal medicines can be quite effective in alleviating spasms and decreasing the pain associated with interstitial cystitis by increasing the flow of qi, nourishing yin and yang (two aspects of qi), and treating the underlying cause of the disorder.

By using multiple approaches to treatment, many of my patients with interstitial cystitis have experienced remarkable improvement in their symptoms and their quality of life, often without taking drugs.

Laurie Steelsmith is a naturopathic physician and licensed acupuncturist in Honolulu, as well as author of "Natural Choices for Women's Health" (Random House). You can reach her and read her past columns at www.DrSteelsmith.com. This column is for information only.