WellBladder.com

Frequently asked questions about bladder health concerns will be answered here, in straight-forward explanations.  Email any questions you have to:  bewell@wellbladder.com

What is Interstitial Cystitis?

Interstitial Cystitis or IC is a syndrome of bladder inflammation and dysfunction, characterized by symptoms of frequency, urgency, and pain.  Symptoms are relieved by urination and exacerbated by having a full bladder.  People with IC often feel as if they have a bladder infection, but standard urinalysis test show that they do not.  Patterns of urination are abnormal.  Patients with IC urinate many times per day.  In moderate cases of IC, patients may void 14-18 times per day.  In severe cases, patients may void 25 or more times per day.  Many times very small amounts of urine are voided, and some patients experience difficulty urinating, or pain with urination.  Urine sometimes contains blood and lymphocytes (white blood cells usually present in infection), but no bacteria are detected in lab tests.  Patients with IC also have greater levels of histamine and substance P in their urine than non-IC patients in control groups.  A person with IC may have significant pelvic inflammation and may experience a worsening of symptoms at certain times of their menstrual cycle, indicating that hormones may play a role.  They may be unable to tolerate eating certain foods because they make symptoms worse.

What is Over-Active-Bladder?

Overactive bladder, or OAB, is a term used to describe a condition in which frequency and urgency interfere with normal patterns of daily living.  Pain may or may not be a part of the symptoms experienced.  This appears to be a catch-all diagnosis used when other more serious bladder diseases have been ruled out, there is no infection, and symptoms continue to persist.  Patients with this diagnosis are often prescribed medications such as Detrol, Ditropan, Vesicare or Enablex to help control symptoms.

What is Bladder Retraining?

Bladder retraining is aimed at increasing bladder capacity and normalizing voiding patterns by gradually increasing the time between voids, regulating fluid intake, and learning relaxation techniques to avoid the sense of extreme urgency.

What is Celiac Disease?

Celiac Disease, also called Celiac Sprue, and Gluten Sensitive Enteropathy, is a genetic autoimmune disorder in which the people lack the ability to digest the proteins found in wheat, all wheat relatives, barley, and rye - commonly grouped together under the term "gluten".  Gluten is the sticky substance that gives bread and pizza dough a stretchy texture.  Gluten is found in all foods made with wheat, barley and rye, including bread, pastries, cereals, pastas, and beer, and in many packaged foods and mixes.  People with Celiac Disease cannot eat these foods without experiencing toxicity and symptoms ranging from mild to severe gastro-intestinal distress, neurological effects such as mental fogginess and weakness, joint pain, skin rashes, mouth ulcers, and general inflammation anywhere in the body - INCLUDING THE BLADDER! These symptoms are not caused by gluten, but by the immune system's response to gluten, which causes an auto-immune reaction, in which the body attacks its own tissues.  See more below.

What is an Autoimmune disorder, or Autoimmune response?

Auto-immune disorders include such well-known diseases as rheumatoid arthritis, type I diabetes, Lupus, and Multiple Sclerosis.  Several studies have been done to investigate whether IC is an auto-immune disease.  Celiac disease, described above, is an auto-immune disorder.  Auto-immune disorders involve a process in which the immune system over-reacts, producing inflammatory cytokines and other substances in response to a perceived invasion, and mistakenly targets the body's own tissues.  In Rheumatoid Arthritis, the tissue attacked is mainly the joints and connective tissue, in Diabetes, the pancreas, in Multiple Sclerosis, the nervous system.  In the past, one of the few treatments for autoimmune disorders was steroids such as Prednisone, which had serious side-effects and consequences for long-term use.  Newer treatments include TNF (Tissue Necrosis Factor) blockers, which help prevent damage to the bodies tissues, and suppress the immune system.  There are also alternative medicine treatments for autoimmune disorders that can be explored with a naturopath or a practitioner of Traditional Chinese Medicine.

What can I do when my bladder pain is flaring?

Keeping a diet journal, a simple notebook small enough to fit into your purse, can help you track what foods may be triggering your bladder symptoms.  Bladder pain can be triggered by eating gluten, by food allergies, by "extreme foods" like those foods that are very acidic, very salty, very sweet, very spicy, etc., and certainly expresso is a very extreme food for the bladder-sensitive.   In general, all forms of caffeine, including espresso, regular brewed coffee, chocolate, black tea, and for some even green tea, are very irritating to the bladder. Bladder pain in some women is triggered by hormonal fluctuations, and is much more severe at certain times of the month.  To treat your pain, it is helpful to determine the cause as much as possible.  Anti-histamines can help to minimize pain caused by an allergic reaction.  Over-the-counter anti-histamines, or natural anti-histamines like nettle leaf tea can be carried with you or kept in a desk drawer at your office.  If you have eaten extreme foods, drinking a few glasses of water can  help to flush your bladder out, and dilute the offending substances.  You can also try drinking a glass of water with 1/2 teaspoon baking soda in it, especially if you have eaten acidic foods.  Ask your physician about this first if you have high blood pressure.  Pelvic pain and inflammation can often be alleviated by using alternating cold packs and heating pads over the pelvic area.  Red Raspberry leaf tea is a very old traditional remedy for womens problems and pelvic pain.  It is an anti-spasmodic, and is particularly useful with cramping.  Chammomile tea is another useful herbal remedy, mild and gentle, safe enough for children.  

Is my bladder ever going to get better?

This of course depends on the cause.  Urologists may tell you that IC is a progressive disease, although many people do experience remissions lasting from months to years (This is also true of many auto-immune disorders).  There are many anecdotal reports of people who have recovered from IC, though, and you may be one of these. Persistence and a positive attitude can made a big difference in your progress. 

If you are an older person, do not believe that incontinence is inevitable.   Proper diet, exercise, and physical therapy aimed at pelvic floor rehabilitation can make a difference for you too.

Is my bladder disease inherited?

If you have IC, the jury is still out on this question.  There is some overlap in cases of identical twins with IC, and some mother-daughter cases have been reported.  Recent studies of co-morbidity of disease in Denmark indicated a possible genetic tendency for certain disease groups to cluster, and one of these disease clusters includes IC, panic disorder depression, and Celiac Disease (see "MUST-READ ARTICLES").

Other serious diseases like bladder cancer tend to occur mostly in cases where the patient has been a heavy smoker, coffee drinker, or exposed to harmful chemicals like pesticides.

Can I pass my bladder disease to my sexual partner?

I think that this is somewhat of a gray area.  Most medical sources usually say no, but some anecdotal evidence shows that it sometimes happens.  I think in a case where one partner harbors an occult infection, and sexual contact is frequent and ongoing, transmission is possible.  In persistent cases of contagious chronic illness, it is a good idea to look at all possible vectors, including partners.  This is even true of strep throat - some people may be asymptomatic carriers of streptococcus bacteria in their nasal passages.

COMMON BLADDER IRRITANTS:

• Caffeine (espresso, coffee, tea, chocolate, green tea)
• Vinegar (all types)
• Alcohol (all forms)
• Soy Sauce and other very salty foods
• Sugar - White cane sugar, brown sugar, etc.
• Tomato products - especially canned tomatoes.  Some people tolerate fresh tomatoes well if they don't over-do it.
• Fruits & Vegetables that are high in Oxalates (contain Oxalic Acid) - including spinach, rhubarb, pumpkin, Kale, and others - the web has lots of information on high-oxalate foods.
• Citrus Fruits and Juices
• Yeast
• Dairy Products
• Wheat
• Gluten (Wheat, Barley & Rye) 
• Peanuts and peanut products
• Cranberries and cranberry products
• Certain food additives, including potassium sorbate