Help for painful bladder condition.
Naperville Sun HealthAware column:
Patients learn to manage painful bladder syndrome
March 25, 2013
A urinary tract infection hits many people — especially women — at some time in their lives. But picture having bladder pain and problems with urination as a chronic condition. That’s the case for people with painful bladder syndrome, also known as interstitial cystitis, or IC, which afflicts an estimated 3 million to 8 million women and 1 million to 4 million men in this country. Primary symptoms include bladder pain, or urgent and frequent urination.
According to Dr. Michael Moen, of Illinois Urogynecology, and medical director of Edward Hospital’s Women’s Center for Pelvic Medicine, “Diagnosis of this syndrome can be elusive. Symptoms vary, and urine tests for infection come up negative. Many of these women have gone months, even years, without the correct diagnosis.”
Unlike those patients, Holly McGrail, 46, of Plainfield, had been diagnosed with painful bladder syndrome before coming to the center. She was taking Elmiron, the one FDA-approved oral medication for IC. She also had received some instillations — insertion of medications into the urethra — to numb and calm the bladder.
At McGrail’s first session, the center’s nurse, Carol Vignali, spent about 30 minutes with her discussing the emotional, as well as physical, aspects of the disease.
“I felt someone was really listening to me and showing compassion,” says McGrail, who was asked to keep a diary to help in guiding her treatment plan.
McGrail then saw Dr. Michael Noone, a urogynecologist with the Women’s Center and member of Illinois Urogynecology.
“Dr. Noone also spent a good amount of time with me,” she says. “This is something I haven’t experienced in other settings.”
Treatment options for IC range from simple bladder retraining and dietary changes in mild cases, to implants of electronic pacemakers for the bladder in more stubborn cases.
“Rather than trying one treatment technique at a time, we find a comprehensive approach is much more likely to bring good results,” Vignali says.
McGrail’s treatment plan included continuing Elmiron, and using lidocaine and Heparin for a six-month series of weekly instillations. Physical therapy to help relax the pelvic floor muscles was added to the mix. Diet is one of the main factors in McGrail’s management of the condition.
“If I pay attention to the diet, the other treatments are more effective, too,” McGrail says.
“We want to empower patients like Holly to manage their condition,” Dr. Moen says. “An important step is identifying their personal IC triggers.”
These might be foods or medicines, stress, sex or hormonal fluctuations. Patients are initially advised to adhere to an IC diet prohibiting foods and beverages that are commonly problematic. They then reintroduce these items one by one to see which, if any, triggers a flare-up. For McGrail, pop, coffee, chocolate and tomato products are triggers.
“If I have coffee for several days and then pop the same day, I’ll probably have a mild burn,” she says. “I can usually prevent that from turning into a full flare by sticking closely to my diet for a week or so.”
McGrail is also an active participant in Edward’s IC support group.
“People feel encouraged to hear from others with IC that there are ways to manage it,” she says.
Naperville, Illinois (IL) - Edward Hospital and Health Services