Even if you diligently follow all steps to keep your interstitial cystitis (IC) symptoms under control, there may be times when you experience an IC flare. Learn to recognize what triggers your IC flares. Some common IC triggers include diet, medicines (including certain vitamins and supplements), exercise, sexual intercourse, hormone fluctuations, stress, certain modes of transportation or long trips, and even tight clothing.
What is an IC Flare?
IC flares are not the same for everyone. Nearly 750 people responded to a 2009 ICA Quick Poll asking them to define an IC flare. Definitions included:
- Period of extreme pain with increased urinary frequency/urgency across several days or weeks (19%).
- Sudden increased intensity of symptoms (12%).
- Dramatic increase in IC symptoms across several hours (7%).
- Worsening of symptoms from baseline (5%).
- Subtle worsening of symptoms (4%).
- Over half (52%) of the IC patients surveyed felt that all of the above definitions defined an IC flare.
In an online ICA survey, about 440 patients offered advice for someone newly diagnosed with IC about how to best cope with an IC flare. Almost half of the respondents (43%) thought that learning your triggers, and, if possible, planning ahead and being realistic about your limitations were the most important pieces of advice.
Other advice included:
- If there are medicines that help you, take them at the onset to decrease the length of a flare (24%).
- Learn the things you can do to help reduce the length of the flare (13%).
- Stop, rest, and take care of yourself (11%).
- Reach out to other IC patients for emotional support (4%).
- Call your doctor and ask what to do (3%).
- Ask you family and friends for extra help (<1%).
If you feel a flare coming on, you may get some relief with these simple strategies that can be done at home:
- Drink some additional water to dilute the concentration of your urine. This can be especially helpful if you are experiencing a diet-related flare.
- Place a cold pack, heating pad, or hot water bottle directly on the perineum (area between the anus and vagina in women, and anus and base of penis in men). Experiment to see whether cold or heat works best.
- Take a warm sitz bath, with or without Epsom salts. Draw a small amount of water into the bathtub or use a plastic sitz bath (available at drug stores), which fits over the toilet.
- Place your knees against your chest, reclining with spread legs or adopting a squatting position. This will help to relax your pelvic muscles.
- Drink a glass of water mixed with one teaspoon of baking soda to help to reduce burning sensations. Consult your doctor first if you are on a salt-restricted diet.
- Be sure to take your medicines. If your healthcare provider gave you specific medicines for flares, this is the time to use them.
- If you think that you have a urinary tract infection (UTI), contact your healthcare provider to have a sample of your urine tested. You can also purchase an at-home UTI test kit to conduct your own preliminary test. If it is positive, see your doctor immediately for treatment.
Be Proactive and Plan Ahead
Start treating a flare-up as soon as you feel it beginning to happen. The sooner you start treating it, the sooner you will conquer it. The longer you let a flare go, the longer it can take to stop it. And, it may build in intensity, requiring even more interventional strategies, including self-help therapies to prescribed medicines such as oral and intravesical (instilled in the bladder) treatments. Here are some general self-help techniques to keep your bladder calm and help you reduce the possibility of a flare:
- Try relaxation techniques
- Use meditation tapes and/or visualization
- Learn self-hypnosis
- Receive massages or learn self-massage
- Go to psychotherapy to learn coping skills and stress reduction techniques
- Take a time-out for yourself -- relax and rest as often as possible
Clothing Flare Tips
If you notice a flare coming on when you are wearing panty hose, tights, tight jeans, slimming undergarments, girdles, or any other garment that places restriction around your waist and pelvic region, take off the restrictive item immediately. Sometimes just removing the clothing offender will help to bring some relief. In place of pantyhose, try thigh-highs.
Intimacy Flare Tips
For many people with IC, intimacy can trigger a flare:
- Before sex: Use antispasmodic or pain-reducing medicines.
- During sex: Use lubricants to reduce discomfort during intercourse.
- After sex: Take a 20-minute sitz bath and place an ice pack on the perineum for 20 minutes after sexual activity. This can be especially helpful in addressing the pain that some people with IC experience for a day or two following intercourse.
Travel Flare Tips
Bouncing and vibrations from cars, buses, trains, planes, and other modes of transportation can cause IC flares because this jars the pelvic region. Short trips may be necessary for a time if you are frequently experiencing flares or you are already in the midst of a flare. To sooth travel flares:
- Learn about finding restrooms on-the-go.
- Sit on comfy pillows to minimize bouncing and vibrations.
- For car travel, carry a portable potty or bedpan in the car. Some IC patients have even installed portable toilets in vans. Portable female urinals are also useful.
- For air travel, arrange ahead of time for an aisle seat near the toilets. Restrict fluids before and during flight if you are prone to urinary frequency.
- Women can wear absorbent pads and men can use a condom catheter while flying or traveling by other modes where access to a restroom is sometimes restricted.
- Try not to travel during peak seasons when things are more hectic and unpredictable.
- Find out in advance the location of restrooms along your route. Search the web before you head out—there are lots of sites with online bathroom ratings. And, some cities have guidebooks that list public restrooms, check your bookstore or library.
Revised November 30, 2010