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IC Optimist – Spring 2025 – Print

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Description

Flares are a fact of life for most IC patients. Whether they happen after driving, eating risk foods, sex or are the result of stress and trauma, patients need practical tips and suggestions that will help them through these painful moments. We are happy to release our updated and comprehensive guide to managing IC flares. In this issue, we broaden our discussion to include phenotyping and how your phenotype determines what flares you may struggle with. We include the many different types of flares that patients can struggle with, including their known triggers and rescue plans. For the first time, we include stretches and exercises that you can do to relax your pelvic floor. You'll find new ways to calm your central nervous system in stress induced flares and so much more. We truly hope that this will help you manage and, most importantly, prevent flares. Author Jill Osborne also shares some of her best tips

In this issue:

1. Understanding IC Flares

This guide is all about flares, those sudden moments when our symptoms get inexplicably worse. Many IC/BPS patients have found themselves frustrated by the fact that flares keep happening. This chapters reviews flare basics, how long flares can last, how your phenotype predicts your flares and how to differentiate between UTI's and bladder wall flares. 

2. Bladder Wall Flares

Bladder wall flares are, by far, the most common flares that occur but not always for the same reason. We review the risk factors, common triggers and a suggested hour by hour rescue plan to reduce frequency, urgency and pain. You'll also have an extended discussion about pain care, including the potential use of opioid medications for more severe pain. For symptoms that persist, traditional therapies such as rescue instillations are discussed as well as when to ask for help and/or to visit the Emergency Room. 

3. Pelvic Floor Flares

Pelvic floor flares occur after intimacy, with driving, travelling and/or sitting for long periods of time. What surprises many patients is that the muscles can also drive urinary symptoms. In this chapter, we receive common triggers and a rescue plan that focuses on relaxing these muscles. We include, for the first time, a series of stretches that you can use to relax and release these muscles, the use of muscle relaxant medications, physical therapy and self-massage.  

4. Pelvic Neuralgia Flare  

One of the most painful flares occur when nerves are compressed and/or stressed by tight muscles. Pudendal neuralgia and sciatica occur when pelvic floor muscles squeeze nerves, resulting in severe, sometimes agonizing, pain. We share the most common triggers and a rescue plan that focuses on calming the nerves and restoring normal muscle tone. Most importantly, these patients must protect these nerves to avoid further injury and trauma. 

5. The CNS Stress Flare

Almost every patient has experienced a stress flare. We now understand exactly how stress can excaberate our symptoms by causing our nervous system to be dysregulated and our muscles more tight. In this chapter, we review the most common triggers for CNS flares as well as a new, indepth, rescue plan that focuses on reducing "fight or flight" to calm the nerves. You'll find simple, quick tips that work as well as a discussion of both OTC supplements and medications that might help. 

6. Menstrual Flare

As estrogen levels fluctuate, so too can urinary symptoms and pain. From the menstrual cycle and endometriosis to the effects of aging and estrogen atrophy, we share the tips that can help reduce these predictable hormone induced flares. 

7. The Urethral Flare

The urethra might see innocuous but it can produce intense, very sharp and sometimes agonizing pain. We review the most common triggers and a urethral rescue plan that focuses on calming and soothing this remarkably sensitive tissue.

8. The Vulvodynia Flare

Have you ever felt like you had a bad yeast infection but the doctor found no sign of yeast?? In women, the vulva can become remarkably tender and painful, often the result of chemical irritants, estrogen atrophy and, even, tight pelvic floor muscles. We review the most common triggers and a simple rescue plan that can help, including the use of some topical creams that can protect and soothe the skin, along with medications that can ease pain. 

9. The Rectal/Anal Flare

There is nothing more frustrating than a throbbing, painful anus and rectum. While hemorrhoids are the usual suspect, tight pelvic floor muscles are often the underlying problem. If you've had moments of pain so severe that you can't walk (aka proctalgia fugax), that is, indeed, a violent pelvic floor spasm. Learn the common triggers for rectal pain and easy things that you can do to soothe the tissue, with a strong emphasis on addressing straining to have bowel movements and constipation. 

10. The Sex Flare

One of the most common flares are those that occur during or after intimacy. Usually the result of pelvic floor dysfunction, there are a number of tips and strategies that you can use to make sex more comfortable. We share why these flares occur, how to navigate those moments when sex might not be possible and tips that you can use to make sex less traumatic to the muscles but still enjoyable! 

11. The Allergy Flare

It's long been known that some patients flare more intensely during allergy season. Why? Because allergens not only trigger a runny nose and sneezing, they can also trigger bladder wall irritation. These patients will, for the most part, be following our bladder wall rescue plan but with the added use of histamines. 

Publisher: Interstitial Cystitis Network

Pages: 36

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