Typical Flare Triggers
(1) DIET - The most common IC flares are diet induced. There is nothing sadder than talking with a patient, crying in pain, who has never been told about diet. One IC patient called our office quite desperate, bemoaning the fact that no therapy had ever helped her. She later admitted that she drank a six-pack of ginger ale each day. In our opinion, few therapies would work when various irritants are assaulting the bladder, day after day.
(2) HORMONES - The bladder is extremely sensitive to the hormone changes that occur each month during the menstrual cycle. However, each patient may respond differently to hormones. Some patients flare when their progesterone levels are higher, while others flare when their estrogen levels are higher. Many women struggle with an IC flare on the day that they ovulate and a few days before their period. The good news is that these hormone-induced flares are often predictable and short term. One thing that you might find helpful is to do avoiding diary for a few months and also track your menstrual cycle. This will help you determine if you are having any hormone induced flares and will also help you see that they can be very short term and often not worth worrying about.
(3) VIBRATION - If you had a broken leg, would it hurt if you shook it up and down? Well, yeah! When an IC bladder is jarred or bounced around it can hurt, thus driving, flying and traveling are well known IC triggers. In fact, one research study found that 50% of all IC patients had pain while driving or riding in a car. The culprit is the vibration of the car on the bladder and pelvis. Because the bladder and surrounding muscles are already so sensitized, jarring and bouncing over roads can create more irritation and also trigger painful muscle spasms. Thus, IC patients frequently report that they cannot drive long distances without experiencing great discomfort. If you’re in an IC flare, it’s best to limit car travel to short distances.
(4) STRESS - Does stress cause IC? Not that we’re aware of but it can certainly trigger an IC flare. IC patients frequently report that their symptoms worsen during periods of high physical or emotional stress. Consider the fact that when patients get very cold, they often have more bladder symptoms. Emotional stress creates similar reactions in the bladder through no fault of the patient. In the past few years, several IC researchers have focused on how nerves in the spinal cord and bladder react in highly stressful situations. They have found that intense stress causes an euroendocrine response throughout the body, brain, spinal cord and that appears to be contributing to our bladder symptoms and pain levels.
(5) CHEMICAL EXPOSURE -
Do you have a very sensitive sense of smell?? If so, you're not alone. Many IC patients seem to have varying levels of sensitivity to smells, sounds and, yes, chemicals. IC patients often report that various chemical exposures and/or medications can trigger an IC flare. The usual culprits are soaps, detergents and laundry products that leave an irritating chemical film in our clothing or skin that can irritate our sensitive tissues. Sometimes harsh smells in the home, such as cleansers, can trigger discomfort.
(6) VITAMINS & SUPPLEMENTS - Visit any IC support group and you’ll find that most patients can’t tolerate multivitamins of any type. Multivitamins are well known IC triggers because they contain Vitamins C and B6, both infamous for irritating the bladder and creating discomfort. Patients often do better when taking individua lvitamins and/or supplements, such as a simple Calcium Citrate pill. The book “A Taste of the Good Life: A Cookbook for an IC Diet”has an extensive discussion of vitamins, as well as suggestions on IC friendly forms of each.
(7) SEX & INTIMACY - A number of IC patients report that sexual intercourse can trigger an IC flare. Men with IC may experience a searing pain at the moment of orgasm. Women with IC often feel their worst 24-48 hours after intercourse, with increased levels of frequency, urgency or pain. Men and women can also struggle with intense pelvic floor muscle spasms. Read more in the ICN Guide To Sex and Intimacy.
(8) EXERCISE - Exercise, particularly workouts that involve the pelvic area, can trigger an IC flare. Bicycle seats put unusually high pressure on the pelvic floor muscles, thus exacerbating ICsymptoms. Other patients have reported that workouts that jar the pelvis, such as running or stair master, can provoke pain. Exercise is possible as an IC patient, but it’svery important to pace yourself and pick your exercises carefully.
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