There may be a sense of panic when you have an interstitial cystitis (IC) flare-up, but it’s important to step back and examine what triggered the flare so that you know how to treat it and how to avoid another IC flare in the future. The cause of an IC flare includes a gamut of things such as food or chemical intolerance, stress, hormone imbalance, pelvic floor dysfunction, infection, intercourse, and even exercise. You can manage your flares if you know your triggers, and the important thing to remember is that they can be a thing of the past once you identify the root causes of your IC and address them head-on. IC flares are a worsening of IC symptoms, and while common, they can also be a bit tricky to manage. They are unpredictable, disrupt your life, and can last from minutes and hours to days or weeks.
Common symptoms of an IC flare
Each person can experience symptoms or a combination of symptoms that are unique to them. This is one of the reasons IC has been historically difficult to diagnose and has often been misdiagnosed. Some of the most common symptoms can include:
- Frequency and/or urgency, urination increases; may be more prominent at night.
- Disrupted sleep
- Increased stress
- Continued pressure even after voiding
- Blood in the urine
- Brian fog
- Pain may worsen so that it’s difficult to relax or move around
- Pain in the pelvic area, lower back, and legs during or after urination
- Discomfort in urethra, vagina, penis, or testicles
- Bloating and/or loss of appetite
Helpful tips for managing a flare; find those that work best for you
- Keep a journal and record how you are thinking and feeling. Let your emotions pour out on paper in a real and honest way. Removing these from your head and body allows you to give your pain or feelings a voice. If you need to, say everything out loud. You may want to consider trying the DriveThru: Mindful Journaling app.
- Once you have completed your daily writing, take time to do a guided meditation, or pray. Identify any untrue thoughts. These can cover such things as “I will always be sick. There is no hope. I will never get better.” Start taking these kinds of negative thoughts captive and replace them with truth such as, “I am strong. I am a fighter. I am smart. I am loved. My life matters. I am healing. This is a temporary setback. My life has a purpose. I am beautiful. My body is healing. I am getting better.” Repeat these as part of your daily mantra.
- Practice correct breathing. When we are stressed, have high levels of fear or anxiety, our breathing becomes shallow, and we tense up, tightening our pelvic floor muscles. Start to notice your breath and where you are holding tension. Take deep cleansing breaths from the stomach and begin to relax. For a guided breathing meditation https://www.youtube.com/watch?v=LE406OUgJ0s or try meditation for anxiety https://www.youtube.com/watch?v=4pLUleLdwY4
- Go for a 10-minute walk outdoors which serves to release endorphins in the body. These are the feel-good hormones that are healthy and can improve your outlook. Try to get some sun, breathe in the fresh air, and get your body moving so that your heart rate increases a bit. Each of these actions can help you feel calm and relaxed.
- Yoga is an excellent way to assist your body and mind: https://www.youtube.com/watch?v=WtGE0Uz9zSE
- Make a healthy cold pumpkin or berry smoothie, which has proven to help soothe the bladder.
- Take some time to call or visit a good friend or cuddle with your pet. Connecting with others releases oxytocin- a hormone that has bonding effects, plus it serves to increase trust and loyalty. It is released whenever we have face-to-face quality time and “tribal” connections within our community. Plus, new research shows that laughing with friends releases feel-good hormones in the brain, which also serve to relieve pain.
- Drink lots of filtered water (half your weight in ounces). You might want to try coconut water which refreshes the body while renewing your electrolytes.
- Make a castor oil packet and place it on your stomach. Rest with a heating pad on top of it for 30-45 minutes.
- Laugh! Try to find a favorite movie or sitcom that makes you laugh (studies show that watching 15-minutes of a comedy in a group setting proved to increase one’s pain threshold by 10 percent). Laughter is another way that the body creates positive chemical reactions. It releases endorphins giving us a sort of “buzz,” which in turn raises our ability to ignore pain.
- Drink a cup of herbal tea to help with an IC flare. There are quite a few blends that are designed to assist in calming your body and bladder: marshmallow root, corn silk, roasted dandelion, holy basil, chamomile with lavender, ginger, licorice root, milk thistle, slippery elm bark, and turmeric. If you are worried about the tea bothering your bladder simply dip the tea bag once or twice into the hot water and then enjoy the cup tea. You can build slowly from there, which will allow your body and immune system time to adjust.
- Treat yourself to a magnesium and Epsom salt bath.
- Plan a tasty, anti-inflammatory meal that you enjoy. Salmon is one excellent choice, and if you need help finding bladder friendly recipes, look to any of the safe and delicious recipes in The Complete IC Diet Cookbook.
- Try an allergy tablet such as Zyrtec (or you can try a combination of quercetin and bromelain) and if you experience good results, then it’s likely that you are struggling with histamine intolerance. We recommend that you work with a nutritionist or functional medicine practitioner to identify root causes. If you are looking for a nutritionist, Brianne Thornton, MS, RD, can help.
- Some have found relief during a flare by drinking a mixture of ¼ teaspoon of baking soda with ½ cup of water.
- There are a variety of supplements available that may bring some relief but always consult with your medical provider before changing or adding anything to your dietary regimen. Some of the anti-inflammatory supplements include fish oil, oil of oregano, grapefruit seed extract (GSE), pumpkin seed oil (helps with bladder spasms and nocturia), black cumin, curcumin, and ginger. Bladder support supplements include Aloe Vera, astragalus root, D-Mannose (if you are prone to UTIs), kava root, I-arginine, slippery elm, vitamin D3- K2 (strengthens the pelvic floor), Bladder Ease, pumpkin seed oil, Quercetin with Nettles, and Bromelain (Bromelain increases the absorption of Quercetin plus they enhance each other’s anti-inflammatory actions). Stress-relieving supplements for consideration include I-theanine, magnesium I-threonate, herbal tea, and CBD oil.
- You may want to consider making an appointment with a pelvic floor physical therapist. There is a brain-bladder connection and IC symptoms may be the result of nervous system upregulation, pelvic floor dysfunction, and an overactive sympathetic nervous system. PT has proven very effective in treating IC or at minimum reducing IC symptoms.
- Think about the positives in your life- which can be done with a “gratitude list.” No matter how bad things might currently appear, there are still many things to be grateful for. The list serves to help you focus on the good rather than on the pain, and it gives you a renewed sense of hope.
- Remind yourself consistently that a flare-up is just a temporary setback. You are strong, heck, you are an IC Warrior, and you will get through this!
- Download the Curable App. Pain is multidimensional, and it’s processed in both the brain and the nervous system. While chronic illness affects both the brain and nervous system, the good news is that we can reprogram ourselves so that the nervous system isn’t as hypersensitive. This means that you can effectively calm your brain’s reaction and fear response to pain, which will help in reducing symptoms.
- Sleep…and then sleep some more. It can be challenging to sleep during an IC flare, but it is one of the most proactive things you can do to decrease symptoms. Quality sleep is crucial because when you are sleeping, you are healing. If sleep is impossible right now, then make it one of your goals. Give yourself permission to sleep 10-12 hours a day for the next four weeks while you also work to restore overall balance to the body.
Most importantly, talk to a doctor (ideally one that practices alternative medicine) whose approach is to discover and address the root causes of your IC. Interstitial cystitis is a combination multiple underlying factors including stress, mastocytosis, pelvic floor dysfunction, gut and bladder dysbiosis, gut infections, leaky gut, infection/pathogens, food and chemical intolerances, hormone imbalance, toxicity, upregulation of the nervous system, histamine intolerance, liver dysfunction, neurogenic inflammation, neurological damage, or trauma to the bladder. You will need the right support system, resources, and information, but healing is 100% possible! Healing is a process, and it requires patience, but you can get your life back, and we are here to help.