Biofilms and Bladder Infections

            Research regarding urinary tract infections may be of interest to IC patients. A few of us have chronic bladder infections as well as IC, and many of you’ll recall your bladder problems starting off with a genuine culture-verified bladder infection. The relationship of IC to bladder infection has been a controversial one for the last 20years. In bladder biopsies of IC patients, no one has consistently found one infective organism that could be an underlying cause for IC. In studies during the 1990’s, which probed for bacterial DNA in IC bladders, results were inconclusive. In some patients no bacterial DNA was found, in others a variety of species’ DNA was found.

          At the time, it was suspected that bacterial contamination of the instruments may have contributed to the inconclusive results. IC research moved on. But patients whose IC occasionally temporarily improves while on antibiotics, have continued to suspect a bacterial connection.

          Urologists are not now seriously suggesting that IC has a bacterial origin, but basic science has uncovered a bacterial phenomenon called biofilms, that may lead IC researchers to eventually take a second look at the possible involvement of bacteria in some way. This will likely be spurred on if IC gets a new name and definition that encourages more IC studies involving other parts of the body. Current leading edge research on the function of normal gut bacteria and its relationship to pain modulation and the immune system may become relevant to IC as well.   

Men with IC struggle for Recognition

 Of the nearly 1 million Americans with IC, an estimated 10% are male. While IC in general may not generate a lot of attention, male IC patients get even less attention than their female counterparts while their suffering is the same. One of the biggest challenges any IC patient faces is getting a correct diagnosis. This is especially true for male patients who often hear a            diagnosis of prostatitis before anything else.

Dr. Stanley Antolak, founder and director of the Center for Urologic and Pelvic Pain in Lake Elmo, Minn., pointed to a study released a few years ago by Roberts and Krieger showing that 95% of men diagnosed with prostatitis have no evidence of infection or inflammation. Staggering numbers, indeed. While   getting diagnosis of IC as a man can be at least as challenging as it is for a woman, it is certainly not impossible. Doctors like Antolak and Shoskes are proof that urologists are listening to male complaints and taking them seriously. Shokes encourages patients to find a caring doctor and be honest with him.

“The one important thing is to build a relationship with the physician who has an interest in your condition and who you can trust”, he said. “[And] it’s important that when symptoms arise that everything is not just attributed to IC or pelvic pain. Any new symptom deserves at least a history and physical with afresh of eyes considering new diagnoses”.  

Finding an IC Friendly Wine

Finding an IC Friendly Wine

 Do you miss enjoying an occasional glass of wine? Wines can irritate a sensitive bladder in several ways. They are naturally acidic and thus, like orange juice or coffee, can trigger IC symptoms. Did you know, however, that some wines are lower in acid than others? Some wines have high alcohol levels which can make a tender bladder sting, particularly for patients with active Hunner’s Ulcers. Patients sensitive to histamine (i.e. as found in chocolate, aged cheeses or sausages) might find red wines more irritating than white wines. Luckily for ICers, there are thousands of wines on the market today to taste. Many may be bladder irritating but some might work for you when enjoyed in moderation. It simply requires some work on your part to learn more about wine, how and where grapes are grown and how it’s made.

Here’s a brief glimpse into the science of winemaking and what to look for when searching for a more bladder friendly wine. Even if wine isn't your thing, a day visiting vineyards and wineries can still be enjoying for their often lush gardens, entertaining tours and supplementary products, such as olive oil and lavender.

Wine Acid Levels:

The acid level of various wines depends upon the type of grape, its growing conditions and location, fermentation and style. As a grape grows, it naturally produces tartaric acid and malic acid. In all climates, grapes accumulate these acids early in the ripening process and then begin to naturally lose them as the grapes get close to harvest.

Sugar Levels, Harvest & Fermentation:

Sugar is also vital to the wine-making process because it’s the natural sugar found in the grapes that is eventually converted to alcohol through the fermentation process. Warm climates definitely produce more sugar in the grapes than cooler climates.

Taste & Perferences:

Wine flavors can be incredibly diverse. Some wines have very fruity and fresh flavors. One of the great joys of wine tasting is smelling the wine and trying to describe its aromas and tastes.

Wines often have characteristics (flavors and scent) that resemble natural fruits, vegetables, herbs and spices. Fruit flavors in wine are very diverse. Wines can smell and taste like apples, blackberries, currants, cherries, oranges, peaches, pears, raspberries and other fruits. Some wines also have a nutty (i.e. pepper or cinnamon flavor).

In Sickness and In health: The Critical role Spouses play

 “For better or for worse.” “In sickness and in health.” Both phrases are often used in weddings, though the newlyweds may not completely realize just what those words mean. IC patients and their spouses are putting such vows to the test navigating this painful, chronic condition together. How they navigate the hard times can impact how they feel.

The study:

In November, researchers from Queen’s University in Ontario, Loyola University Medical Center in Maywood, III., and the University of Rochester Medical Center in Rochester, N.Y., released their findings that a supportive spouse can improve the mental health quality of life in women suffering from IC.

“The primary finding in this study is that ‘distracting’ spousal responses act to ‘buffer’ the negative effects of pain on mental quality of life for women suffering from IC”, said Dean A. Tripp, Ph.D., associate professor in the Departments of Psychology, Anesthesia & Urology at Queen’s University, and one of the researchers conducting the study.

The study surveyed 96 women about the responses of their husbands to their pain as well as the women’s quality of life, depression and their disability. Tripp said he and his colleagues found it unacceptable that no such study had yet been conducted for IC patients considering that IC clearly impacts the entire family.

IC in the Workplace!

 IC can’t be left at home, so dealing with it in the workplace is a given for employed ICers. Some bosses and co-workers are compassionate and some aren’t. No special formula exists to deal with co-workers, but there are some things to keep in mind. Since IC can take so long to diagnose, some patients must involve their co-workers before they know what’s wrong.

Inevitably, there will be some bosses and co-workers who won’t understand. Though some co-workers are sympathetic, the boss is far from it. Mostly, people who are understanding and sympathetic in general are more likely to be that way in dealing with IC. But those who lack understanding are going to be the same way in dealing with the situations.

“When you treat your disease as you would anything else-just one aspect of your life-others will be likely to do the same”—Anonymous.

Courtesy : IC Optimist

How Urologists can help IC patients

Urologists can help IC patients with their symptoms and improve their quality of life. Urologists need to look at the entire patient and not focus solely on the bladder. One of the major conditions in conjunction with IC is Pelvic Floor Dysfunction (PFD). The other conditions associated with IC are allergies, fibromyalgia and migraines. PFD is estimated to be present in 70 to 80 percent of IC patients.

It is very important for urologists to keep a track of patient’s progress. Diagnosing IC is a trial and error process, which is something both the urologist and the patient must understand in working together to find a viable solution.

IC is indeed very painful, but proper management and a little support from your family and friends and some support from your urologist can make life as beautiful as it was before you were diagnosed with IC.

courtesy : IC Optimist

Comfora or Elmiron

Elmiron or Comfora:

              Who out there is not worried about their money? Elmiron is burning a big-hole in the pockets of the patients. When you have a chronic illness like IC, money cannot be.

               Comfora is orally bioavailable Pentosan Polysulfate Sodium. Its mechanism of action is thought to be adherence to the bladder surface supplementing the defective natural glycosaminoglycan layer. It is hypothesized that this action ameliorates the symptoms of interstitial cystitis. Orally administered pentosan has a urinary excretion half-life of 4.4 hours for the unchanged drug. A single dose is completely eliminated in 144 hours.

               The recommended dose is 300 mg/day taken as one 100 mg capsule orally 3 times daily. The capsules should be taken with water at least 1 hour before meals or 2 hours after meals

              Some patients with interstitial cystitis may require 6 to 8 weeks of therapy with pentosan to achieve relief of symptoms. Long-term continuation of pentosan therapy is necessary for persistent therapeutic effect.

              Elmiron and Comfora only differ in their price tag. Elmiron placed at a higher value is not affordable by all. Swati Spentose Pvt. Ltd. took the initiative in launching the only Indian Brand- Comfora. large segment of patients, for whom it was difficult to afford Elmiron can now buy it and lead a comforting life even during IC.

             The next issue will cover the All-India USICONS held at the capital as well as the regional USICONS attended by our expert staff.

             The symptoms in women exacerbate just before or during menstruation, during ovulation or if they are taking contraceptive pills. It should be emphasized, however, that many patients never progress further than a relatively mild form of IC.

Refined by Sanaa Jummal