How long do interstitial cystitis flares last? (+1 factors)

In this article, we will discuss how long interstitial cystitis (IC) flares last. We will also discuss some triggers which may flare up symptoms and duration of IC. 

How long do interstitial cystitis flares last?

Interstitial cystitis (IC) may last for 3-14 days. However, some patients may experience IC flares for several weeks and months. You should consult your doctor for a proper diagnosis of IC as in the initial phases it is often mistaken for urinary tract infections (1).

IC most often affects women and may compromise their quality of life due to frequent urge to urinate and lower abdominal pain. IC flares and duration can be triggered by some factors such as sexual activity, mensuration, sitting for too long, and depression.

You should keep a close eye on the triggers that flare up your IC symptoms. You can lessen the symptoms of IC flares easily at home. However, if the symptoms persist, consult your doctor immediately.

What does research suggest?

In one of the retrospective studies, 89% of the female patients (n=45) presented with only one symptom in the initial phases of IC for over two years. That symptom was either pain, urinary urgency, or nocturia (2). 

In another survey, it was established that IC flares are most common in women (89.8%) with a mean age of approximately 54 years. Frequency and urine urgency were reported by 91.7% and 81.3% of the patients, respectively. 

The duration of IC flares lessened after urination (73.6%) or taking medication (46.8%). On the other hand, sexual intercourse and constrictive clothing increased the duration of IC flares in 50% of the patients (3). 

What are the symptoms of IC flares?

IC is often referred to as bladder pain symptoms. Although, it is important to know that in IC the inflammation is not caused by the infection. IC flares are characterized by (3):

What factors trigger and affect the duration of IC flares?

Several factors may trigger the IC flares and prolong their duration, including:

Food and drinks

Food that is high in ascorbic acid (vitamin C) and citric acid may prolong and trigger IC flares. Examples include tomatoes, oranges, and lemons. Spicy food and artificial sweeteners are also known to make IC flares worsen.

You should also avoid alcohol, coffee, citrus fruits, cranberry juice, caffeinated beverages, soda, and drinks that contain a high content of artificial flavour and artificial sweeteners as they may trigger and recur IC flares (4).

Tight clothes

Tight jeans and pants, leggings, undergarments, and slimming shapewear may put undue stress on the abdominal and pelvic area. This may worsen the symptoms of IC flares. You should change your clothes immediately to get relief from the IC flare.

Sexual activity

Because of the inflammation, sexual intercourse may trigger and prolong the duration of IC flares. You may use lubricant during sex, or use pain medication after sex to get relief from IC flares induced by sex (5).

Hormonal changes

You may experience IC flares during menstruation, pregnancy, and menopause due to hormonal imbalance, However, such IC flares are brief but may be frequent till the hormones go back to normal (6).

Stress

Stress and depression are known to activate spinal and bladder nerves, flaring up IC symptoms. If you have chronic depression, you are likely to experience IC flares more frequently. Your doctor may prescribe antidepressants to reduce the stress,

How to manage and prevent IC flares?

There is no specific medication to prevent IC flares. The treatment protocol is mainly symptomatic. You should work with your doctor to find the right treatment for you. Otherwise, IC flares will keep on happening due to the triggers discussed previously.

Cold or heating pads

You may put cold or heating pads on the perineum (area between the anus and vagina/ base of the penis). You need to experiment between the two packs to see which one works best for you. You may also take a warm sitz bath (7).

Sleeping position

You should sleep in such a manner that helps to relax the pelvic muscles. You should either lie on your side in a fetal position (knees against your chest), or on your back while keeping your legs straight. 

You may put a warm water bottle on your abdomen or between your legs for thirty minutes before sleeping. This may help ease the pain and relax your pelvic muscles. Avoid getting stressed before going to sleep as it may trigger IC flares.

Diet

You should not consume spicy food. You should also avoid fruits and vegetables that are high in vitamin C and citric acid. Cut down your intake of caffeinated drinks, alcohol, soda, and citrus juices. Drink plenty of water to keep yourself hydrated (4).

Reduce stress

You should stop taking undue stress and avoid stressful conditions. Your doctor may prescribe tricyclic antidepressants like amitriptyline to reduce depression, help relax your bladder and manage pain (8).

However, you should not discontinue amitriptyline abruptly. Amitriptyline should be tapered off before discontinuation to reduce the incidence of withdrawal and rebound symptoms such as agitation, dizziness, change in appetite and sweating. 

As a healthcare professional, I would suggest you make an appointment with a nutritionist and physiotherapist to help you control IC flares and associated symptoms. Your doctor may prescribe you medicines to help reduce pain, but it is usually not necessary.

You should identify your triggers to help reduce IC flares. You should also adopt bladder hygiene to prevent sudden leakage of urine and prevent urinary tract infection. Infections can worsen the symptoms of IC.

References