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Is It a Flare or Infection? 3 Ways to Figure It Out

Is It a Flare or Infection?  3 Ways to Figure It Out

Laboratory Woman Holding TubesBy definition IC is diagnosable by having symptoms of a UTI but a negative culture, best done on a well done cath specimen  If the culture is negative with lower tract irritative symptoms(LTIS of frequency, urgency, burning on urination) and no gross hematuria(blood seen in the urine), one is fairly safe in assuming IC, especially if this happens over and over again    Other urological workup can be done but this definition essentially seals the deal

#1 Way to Figure It Out

If there are associated symptoms of IBS, GERD, fibromyalgia, vulvodynia in  women, prostatitis in men, this increases the likelihood that one is dealing with IC bladder pain syndrome   This particular group of disease labels often accompany interstitial cystitis  This is particularly the case for IBS since almost all women and men who have IC have disturbed bowel function(poor digestion, gas, bloating, poor appetite, diarrhea, constipation etc)

#2  Way to Figure It Out

Most people with IC know their symptoms pretty well  At times the flare doesn’t seem typical in the way the symptoms come on and how the flare evolves  In these situations it’s best to get a urine culture on a cath specimen to be sure this atypical presentation is not a bacterial infection

Why do bladder infections occur with IC which is defined as a nonbacterial inflammatory change of the bladder?  Well, let’s think about this  Bacterial infections in the body are largely opportunistic  Even if you innoculate a lady’s bladder with organisms the normal bladder within several voidings will show the bacteria the door  No bacteria left in the bladder

In other words the bladder has the natural capability of removing bacteria   It is suggested that almost all women get organisms pushed into the bladder during intercourse but few women get infected….or the human race wouldn’t be as successful at procreation as it is today

But the IC bladder mucosa is not normal and its GAG layer is more than likely defective due to the hot and mobile qualities energetically  So the IC bladder is prone to bacterial infections

What this means is important for anyone with IC  The imbalance in the bladder produces often times a mix of nonbacterial inflammatory episodes(that we call a flare) and bacterial infections that need treatment with herbs or antibiotics

#3 Way to Figure It Out

I mentioned at the outset that further urological workup may be necessary  This is particularly the case if there is gross hematuria associated with symptoms   Although IC can produce gross hematuria with LTIS one should not ignore this cardinal symptom marker of urinary blood, especially if associated with clots

I have seen a patient who LTIS with gross hematuria and a classic Hunner’s ulcer by endoscopy, and a negative upper tract Xray who had by ureteroscopy a ureteral cancer  Although this rare presentation of 2 diagnoses one must always be very vigilant when gross hematuria occurs in the clinical course of IC

Best in Health DB

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