Curb cys­ti­tis by avoid­ing the trig­gers

The Weekend Australian - Travel - - Health - LINDA CAL­ABRESI

I ama 70-year-old wo­man re­cently di­ag­nosed with in­ter­sti­tial cys­ti­tis. There seems to be lit­tle known about the cause of this con­di­tion, and ap­par­ently no cure. I would be grate­ful for any in­for­ma­tion. IN­TER­STI­TIAL cys­ti­tis is a con­di­tion in­di­cated by a num­ber of symp­toms rather than di­ag­nosed by any tests. Th­ese in­clude chronic blad­der pain and a feel­ing that you need to pass wa­ter fre­quently and ur­gently, symp­toms very sim­i­lar to those as­so­ci­ated with a uri­nary tract in­fec­tion (UTI). How­ever, un­like a UTI, peo­ple with in­ter­sti­tial cys­ti­tis usu­ally don’t have any pain when they ac­tu­ally pass wa­ter and no in­fec­tion is found in their urine on test­ing.

In­ter­sti­tial cys­ti­tis oc­curs more com­monly in women, and usu­ally starts around the age of 40— al­though it can start at any age. The ex­act cause re­mains un­known, though pos­si­bil­i­ties in­clude a de­fect in the pro­tec­tive lin­ing of the blad­der, in­flam­ma­tion and a prob­lem with the im­mune sys­tem. In­ter­sti­tial cys­ti­tis usu­ally fol­lows a fluc­tu­at­ing course; you will prob­a­bly have ‘‘ good’’ days and

bad’’ days. Some­times cer­tain trig­gers will bring on a flare-up of symp­toms, per­haps foods such as cit­rus fruits, toma­toes, pineap­ples, spicy foods or al­co­hol (ap­par­ently red wine is more of­ten a cul­prit than white).

There is no cure, but recog­nis­ing and avoid­ing trig­gers can help. Blad­der train­ing (so you in­crease the time be­tween go­ing to the toi­let) can be ef­fec­tive, as can a daily an­ti­his­tamine tablet or some over-the­counter reme­dies such as Ural, L-Argi­nine and Slip­pery Elm. There are treat­ments your doc­tor might pre­scribe, in­clud­ing some that are in­serted di­rectly into the blad­der.

While it is pos­si­ble your symp­toms will get bet­ter by them­selves, gen­er­ally this is a longterm con­di­tion. There are sup­port groups, such as the In­ter­sti­tial Cys­ti­tis As­so­ci­a­tion (www.ichelp.org.) Is it safe to be tak­ing the Pill if I have poly­cys­tic ovar­ian syn­drome and am over­weight? I am28, don’t smoke and rarely drink al­co­hol. THE oral con­tra­cep­tive pill is com­monly used in young women with PCOS be­cause it reg­u­lates pe­ri­ods, which are of­ten ir­reg­u­lar and heavy, and it re­duces the amount of male hor­mone pro­duced by the ovary. This will help symp­toms of acne and in­creased hairi­ness, which are also com­mon in PCOS. Un­for­tu­nately, how­ever, there are risks. PCOS is gen­er­ally as­so­ci­ated with in­creased in­sulin re­sis­tance, a fore­run­ner to di­a­betes, which oc­curs more com­monly in women with PCOS. The Pill can in­crease your in­sulin re­sis­tance, adding to your risk of de­vel­op­ing di­a­betes. Check with your doc­tor to de­ter­mine your risk. You can re­duce your level of in­sulin re­sis­tance through ex­er­cise and diet, in par­tic­u­lar a low GI diet which would make tak­ing the Pill a lot safer for you. Last month our one-year-old son had a febrile con­vul­sion. He was checked at the hospi­tal and given the all-clear. How likely is it that he will have an­other of th­ese fits? WHERE it is a sim­ple febrile con­vul­sion, most chil­dren — at least two-thirds — will only ex­pe­ri­ence the one. Up to one in three will have a sec­ond con­vul­sion, but only 10 per cent will have more than this. Febrile con­vul­sions are very com­mon, with about 4 per cent of chil­dren un­der the age of 5 hav­ing had one at some stage. It is im­por­tant to re­mem­ber the chance of a febrile fit caus­ing any long-term harm is min­i­mal.

Keep­ing tem­per­a­ture down is the gen­eral ad­vice to pre­vent re­cur­rences. How­ever, febrile con­vul­sions are more re­lated to a rapid rise or fall in the child’s tem­per­a­ture rather than how high the fever gets. Linda Cal­abresi is a Syd­ney GP and ex­ec­u­tive ed­i­tor of www.6min­utes.com.au, a news ser­vice for Aus­tralian doc­tors. Send your queries to lin­da­cal­abresi@gmail.com

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