Curb cystitis by avoiding the triggers
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 firstname.lastname@example.org