Skin flake so readily?
than normal. The symptoms are similar to those caused by acute cystitis but unlike that condition they don’t go away with antibiotic treatment. Women with IC may experience discomfort during sex.
The cause isn’t known but it is thought to be due either to damage to the bladder lining which allows irritating substances in urine to penetrate to the deep layers of the bladder wall, or to an abnormal reaction of the immune system within the bladder, leading to the release of chemicals that cause inflammation.
Another theory is that there are changes to the nerves that carry sensations from the bladder up in to the brain.
There is no single treatment that works for everyone with IC. Foods that irritate the bladder, such as caffeine, citrus fruits, tomatoes and chocolate can make symptoms worse, along with alcohol, spicy foods and fizzy drinks, so it is worth keeping a food diary and avoiding anything that makes your bladder more uncomfortable.
Stress can be another factor and many patients find counselling helpful not only for managing stress but also for coping with their bladder discomfort. Drugs that modulate the pain messages from the bladder, such as amitriptyline or gabapentin, can also be beneficial.
Drugs such as cyclosporine, that work by reducing inflammation, can also be used in severe cases. All these treatments are available on the NHS so chat with your GP. Following your reply to a reader enquiring about the shingles vaccination (May 2), it may be helpful for people to know that if they are not entitled to get the vaccination then they can have it done privately.
I could have had the jab in London but had it done when I was on holiday in the US. M O’Broin, by email In your column (May 23) one of your readers asked if there was a natural way to thin the blood without using aspirin. I use vitamin E capsules and fish oils. A Wills, by email
If you have a health question for Dr Rosemary please write to her in confidence at The Northern & Shell Building, 10 Lower Thames Street, London EC3R 6EN or email health@ express.co.uk
Dr Rosemary’s reply will appear in this column. She regrets that she cannot enter into personal correspondence and that due to the volume of letters she cannot reply to everyone. Find out more about Dr Rosemary at drrosemaryleonard.co.uk