Understanding IC Flares - Interstitial Cystitis Network

ICN special report: 

A Guide to Managing IC Flares 

published by the Interstitial Cystitis Network • volume 2, issue 1 • Spring 2005 

Understanding IC Flares 

Do You Know What 

Your IC Triggers Are 

The A to Z Guide 

for Coping With 

Flares 

What Not to Do 

During a Flare 

IC flares 

are often 

preventable. 

This guide 

will help! 

Plus ten products that can help you manage your flares!

ICN special report: 

A Guide to Managing 

IC FLARES 

from the publisher 

Published by the Interstitial 

Cystitis Network 

Publisher: Jill Osborne 

Editor: Courtney Allen 

Advertising Sales: 707-538-9442 

e-mail: jill@ic-network.com 

Interstitial Cystitis Network: 

http://www.ic-network.com 

info@ic-network.com 

Administrative Offices: 

4983 Sonoma Highway, Suite L 

Santa Rosa, CA USA 95409 

Every IC support group leader is charged 

with one key task, to help IC patients 

understand, manage and prevent common 

IC flares. Flares are a fact of life for most 

IC patients. Whether they happen once 

every couple of years, or once a week, the 

pain and discomfort that they can create 

can be overwhelming. Yet, if there’s one 

thing that we’ve learned in the last twenty 

years, it’s that IC flares are often preventable. 

I’m sure that some of you reading this are 

saying “What’s a flare I hurt all the time.” 

Well, I did too. The first year of my IC was 

solid, intense pain that got worse each day. At the end of that first year, I 

was in agony and could barely sleep. Of course, I didn’t know anything 

about IC back then. I was drinking a quart of cranberry juice every day in 

a desperate attempt to get better. 

It took an IC support group leader to get me started in the right direction. 

She taught me about diet and, more importantly, about pacing 

myself. Her motto was: “If it hurts, stop and rest!” She was right. When I 

looked at myself honestly I could see that I had never given myself permission 

to say “I don’t feel well.” Big mistake. When I finally gave 

myself the chance to rest, my recovery began. 

I’d like to add to that advice with some of my own! If it hurts, you 

should stop and rest, but stopping to rest does not mean that your life 

must stop with you. IC does not diminish your mind, your heart or your 

soul. Put your mind to good use. Take the time to learn about IC and 

then use that information to improve your life. Remember that your body 

is more than just your bladder. Whether you’re an artist, a craftsman or 

an athlete, your hands still have potential. Use them frequently! IC will 

not reduce the love in your heart for family and friends. Show it to them 

each and every day and you will receive much in return! In other words, 

truly believe in yourself! Yes, you have IC but you will still accomplish 

great things! 

I hope that this Special Report gives you many new ideas on handling 

your IC flares! As always, we welcome any new suggestions you may have 

to offer!

contents 

4 Understanding IC Flares 

by Jill Osborne, M.A. 

• What Does an IC Flare Feel Like 

• Why Do IC Flares Occur 

• What Should I Do If I Feel a 

Flare Begin 

• How Does a Typical IC Flare Begin 

• Could My Flare Be a UTI 

7 Do You Know What Your IC 

Triggers Are 

• Eight Things That Can Cause an 

IC Flare 

11 The A to Z Guide for Coping 

with Flares 

by Courtney Allen and Jill Osborne, M.A. 

18 What Not to Do During a Flare 

Copyright © 2005. Any reproduction is prohibited without prior written permission from the ICN. 

Disclaimer: The Interstitial Cystitis Network website and publications are for informational purposes 

only. The IC Network is not a medical authority nor do we provide any medical advice. Nothing 

contained in this publication should be considered medical advice and should not be relied upon 

as a substitute for consultation with a qualified medical professional. We strongly recommend 

that you discuss your medical care and treatments with your personal medical care provider. Only 

that medical professional can, and should, give you medical advice. 

Opinions expressed in articles are those of the authors and do not necessarily reflect those of the 

ICN or its editorial board. The ICN assumes no liability for any material published herein. 

ICN SPECIAL REPORT ON IC FLARES • SPRING 2005 • 3

Understanding 

IC Flares 

by Jill Osborne, M.A. 

Lasting from hours to 

weeks, IC flares can 

be unpredictable, 

disruptive and difficult 

to manage for both 

newly diagnosed and 

veteran IC patients. 

INTRODUCTION 

Interstitial cystitis patients often 

struggle with “IC flares,” a sudden 

and dramatic worsening of their 

bladder symptoms. Lasting from 

hours to weeks, IC flares can be 

unpredictable, disruptive and difficult 

to manage for both newly diagnosed 

and veteran IC patients. 

Over the years, we discovered that 

a number of events can trigger an IC 

flare. Many IC patients quickly learn 

the subtle, yet distinct differences in 

the onset, duration and symptoms of 

flares depending upon the trigger. 

Food related flares, for example, can 

be felt within minutes or hours of 

eating a risk food and may last a day 

or longer. A sex induced flare may 

occur 24-48 hours after intimacy and 

last for several days. Hormone 

induced flares, such as the flare 

which may occur during ovulation, 

may last just a few hours. The good 

news, however, is that many IC flares 

are preventable and are often predictable. 

The most successful IC patients 

are actively involved in their care. 

They don’t depend upon their doctors 

to do all the work. They understand 

and accept that while there are 

many therapies that can help reduce 

their discomfort, prevention does 

begin at home. We hope that this 

guide will help you interpret, manage 

and prevent the most common IC 

flares. Be a detective and track your 

flares in a journal. Learn from them 

so that you can avoid that discomfort 

in the future. 

4 • ICN SPECIAL REPORT ON IC FLARES • SPRING 2005

WHAT DOES AN IC FLARE FEEL 

LIKE 

Depending upon the triggering 

event, an IC patient may experience 

a variety of symptoms during their 

flare. They may have just one, or all, 

of those symptoms listed below. 

Frequency: During flare periods, 

patients can experience urinary frequency, 

especially at night. Mild IC 

patients may urinate 11 or more 

times in a 24-hour period, while 

more severe IC patients urinate 40 or 

more times a day. 

Urgency: Some IC patients struggle 

with a sudden need to urinate 

and/or a sensation of constant pressure 

to urinate. 

Pain: Flares can provoke mild to 

severe pain. Some patients may 

describe the pain as razorblades in 

their bladders, while others may 

complain of a constant and “difficult 

to ignore” pain. During most IC 

flares, the pain worsens as the bladder 

fills with urine and may be 

relieved after urination. Bladder 

pain is most commonly felt in the 

subrapubic region, directly above the 

pubic bone. However, it’s not unusual 

for pain to radiate into the lower 

back, upper legs, perineum, rectum 

and/or reproductive tract. Women 

may complain of vulvar, vaginal or 

clitoral pain while men may experience 

pain at the tip of the penis or 

in the testicles. Both men and 

woman have reported that their 

urine may feel hot or burn during 

urination. 

Urethral Symptoms: Some 

patients experience discomfort 

entirely in their urethra. It can be a 

sharp, burning pain. 

Other Symptoms: There are a 

number of unique sensations that 

occasionally occur during IC flares. 

Some patients experience a moment 

of intense discomfort at the end of 

urination when their bladder walls 

touch briefly. This type of pain is 

startling and creates a shiver up the 

spine. Patients with bladder spasms 

often feel their bladders “flip flopping” 

in their pelvis. In severe 

spasms, it may be difficult for a 

patient to urinate and require 

catheterization. One of the strangest 

sensations occurs when the pudendal 

nerve becomes irritated. These 

patients feel a strange, odd irritation 

and/or arousal sensation of the clitoris. 

WHY DO IC FLARES OCCUR 

IC research is at an all time high 

as scientists around the world seek to 

discover the underlying cause of IC. 

Some researchers, such as C. Lowell 

Parsons, believe that IC is a GAG 

layer deficiency that creates a damaged 

bladder wall. Other researchers 

believe that IC patients have 

barriers to healing, such as the 

Antiproliferative Factor discovered 

by Dr. Susan Keay (Univ. of 

Maryland). What most do agree on, 

however, is that IC flares are usually 

triggered by either an irritation of 

the bladder wall and/or of the pelvic 

floor muscle. 

Bladder Wall Irritation: Patients 

with bladder wall irritation and/or 

abnormalities (i.e. petechial hemorrhages, 

glomerulations) often report 

that they have “ground glass” or 

“razor blades” in their bladders. In 

these cases, the bladder wall becomes 

irritated and painful as urine touches 

the tender tissues. Emptying the 

bladder usually reduces this discomfort. 

Patients with mild IC may simply 

experience more frequency or 

urgency. Patients with wounds in 

their bladder (i.e. Hunner’s Ulcers) 

may experience severe pain as the 

urine touches the wound. Asking 

one of these patients to “hold” their 

urine can be agonizing and cruel. 

Restroom access is vital for these 

patients. 

Pelvic Floor Muscle Tension or 

Spasms: Physicians treating IC & 

other pelvic pain patients often discover 

pelvic floor muscles so tense 

that they feel like tight rubber bands. 

The patient, however, may not be 

aware that these muscles are contributing 

to their bladder symptoms. 

The symptoms are subtle. Some 

patients share that it’s difficult to 

start their urine stream, thus requiring 

a 2 to 5 minute period of sitting 

on the toilet while they wait for 

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their muscles to relax. Others 

describe a deep, painful tension or 

burning that makes sitting uncomfortable. 

Some patients may experience 

sharp, localized pain. The good 

news is that urologists and physical 

therapists around the country now 

incorporate pelvic floor assessments 

and treatment in their IC clinics. 

In A Headache in the Pelvis, 3rd 

ed., authors David Wise, PhD. and 

Rodney Anderson, MD (Stanford 

University) suggest that pelvic floor 

tension may be the root cause of 

many pelvic pain syndromes. They 

state “the overuse of the human 

instinct to protect the … contents of 

the pelvis from injury and pain by 

contracting pelvic muscles” can create 

long term muscle tension which 

results in painful trigger points, a 

reduction of blood flow and, in general, 

a difficult environment for the 

organs in the pelvis to thrive. 

Physiotherapy can, in some cases, 

reduce the severity of these symptoms. 

HOW DOES A TYPICAL IC FLARE 

BEGIN 

A typical flare is often first 

noticed at night, when daily distractions 

are at a minimum. A patient 

may go to bed at 11pm, then wake 

up at midnight feeling as if their 

bladder is very full. They urinate, go 

back to bed and then wake up 30 

minutes later, again feeling that their 

bladder is full. They trudge back to 

the restroom only to release just a 

small amount of urine. Within minutes 

of returning to bed, they may 

feel the need to urinate again, however, 

are able to release only a few 

drops thus beginning a long and 

painful night of frequency, urgency, 

pain and/or sleeplessness. 

One confusing part of an IC flare 

can be the sensation of being “full” 

despite the fact that you may have 

recently emptied your bladder. This 

is how the bladder tells you that it is 

extremely irritated. It’s important to 

remember that if you’ve urinated 15 

minutes earlier, you may not have 

that much urine in your bladder. Try 

not to strain and push urine out 

because this can create yet more 

muscle tension. It’s better to get up, 

walk around if you can, perhaps 

drink some water, and then try again 

a little later. Remember, urination 

should be the result of relaxation. 

Straining is not normal. 

COULD MY FLARE BE A UTI 

Many IC patients automatically 

assume that if they have bladder 

symptoms, they must have a UTI. In 

fact, some have taken antibiotics for 

years only to discover after the fact 

that they never had infection, that 

they were just having IC flares. The 

symptoms are virtually identical. 

However, patients with a UTI may 

have an additional burning sensation 

in the urethra during urination. 

They may see blood in their urine, 

experience fever, chills and/or low 

back pain. When untreated, bladder 

infections can progress up to the kidneys 

and become life threatening. 

Thus, if you suspect that you have a 

bladder infection, it’s worth a quick 

phone call and/or visit to your urologist 

to rule this out. 

WHAT CREATES THE PAIN AND 

DISCOMFORT 

When urine touches irritated 

bladder tissue or enters the bladder 

wall through a wound, it can irritate 

nerves and trigger mast cells to 

release histamine. Histamines create 

irritation, redness, swelling and discomfort. 

They are also well known 

for provoking even more nerve 

inflammation. The irritated nerves 

can then, in turn, release substances, 

such as Substance P, which further 

irritate the mast cells. Thus patients 

can struggle with a vicious cycle of 

inflammation and/or pain. 1 As mentioned 

earlier, this pain can then 

provoke muscle tension, which can 

lead to more pain. 

Luckily, many IC therapies can 

help. Bladder coatings help to protect 

the bladder lining. 

Antihistamines help reduce the irritation 

caused by the mast cells and 

histamine. A low dose antidepressant 

can help stabilize the nerves. 

A reverse situation can also occur 

with the flare beginning with a muscle 

spasm that then triggers bladder 

discomfort. Patients struggling with 

IBS or constipation often experience 

muscle spasms which then trigger 

bladder symptoms. Some patients 

find that exercise or sex can induce 

muscle spasms and thus lead to pain. 

Some may also involuntarily contract 

their pelvic floor muscles in 

stressful situations. 

WHAT SHOULD I DO IF I FEEL A 

FLARE STARTING 

Catch it early. If you feel that your 

bladder is starting to get sensitive, 

act early. Don’t wait until your symptoms 

and/or pain are out of control 

before you take action. Use your 

pain medications as recommended by 

your doctor. Stop and rest if you can. 

Try using a heating pad to help 

reduce any building muscle tension. 

A relaxation exercise certainly can’t 

hurt and will likely help in the long 

run. The A to Z Guide to Handling 

IC Flares will have many more suggestions 

for you. 

DO FLARES EVER STOP 

HAPPENING 

Yes! Patients go into remission frequently. 

The key, though, is to make 

sure that you do not irritate your 

bladder unnecessarily. Diet and therapy 

are the foundation that leads 

most often to success and remissions. 

1 Nickel, C. Interstitial Cystitis: 

Characterization & Management of an 

Enigmatic Urologic Syndrome. 

Reviews in Urology, Vol. 4, No. 3 

2002. Available at: 

http://www.medreviews.com 


Do You Know What 

Your IC Triggers Are 

Eight Things That Can 

Cause an IC Flare 

1. DIET 

The most common IC flares are 

diet induced. There is nothing sadder 

than talking with a patient, crying 

in pain, who has never been told 

about diet. One IC patient called our 

office quite desperate, bemoaning 

the fact that no therapy had ever 

helped her. She later admitted that 

she drank a six-pack of ginger ale 

each day. In our opinion, few therapies 

would work when various irritants 

are assaulting the bladder, day 

after day. 

Coffees and teas are the worst IC 

triggers because they irritate the 

bladder in two ways. Their acid levels 

are quite high, thus drinking even 

one cup of decaf coffee a day can 

trigger bladder wall irritation. If 

you’re drinking regular coffee or tea, 

you get a double whammy because 

the caffeine stimulates the nerves 

and muscles. Caffeine is also a 

diuretic, thus creating dehydration 

and more concentrated and irritating 

urine. 1 

Herbal tea blends are also frequently 

irritating, especially if they 

include the strongly acidic rosehips. 

Green teas are supposed to be 

healthy for the body but, in IC 

patients, are devastating due to their 

very high acid levels. If you’re struggling 

with flares or pain, we strongly 

suggest that you avoid any of the 

above for at least a month if not 

longer to give the bladder irritation 

time to improve. Try hot water with 

honey as an alternative. 

Sodas and fruit juices are also 

common offenders, again due to 

their acid level. Sodas remain the 

worst of the cold drinks due to their 

high acid and caffeine levels. Throw 

in Nutrasweet (aspartame), which is 

a well known bladder irritant, and 

you could be setting yourself up for a 

long, sleepless night if not days of 

Drinking even one cup 

of decaf coffee a day 

can trigger bladder 

irritation. 


pain. Sadly, many fruit juices have 

citric acid added for flavoring and/or 

as a preservative. 

If you’re desperate for something 

cold to drink, try “Baby” pear or 

apple juice, which are lower in acid 

or a low sodium mineral water with a 

splash of flavoring. Check out 

Torani.com for more info on flavorings. 

There are several other dietary 

triggers that are worth knowing 

about. There are three excellent 

resources available if you would like 

to improve your education. 

• The ICN Special Report on Diet, 

$10 via the ICN Shop 

• Bev Laumann’s “A Taste of the 

Good Life: A Cookbook for an IC 

Diet”, $23.99 via the ICN Shop 

• The ICN Patient Handbook 

http://www.ic-network.com/handbook/ 

Green teas are 

supposed to be 

healthy for the body 

but, in IC patients, are 

devastating due to 

their very high acid 

levels. 

8 • ICN SPECIAL REPORT ON IC FLARES • SPRING 2005 

2. HORMONES 

The bladder is extremely sensitive 

to the hormone changes that occur 

each month during the menstrual 

cycle. However, each patient may 

respond differently to hormones. 

Some patients flare when their progesterone 

levels are higher, while others 

flare when their estrogen levels 

are higher. While some doctors may 

disagree as to why this occurs, we 

can all agree that many women 

struggle with an IC flare on the day 

that they ovulate and a few days 

before their period. 2 

The good news is that these hormone-induced 

flares are often predictable 

and short term. One thing 

that you might find helpful is to do a 

voiding diary for a few months and 

also track your menstrual cycle. This 

will help you determine if you are 

having any hormone induced flares 

and will also help you see that they 

can be very short term and often not 

worth worrying about. 

Many women who are menopausal 

also struggle with weaker, sensitized 

tissues in the vulva, vagina and bladder 

due to their decline in estrogen 

levels. Estrogen helps to bulk up and 

strengthen the skin. Thus, when 

estrogen is depleted, the skin in the 

vagina or vulva can thin and become 

more sensitive. A quick examination 

by an OB-GYN can confirm if this is 

occurring. Of the many treatment 

options available, EString ® seems to 

be preferred over an estrogen cream, 

simply because creams often have 

irritants (such as propylene glycol) 

that can create a burning sensation. 3 

Some patients have found success 

with a plain estrogen cream made by 

a compounding pharmacist without 

the irritating preservatives. 

3. VIBRATION 

If you had a broken leg, would it 

hurt if you shook it up and down 

Well, yeah! When an IC bladder is 

jarred or bounced around it can hurt, 

thus driving, flying and traveling are 

well known IC triggers. In fact, one 

research study found that 50% of all 

IC patients had pain while driving or 

riding in a car. 4 

The culprit is the vibration of the 

car on the bladder and pelvis. 

Because the bladder and surrounding 

muscles are already so sensitized, jarring 

and bouncing over roads can 

create more irritation and also trigger 

painful muscle spasms. Thus, IC 

patients frequently report that they 

cannot drive long distances without 

experiencing great discomfort. 

If you’re in an IC flare, it’s best to 

limit car travel to short distances. 

This is not the time to drive five 

hours or across the country. If you 

need to travel, it helps to be in a car 

that has a good, smooth suspension. 

You may find that using a muscle 

relaxant and/or heat can help. 

Above all, don’t force yourself to 

hold your urine throughout a long 

car ride. Stop and use the restroom 

as frequently as you need to. Better 

yet, carry along some travel johns 

and/or a popup tent so that you can 

stop anytime you need to. 5 

Travel by train or plane can be 

challenging. When making your 

reservations, please let airline or rail 

staff know that you have disability 

and must be seated near a restroom 

or in an aisle seat so that you can get 

to the restroom easily. When you 

arrive at the plane or train, make 

sure that you inform the attendant of 

your needs. Use medication as suggested 

by your physician. It can also 

help to bring along our restroom 

alert card and/or a letter from your 

physician explaining that you have 

IC and will need restroom access frequently. 

6 

You can find more articles on 

planning IC friendly trips and vacations 

on our website!

4. STRESS 

Does stress cause IC Not that 

we’re aware of but it can certainly 

trigger an IC flare. IC patients frequently 

report that their symptoms 

worsen during periods of high physical 

or emotional stress. Consider the 

fact that when patients get very cold, 

they often have more bladder symptoms. 

Emotional stress creates similar 

reactions in the bladder through no 

fault of the patient. 

The human body has complicated 

neurological functions that we are 

still trying to understand. In the past 

few years, several IC researchers 

have focused on how nerves in the 

spinal cord and bladder react in 

highly stressful situations. They have 

found that intense stress causes a 

neuroendocrine response throughout 

the body, brain, spinal cord and that 

appears to be contributing to our 

pain levels. 7 

While this research continues, it’s 

important for IC patients to remember 

that there is no shame in having 

an IC flare as a result of stress. But, if 

it happens frequently, try to reduce 

your stress load and/or consider 

learning some new stress management 

skills by taking any one of the 

many stress management classes 

available at colleges and health centers 

around the country. Learn some 

new skills. As you get better at handling 

stress, the likelihood that it 

can trigger a flare will be reduced! 

5. CHEMICAL EXPOSURE 

IC patients often report that various 

chemical exposures and/or medications 

can trigger an IC flare. The 

usual culprits are soaps, detergents 

and laundry products that leave an 

irritating chemical film in our clothing 

or skin that can irritate our sensitive 

tissues. The most irritating 

detergents are those most commonly 

seen in mass advertising, such as 

Cheer or Tide. Patients report that 

Ivory Snow and Dreft are more IC 

friendly. Rinse twice to remove all 

detergent residue. 

The bath soaps considered the 

most IC friendly are Dove ® or Basis. 

Liquid soaps often have many more 

irritating perfumes, so stick with the 

simple bars of soap instead. 

Bubble baths are notorious for 

causing irritation in the urethra, 

vulva and perineum, thus, we suggest 

using only baking soda in your bath 

water. 

Smoking can create a terrible 

chemical load in the bladder and is, 

sadly, the #1 cause of bladder cancer. 

If you’re a smoker, we strongly 

encourage you to stop immediately! 

A cigarette might make you feel 

more comfortable, but it certainly 

won’t help an IC irritated bladder 

and could make it worse. 

Chlorine has been known to trigger 

IC flares in some IC patients. If 

you swim regularly, try to use a pool 

where you have verified that the staff 

know how to manage the pool chemicals 

safely. After swimming, always 

remove your suit quickly and 

shower! 

6. VITAMINS & SUPPLEMENTS 

Visit any IC support group and 

you’ll find that most patients can’t 

tolerate multivitamins of any type. 

Multivitamins are well known IC 

triggers because they contain 

Vitamins C and B6, both infamous 

for irritating the bladder and creating 

discomfort. Thus, if you’re using vitamins 

or supplements and are struggling 

with bladder discomfort, this 

could be the culprit. Patients often 

do better when taking individual 

vitamins and/or supplements, such as 

a simple Calcium Citrate pill. The 

book “A Taste of the Good Life: A 

Cookbook for an IC Diet” has an 

extensive discussion of vitamins, as 

well as suggestions on IC friendly 

forms of each. 


Some “bladder” supplements 

received at health food stores can 

also trigger IC flares, especially if the 

sales staff do not understand the difference 

between IC and UTI. UTI 

products, such as cranberry pills, are 

often very high in acid thus irritating 

to the IC bladder. When considering 

using a supplement, always ask for 

research showing that that supplement 

has specifically helped interstitial 

cystitis patients, rather than just 

cystitis patients. Prelief, CystaQ, 

ProstaQ, Cystoprotek, Prostaprotek 

may be worth exploring further. 

STRESS 

7. SEX & INTIMACY 

A number of IC patients report 

that sexual relations can trigger an 

IC flare. Men with IC may experience 

a searing pain at the moment of 

orgasm. Women with IC often feel 

their worst 24-48 hours after intercourse, 

with increased levels of frequency, 

urgency or pain. Men and 

women can also struggle with intense 

pelvic floor muscle spasms. 

In some cases, this discomfort may 

simply the result of friction on the 

tender tissues of the bladder or perhaps 

from using an irritating spermicide. 

Lubrication is essential to having 

IC friendly sex. Using K-Y Jelly 

or other lubricants can greatly 

improve your sexual comfort. 

It’s worth noting that an IC 

patient who has recently had pain 

and discomfort probably shouldn’t 

engage in wild, athletic sex. This is 

the time for soft, gentle sex and intimacy. 

Prolonged, aggressive intercourse 

could provoke muscle spasms. 

Thus, be creative and look for more 

IC friendly options! You’ll find several 

suggestions on how to make sex 

more comfortable in the ICN Patient 

Handbook and “The Ultimate 

Guide to Sex and Disability,” now 

available in the ICN Shop! 

8. EXERCISE 

Exercise, particularly workouts 

that involve the pelvic area, can 

trigger an IC flare. Bicycle seats put 

unusually high pressure on the pelvic 

floor muscles, thus exacerbating IC 

symptoms. Other patients have 

reported that workouts that jar the 

pelvis, such as running or stair master, 

can provoke pain. Exercise is 

possible as an IC patient, but it’s 

very important to pace yourself and 

pick your exercises carefully. It’s 

probably not a good idea to do a 

massive workout when your bladder 

is already tender. Focus on exercises 

that keep your pelvis level, such as 

walking, rowing, swimming or yoga. 

Consider trying the The Hatha Yoga 

Program For Interstitial Cystitis, currently 

available on video in the ICN 

Shop. 

REFERENCES 

1 Laumann, B. A Taste of the Good 

Life: A Cookbook for an IC Diet. Los 

Angeles Freeman Family Trust 

Publications. 1999 Available via the 

ICN Shop 

2 Sandler, G. Patient to Patient: 

Managing IC and Related Conditions. 

New Orleans Bon Ange, LLC. 2000 

P.53 Available in the ICN Shop 

3 Vliet, E. Screaming To Be Heard: 

Hormonal Connections That Women 

Suspect and Doctors Ignore. New York: 

M. Evans & Company, 1995 

4 Ho N, Koziol J, Parsons CL. 

Epidemiology of Interstitial Cystitis, in 

G. Sant (Ed.), Interstitial Cystitis. 

Philadelphia: Lippincott-Raven 

Publishers, 1997 

5 Osborne, J. “IC & Driving: How to 

Survive Long Car Rides” ICN Patient 

Handbook Self Help Tip of the Month, 

February 2002. http://www.ic-network.com/handbook/ 

6 Osborne, J. “Flying The Friendly 

Skies” ICN Patient Handbook Self 

Help Tip of the Month, September 

2003 http://www.icnetwork.com/handbook/ 

7 Buffington CA. Comorbidity of interstitial 

cystitis with other unexplained 

clinical conditions. J Urol. 2004 

Oct;172(4 Pt 1):1242-8. Review 


The A to Z Guide 

for Coping with Flares 

by Courtney Allen and Jill Osborne, M.A. 

Flare! As IC patients, the word 

sends tingles down our spines, 

makes us cringe and, quite 

frankly, can be frightening. Patients 

early in their diagnosis often find 

that flares make them feel helpless as 

well. With the help of many ICN 

members, we have gathered a long 

list of tips for coping with flares. 

From antihistamines to zzz’sss, we 

hope that you will use this list whenever 

you are struggling with a flare. 

This list empowers you with a variety 

of flare-coping strategies. 

We would like to take the time to 

extend a very big thank you to all of 

the ICN members who signed onto 

the message boards and shared their 

tips with other IC patients. 

Furthermore, we would like to 

encourage all of you to take a 

moment to add your additional tips 

to this list. You can find it on the 

message boards under flare-coping 

strategies. We hope to see you there! 

A 

ACCEPT HELP FROM OTHERS 

Not only should you accept help 

from others, but you should ask for it 

when you need it. 

ACKNOWLEDGE YOUR ANGER 

It’s normal and natural to become 

very angry when you’re struggling 

with pain and/or a flare but it’s very 

important that you not take it out on 

your family or friends. Find a way to 

express your anger each day, possibly 

by exercising, walking, or writing in 

a journal. Talking with a trusted 

friend may help as well. 

ACT EARLY 

Catching a flare early can save 

you hours or even days of pain and 

suffering. Take the appropriate medication, 

rest, and relax as much as 

possible at the first signs of a flare. 

ANTIHISTHAMINES 

By controlling and reducing mast 

cell activity, antihistamines, such as 

Vistaril and Atarax, help reduce the 

inflammation that occurs in the 

bladder. Vistaril and Atarax are also 

well known anti-anxiety agents that 

can also improve sleep quality. 

ANTISPASMODICS 

Unsure whether you are experiencing 

spasms If you’re having trouble 

starting your urine stream, or if 

you are suffering from pain during 


urination, you may be having a 

spasm. The same is true for patients 

who have flares after sex. 

Antispasmodics such as Ditropan, 

Detrol, Hyoscyamine or Flexeril can 

be very effective in reducing the discomfort 

of pelvic floor muscle 

spasms. In fact, many patients find 

antispasmodics are helpful in the 

days after a spasm to help the muscles 

settle down. 

AROMATHERAPY 

Many people believe that aromatherapy 

has beneficial physical 

and psychological effects. If you are 

not especially sensitive to scents, 

experiment with a few drops of 

essential oils on your pillow or next 

to your bed. There are also a variety 

of aromatherapy lotions, candles, and 

other products available. 

ASK OTHERS NOT TO 

DISTURB YOU 

We all know that flares can make 

you quite irritable. And though 

friends and family may usually be a 

great resource, sometimes their presence 

can be overwhelming. Allow 

yourself the luxury of a little quiet 

time when you need it. 

Stop and rest, even if just 

for 10 minutes, and give 

yourself permission to say 

“No” when you’re not 

feeling well. 

ASSESS YOUR PAIN LEVEL 

Is your pain sharp or dull Is it 

continuous or does it come and go 

Where specifically is the pain located, 

in your bladder, your urethra, 

your perineum, or for women, the 

vulva Do you experience pain 

before, during or after urination 

These are all details that you need to 

be able to accurately describe to your 

doctor. Take notes now. 

B 

BAKING SODA 

Patients report that they have 

found relief from baking soda, 

TUMS or Alka Seltzer. Follow the 

preparation directions on a packet or 

box of TUMS or Alka-seltzer or 

combine 1/2 teaspoon of baking soda 

to a standard glass of water. Patients 

who must restrict salt intake, such as 

those with high blood pressure or 

heart conditions, should consult with 

their medical care provider before 

using baking soda. 

BLAND FOOD 

Acidic and spicy foods are the 

cause of many flares, and continuing 

to eat them during a flare will further 

irritate your bladder. Take a break 

from more exotic fare and enjoy 

IC-friendly foods. For a list of ICfriendly 

foods, visit the ICN Patient 

Handbook on our website. 

BREAK YOUR ISOLATION 

One of the hardest parts about 

having an IC flare is that it’s very 

isolating. We often stay at home and 

cocoon, especially when driving 

hurts or it’s hard to get together with 

family. But, isolation can have a distinctly 

negative impact on a person’s 

quality of life, often opening the 

door to depression. Try to break your 

isolation each and every day. Invite 

friends and family over for a movie 

night, throw a potluck dinner, or at a 

minimum, have at least one conversation 

a day with a friend or family 

member. Be honest if you’re lonely. 

Ask for visits and phone calls. 

BREATHE 

Your breathing patterns can tell 

you a lot about your current state. 

Are you taking quick shallow 

breaths Then you’re probably 

stressed and tense, which can intensify 

a flare. Slow down and take a 

few deep breaths. This is a great time 

to use a relaxation audiotape. 

C 

CALL YOUR DOCTOR OR GO 

TO THE EMERGENCY ROOM 

WHEN NECESSARY 

Don’t hesitate to wake your 

spouse or family if you need help or 

need to go to the hospital in the 

middle of the night. Be prepared 

with a detailed list of the medications 

you have taken or are regularly 

taking, as well as contact information 

for all of your physicians. 

COLD 

Whether it is ice, a cold compress, 

or a cold water spray, many IC 

patients find that cold can effectively 

calm a flare. One IC patient suggested 

sitting in a cold bath for 20 minutes. 

However, be careful not to 

apply a cold compress for a long period 

of time, as extended cold can create 

tighter muscles. Try initially 

using a cold compress and then 

applying some gentle heat. See Heat 

below. 

CONSTIPATION 

Having an IC flare is bad enough, 

but throw in constipation and you 

can be miserable. The reality is that 

many IC patients don’t drink enough 

water and/or take medications that 

can provoke constipation. Thus, it’s 

important that you work hard to prevent 

this. There are many constipation 

strategies available, such as 

Power Pudding (featured in the 

ICN’s Winter 2005 newsletter) and 

bulk, affordable psyllium husk (available 

in the ICN Shop). 


D 

DON’T FORCE YOURSELF 

THROUGH THE PAIN 

We see it every day; young mothers 

and fathers who try to ignore the 

pain while continuing to keep a 

crazy schedule. Pain is a message. 

Your body is telling you that there is 

a problem. Give yourself permission 

to stop and rest when the pain gets 

bad. Forcing yourself through the 

pain is akin to walking on a broken 

leg. It simply doesn’t make sense. 

Pace yourself. Stop and rest, even if 

just for 10 minutes, and give yourself 

permission to say “No” when you’re 

not feeling well. 

DRIVING 

IC can make driving uncomfortable, 

especially when you’re in a 

flare. This is not the time to be sitting 

in a car, bouncing over bumpy 

roads. The vibration alone can provoke 

more pain and muscle spasms. 

So, if you’re in a flare, try to stay 

away from long car rides unless 

you’re going to the doctor. If possible, 

drive a car with a smooth rather 

than rough suspension. 

DRY MOUTH 

Yes, we’ve all struggled with it. 

Dry mouth is a common side effect 

from many IC medications, particularly 

antidepressants. If you have dry 

mouth, it’s important to understand 

that your teeth may be in jeopardy. 

Saliva is a natural protection against 

cavities, and without it your teeth 

suffer from their destructive power. 

Try the Biotene line of products, 

available in most drug store chains. 

They have a wonderful mouth gel, 

tooth paste and even chewing gum 

that can help. Sip water. Brush your 

teeth regularly, especially if you’re 

using candy to keep moisture in your 

mouth. 

E 

EGG WHITES 

Did you know that egg whites are 

natural acid reducers If you’re struggling 

with finding something to eat 

during a flare, how about making 

yourself an egg white omelet Or 

consider purchasing “Just Whites,” a 

powdered egg white available in the 

baking section of most grocery stores. 

We often use a teaspoon of Just 

Whites in smoothies, pancakes and 

more. They’re great for cooking and 

baking. 

ENCOURAGE YOUR FAMILY AND 

FRIENDS TO LEARN ABOUT IC 

Consider putting together a small 

informational packet for them. 

Although they will never be able to 

completely understand the full scope 

of pain and emotions related to IC, a 

little patience and understanding on 

their part can go a long way. 

EXERCISE GENTLY 

It’s important to move when you 

can. Take a gentle walk and get 

yourself out of the house. You don’t 

have to go far, just move. Patients 

have reported great success using the 

Hatha Yoga video for IC because it 

can help relax those tight pelvic 

floor muscles we struggle with during 

flares. See Stretch and Yoga below. 

F 

FIGHT FATIGUE 

When you’re not sleeping well 

and taking medications that make 

you lethargic, it’s easy to sleep all 

day. Fight that fatigue through movement. 

Energy creates more energy. If 

you take a walk, you’ll find that 

you’re just a bit more energized to do 

other projects. Be active each day, 

whether it be by reading, writing, 

gardening, working or crafting. 

FOOT BATHS AND 

FOOT MASSAGES 

These quick and easy luxuries are 

very soothing and can offer at least a 

temporary distraction. Take time to 

savor the sensation. 

FREQUENCY 

If you’re struggling with frequency, 

this is the time to examine your IC 

diet. We find that so much of the 

frequency patients experience during 

flares is the result of irritating the 

wounds in our bladders. It seems that 

the patients who drink just one cup 

of coffee each morning struggle significantly 

more with frequency. 

Thus, get back to the basics and 

avoid that top 5 list of forbidden 

foods: cranberry juice, coffees and 

teas, carbonated beverages, tomatoes 

and tobacco. 

FRIENDS 

IC does not change your ability to 

be a friend or to help a friend. You 

need your friends. So, stay in touch. 

Let them know how you’re doing. If 

you’re not well enough to go out 

with them, invite them over to your 

place for movies or take out. One of 

the best benefits of being involved in 

an IC Support Group are the friends 

that you make who really understand 

what you’re going through! 

FRUIT 

Think pears! Fruit lovers often 

despair when they first see the IC 

diet because they think that they 

can’t eat any. That’s wrong. IC 

patients can tolerate a variety of 

fruits, but it takes some work to 

determine what you can eat safely. 

Pears are the best tolerated fruit. If 

you do well with pears, try a mild 

apple, such as a Gala or Fuji apple. If 

you do well with that, test yourself 

with melons and/or tropical fruits, 

such as mango or papaya. Remember, 

too, that it’s about quantity. You 

might not be able to eat a whole 

apple, but 1/2 might be just right! 


G 

GET INVOLVED 

Use the pain constructively by 

writing a letter to your congressperson 

or senator demanding more 

money for IC research. Pour out your 

heart and your pain to a constructive 

purpose. Tell them just what IC feels 

like. Request more research money. 

Emphasize the need for more education 

for primary care providers who 

don’t know enough about IC. Read 

the ICN Activist’s Corner for more 

information and ideas! 

that fit right over the bladder. 

Bodiheat pads are perfect to wear 

discreetly during the day. 

HELP 

Whether it be driving to the 

emergency room, going to doctors 

appointments or just shopping, ask 

for help if and when you need it. 

Family and friends are often very 

willing to step in and assist us if we 

give them a chance. Don’t suffer in 

silence. If you need help, ask for it! 

Give your family the chance to help 

you just as you would help them if 

they were ill or injured. 

HOUSEKEEPING 

To clean or not to clean, that is 

the question. If you’re in a flare, 

don’t push yourself. You don’t have 

to scrub the house from top to bottom, 

but you’ll probably be able to 

pick up a few things. The point here 

is that pushing yourself despite the 

pain can be counterproductive. If 

your house is a mess and you can’t 

clean it, hire a housekeeper to come 

in for a few hours a week. Better yet, 

call your friends and offer them a 

pizza party and movie in exchange 

for a little spring-cleaning help. 

GIVE YOURSELF FREQUENT 

REWARDS 

You’re working hard right now to 

cope with your IC, understand your 

therapies, and figure out your diet. It 

can be exhausting. This is the time 

to reward yourself for your hard 

work. For every doctors appointment 

you make, give yourself a reward, 

whether it be a new nail polish, a 

warm bath, or a well-deserved nap. 

H 

HEAT 

Place a heating pad across your 

belly, over the bladder. This can be 

very soothing right before going to 

sleep. Try using a microwaveable pad 

or an electric pad that has an automatic 

shut off. The ICN Shop has 

special shaped microwaveable pads 

IC does not change your 

ability to be a friend or 

help a friend. 

Our Top Ten Products That Can Help YOU 

Manage Flares...Now Available at icnshop.com 

(1) The ICN Special Report on Diet 

Diet IS the #1 flare trigger. If you're not up on the latest info, you should be. $10.00 

(2) Perineal Wash Bottle 

One of the easiest, simplest ways to reduce that sensation of “urine burn” that we 

often struggle with during flares. There's nothing more soothing than using cool 

water to soothe those tender tissues! $2.99 

(3) BodiHeat Heating Pads 

A long time favorite, these flat, light heating pads stick to your underwear and can 

be worn all day or night. They are great for commutes, long car rides, plane flights 

or for work! $3.99 for three 

(4) Comfort Valley Microwaveable Heating Pads 

Custom made specifically for bladder & pelvic pain patients, this triangular heating 

pad sit comfortably right over the pelvis! $19.99 

(5) UTI Home Test Kit 

Is it an IC flare or a UTI This home test kit can help you figure it out. $9.99 

(6) pH Urine Test Kit 

IC patients have long known that acidic urine can trigger bladder discomfort. This 

test can help you determine if you're urine is too acidic! 50 test strips for $12.99 

(7) Pain Relief CD 

Guided relaxation tapes & CD's are always a plus during a flare because they can 

help you reduce muscle tension in the pelvis! We love the guided relaxations 

offered by Potentials Unlimited! $19.99 

(8) Very Private Intimate Moisture 

Lubrication is essential in making sexual relations more comfortable! $12.95 

(9) Bladder Friendly Chair Cushion 

When you can't sit comfortably, this cushion can help. It reduces pressure on those 

tender tissues in the perineal area! $23.99 


(10) Carob Malt Balls 

Okay, so you're desperately missing your chocolate and working hard to fight your 

flare. How about a nice reward Carob is IC friendly and these malt balls get rave 

reviews $3.99

HYPNOSIS 

A licensed hypnotherapist can 

work with you to teach you self-hypnosis. 

Self-hypnosis can allow you to 

relax quickly anywhere (and relaxed 

muscles will help the pain), or fall 

asleep even though you are in pain. 

I 

IC BUDDIES 

One of the mistakes that IC 

patients frequently make is that they 

expect family and friends to understand 

what they are going through. 

Inevitably, it creates even more frustration 

on spouses, family members 

or friends. Develop some IC buddies 

that you can call! They can say that 

they understand and mean it. Better 

yet, they may also have some very 

useful suggestions. IC buddies are 

easily found at support groups 

throughout the USA or through the 

ICN Message Boards. 

ICE AND ICE PACKS 

Placement of the ice or ice pack 

depends upon personal preference, 

though some IC patients advocate 

placing it on the perineum, the small 

patch of muscle and tissue located 

between the vagina and the anus. 

Caution! Ice should be wrapped in a 

cotton cloth before placing it on 

your skin. Applying cold for too long 

can lead to tight and tense muscles. 

infection (UTI). Call your urologist 

to ask for a urinalysis. It can be helpful 

to have a UTI Test Kit at home 

that you can use to help rule this out 

at home. UTI test kits are available 

in most drug stores and in the ICN 

Shop. 

J 

JOIN AN IC SUPPORT GROUP 

Okay, admit it! At one point in 

time you truly thought that you were 

the ONLY PERSON who had IC! 

No one could possibly understand 

your pain, right Right. There’s nothing 

more comfortable than walking 

into a room of other IC patients and 

seeing people your age who really 

understand. Even if you’re not a support 

group person, try to go at least 

once a year just to catch up on the 

latest info and make some new 

friends. Join an ICN chat, read ICN 

articles or post on an ICN message 

board. 

Talk to other IC patients who 

have experienced what you’re going 

through. Even from the safety and 

relative comfort of your own home, 

you can reach out to other patients 

and remind yourself that you’re not 

alone. 

K 

KNOW THAT YOUR CURRENT 

LEVEL OF PAIN AND 

DISCOMFORT IS TEMPORARY 

A flare is by definition a temporary 

intensification of the pain, discomfort, 

and irritation associated 

with IC. Though some flares seem to 

last forever, most can and will be 

over in a limited matter of time. 

KNOW YOUR LIMITS 

Being stubborn and refusing to 

accept your personal limitations will 

aggravate symptoms in both the 

short and the long term. Consider 

INFECTION 

Rule out infection as a possible 

cause of your bladder pain. Though 

an IC flare feels very similar to a 

UTI, there are some subtle differences. 

Many patients report that 

UTI’s have more of a burning quality, 

particularly during urination 

and/or in the urethra. So, if you’re 

having a particularly bad flare, have 

a fever, low back pain and/or more 

burning during urination, you could 

have picked up a classic bladder 

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or visit www.puroast.com 


the fact that everyone has restrictions, 

health-related or otherwise. 

Don’t push yourself through the 

pain. 

KNOWLEDGE IS POWER 

We hear the same story almost 

every week. An IC patient will call 

our office and say they’ve tried 

everything for IC only to discover 

that they don’t know the most basic 

concepts, such as diet. Knowledge is 

power. Gather your information from 

reputable sources. Read, at a minimum, 

the “IC Survival Guide” by 

Robert Moldwin. If you’re struggling 

with the diet, read “A Taste of the 

Good Life; A Cookbook for an IC 

Diet.” by Bev Laumann. Try reviewing 

some of the latest research at the 

National Library of Medicine online 

(PUBMED). Visit the ICN & ICA 

websites regularly to build your IC 

knowledgebase. 

L 

LAVENDER 

Lavender scents can be immediately 

calming. Furthermore, a recent 

study by the Florida College of 

Dentistry found that subjects reported 

that their memories of painful 

experiences were less intense after 

inhaling lavender scents during the 

event. Try using lavender in a cotton 

sack in your dryer to add a soft, gentle 

scent to your linens! 

LOVE 

Hugs, kisses and caresses are IC 

friendly! IC doesn’t change the love 

that we have in our hearts or our 

ability to love. Show your love to 

family and friends frequently. A 

batch of home-made cookies, love 

notes, cards … the ways to express 

love are endless. If sexual relations 

are difficult for you, take a moment 

and read the chapter on sex and IC 

in the ICN patient handbook. 

Hugs, kisses and caresses are IC friendly! 

LOW ACTIVITY 

Don’t push your physical limits. 

Relax and let your body recuperate, 

but don’t confuse low activity with 

no activity. Occasionally get up, if 

only to get yourself a glass of water 

or to fix yourself a snack. 

M 

MEDICATION, PAIN OR 

OTHERWISE 

Remember these three rules for 

medication. 1) Always use medications 

as instructed by your physician. 

2) Never use medication belonging 

to someone else. 3) Remember that 

the earlier you catch a flare, the easier 

it is to stop and the less medication 

it may take to stop it. 

MUSCLE RELAXATION 

Your body’s natural reaction to 

pain is to tighten muscles. Thus, 

when you’re struggling with an IC 

flare, your pelvic floor muscles can 

be extremely tense, thus creating 

even more discomfort. A classic 

symptom of muscle tension is difficulty 

in starting urination. Many IC 

patients report that their pelvic floor 

muscle spasms create a burning sensation 

or can even feel like a yeast 

infection. Still others report that it 

feels like there is a foreign object in 

their urethra, vagina or rectum. 

If you’re struggling with muscle 

tension, try listening to a guided 

relaxation audiotape to relax your 

body. Commonly available at bookstores, 

we recommend the tapes by 

Potential’s Unlimited (Barry 

Konicov). If you can’t find those, try 

the Health Journey’s series of tapes. 

MUSIC 

Music really does set your mood. 

Listen to relaxing music when you’re 

feeling stressed or upbeat music 

when you’re feeling down. 


N 

NEUROMODULATION 

We mention neuromodulation 

here to urge you to be cautious. 

Neuromodulation (also known as 

InterStim ® ) is not FDA approved for 

pain control, though it has helped 

patients with extreme frequency 

and/or urgency. Some patients have 

been disappointed to discover, after 

the surgery, that it did not help with 

their pain symptoms. But when 

you’re in a bad flare, you might be 

desperate enough to consider any 

surgery. Be cautious. Do your 

research. Don’t let desperation push 

you into having a surgical procedure 

before you have tried other, less risky 

therapies first. You can find more 

information on neuromodulation in 

the ICN patient handbook under 

“Nerve Stimulation.” 

NEUROTONIN 

Medications like Neurontin have 

the potential of helping with nerve 

related pain. This may be worth talking 

about with your doctor to see if 

you might be a candidate. 

NOTE YOUR SYMPTOMS 

Keeping a voiding diary can help 

identify the causes of flares and can 

also help your doctor determine 

which medications are currently 

working and those which may best 

benefit you in the future. 

O 

OPEN A BOOK 

Distract yourself and escape into a 

world of your choosing. Getting your 

mind off of a flare can be tremendously 

therapeutic. 

OVULATION AND 

MENSTRUATION 

Women with IC frequently discover 

that their symptoms flare the 

day that they ovulate and/or a few 

days before their period starts. This is 

typical and due to hormonal fluctuations. 

During these times, be prepared, 

rest frequently, follow the diet, 

avoid long drives and remember that 

this, too, shall pass. These are the 

easiest flares to handle because they 

are often resolved quickly. 

P 

PELVIC FLOOR MUSCLES 

You’ve got them, but are you 

using them properly The pelvic 

floor muscles are nearest the bladder 

and are frequently involved during 

flares and muscle tension. Patients 

with weak muscles may struggle with 

incontinence. IC patients often 

struggle with tight muscles and may 

find it difficult to start their urine 

stream. Having a pelvic floor assessment 

is becoming vital. To treat the 

bladder without treating any underlying 

muscle issue isn’t practical! Ask 

your doctor to test your pelvic floor. 

PRAYER 

Regardless of your religious beliefs, 

expressing your pain, your hopes, and 

your desires can be very therapeutic. 

For those of you that believe in the 

power of prayer, encourage family 

and friends to join you. Faith can be 

a great source of comfort and inspiration! 

PRELIEF 

This over-the-counter medication 

works best taken right before you 

ingest an acidic food or beverage, but 

some patients find that taking it 

alone during flares can relieve pain. 

For more information refer to the ICN 

handbook or visit www.prelief.com. 

POWER OF POSITIVE THINKING 

Staying optimistic can reduce 

stress and help you heal faster. It’s 

natural to feel discouraged, especially 

during flares. Feel free to lean on 

your fellow ICN members for support 

when you need it. There are also 

several small books filled with affirmations 

available to help you get 

through rough days. ICN President 

Jill carries one with her frequently to 

help handle the stress of waiting for 

appts, traveling, etc. By repeating 

affirmations to yourself quietly, you 

help to break building anxiety and 

can better focus on the future. 

Norman Vincent Peales book “The 

Power of Positive Thinking” can be a 

great place to begin. The ICN Shop 

also has some books and audiotapes 

that can help, including one called 

“Be Positive.” 


Q 

QUESTIONS 

The only embarassing question is 

one left unasked! Ask questions of 

your doctors, your nurses, and your 

fellow IC patients. Use the knowledge 

you gain to better manage your 

IC. When speaking with your doctor, 

being educated on the topic will be 

beneficial, especially if you have an 

intended outcome in mind. 

R 

REDUCE STRESS 

Consider what brings stress into 

your life. How might you be able to 

decrease the effect of these stressors 

in the future Be honest with yourself. 

Are you a good stress manager 

If not, this is a great time to take a 

class on stress management and 

improve your skills. 

RELAXATION 

Reduce the tension in your body 

every day. Tension = muscle spasms 

= pain and discomfort = an exacerbated 

bladder. Just 10 minutes of 

guided relaxation (by listening to an 

audiotape), twice a day, can dramatically 

improve your mental and physical 

health. During your next coffee 

break, find a quiet spot and listen to 

a tape. 


WHAT NOT TO DO 

DURING A FLARE 

• Never take extra medication beyond the dosages that a doctor 

recommends or mix medications without your doctor’s approval. 

Talk with your physician and pharmacist first to check for medication 

safety tips, safe dosages, any concerns about mixing medications, 

etc. 

• Do not drive or operate a motor vehicle while heavily medicated. 

Please preserve the safety of yourself, your family, and others on 

the road by not driving when you are impaired. 

• Never use medication that was prescribed to another member of 

the family. 

• Do not strain while urinating. Try to resist over-exerting because it 

can severely strain your pelvic muscles. 

• Don’t choose to ignore early signs of a flare. No one would want 

to have a flare, but denying that you are in the beginning stages of 

a flare or trying to “grin and bear it” are just going to cause you 

more pain and suffering in the long run. Acting early will help 

lessen the symptoms and most effectively treat a flare. 

REST 

Rest and sleep can be two very 

different things. Although sleep can 

be a great relief when you are experiencing 

a flare, it may not always be a 

possibility. Take a few minutes to sit 

or lie down. 

S 

SEX 

To have sex or not have sex … 

this is the eternal question asked by 

IC patients in love. Sex is possible 

with IC but it needs to be 

approached carefully. Lubrication is 

essential. We want to avoid friction 

on those tender tissues. Avoid prolonged, 

aggressive intercourse which 

is well known to trigger muscle 

spasms. It’s best to focus on stroking, 

caressing and other less aggressive 

approaches. There are several 

resources that can help you rebuild 

your sex life, including books, videos 

and lubricants in the ICN shop. 

STAY CALM 

It can’t be said too many times; 

stress makes flares worse. Most of us 

would never claim that it’s easy to 

stay calm during a flare, but irregardless 

of ease, it remains important to 

stay relaxed. 

STRETCH 

You may not feel like running 

around the block but that doesn’t 

mean that you can’t do some easy 

stretches to reduce tension and keep 

your body comfortable. “Stretch Into 

Better Shape” is a booklet written 

specifically for IC patients to help 

them move comfortably. 

SUNSHINE 

Sunlight is a natural antidepressant 

and also keeps your body on a 

natural time-clock. Open the blinds 

and let a little light in, or sit on a 

lounge-chair on the back porch or 

patio when you feel up to it. 

T 

TEA 

Some patients mistakenly assume 

that tea is more bladder-friendly 

than coffee. Most teas can be very 

acidic, especially green teas. 

Try a very mild chamomile or 

mint tea first. These are usually well 

tolerated and are generally comforting. 

If you are in a flare, hot water 

and honey is the better choice. 

Avoid herbal blends, which often 

contain other herbs known to be irritating, 

such as rose hips. 

TENS 

A TENS unit can be quite helpful 

during flares. They work by creating

a source of distraction from the pain. 

IC patients often place the electrode 

pads on their lower belly or upper 

legs. TENS units can be purchased 

for under $70 from Rajala.com with 

a prescription. Please note, however 

that they require instruction to use. 

A TENS unit should never hurt. If 

you’re using one and it’s causing any 

pain, you’re using it incorrectly. 

U 

UNDERSTAND THAT EACH IC 

PATIENT FINDS DIFFERENT 

THERAPIES TO BE HELPFUL 

Be willing to work with your doctor 

and other health care professionals 

(pelvic floor specialists, pain specialists, 

dieticians, etc.) to find the 

best flare-coping strategy for you. 

URETHRAL DISCOMFORT 

Some IC patients struggle with 

discomfort just in their urethra. This 

can be due to a number of factors. 

Some urethral irritation can be 

caused by laundry detergents or 

soaps. We suggest using Ivory Snow 

detergent and DOVE or Bases bath 

soap. Avoid all bubble bath products. 

These are well known to trigger urethral 

agony. 

UTI 

See Infection above. 

V 

VANILLA ICE CREAM 

Okay, so vanilla ice cream won’t 

actually heal you or reduce your discomfort, 

but IC patients suggested it 

as a way to enjoy a little luxury and 

feel normal during a flare. 

VENT APPROPRIATELY! 

When it comes down to it, sometimes 

you just need to release your 

frustration. Before you fly off the 

handle, ask yourself if it’s your anger 

or frustration talking. If it is, gather 

your thoughts first and take several 

deep breaths. It might be helpful to 

take an hour and walk away from the 

situation to calm yourself. Make a 

list of what your issues are and then 

ask yourself what that person can do 

to help you. If you have an IC related 

stressor, sign onto ICN and share 

your IC related aggravations with 

other IC patients. If you have a family 

issue, be gentle. Remember, your 

family members don’t have IC and 

don’t understand what you’re going 

through. They can’t read your mind. 

Focus your thoughts and share with 

them what you need to get through 

this difficult time. Often, simply 

communicating your needs can help 

unleash your negative emotions. 

W 

WALKING 

Make a daily walk part of your 

routine. Take an after dinner walk 

with a friend or your spouse, walk 

your dog, or start your morning with 

a stroll in the sunshine. If necessary, 

walk for only five minutes, but try to 

do it everyday. 

WATER 

Water dilutes the urine and 

reduces its irritating effects. Be sure 

to stay well hydrated on a daily basis 

by drinking six to eight glasses of 

water a day. Try sipping a glass of 

water over a period of an hour, 

rather than drinking a full glass at 

one time. 

WEAR COMFORTABLE CLOTHES 

Tight or restrictive clothing can 

create additional pressure on the 

bladder, making a flare worse. So, 

wear loose clothing that makes you 

feel comfortable and relaxed. Fabrics 

with a little stretch to them are 

highly recommended. 

X 

EXAMINE THE CAUSES OF 

YOUR FLARES 

Some flares come from obvious 

sources; spicy or acidic foods, high 

stress, or hormones. Others sneak up 

on you with little warning. If you’re 

keeping a voiding or diet diary this 

task will be easier and will help you 

avoid flares in the future. 

Y 

YOGA 

Yoga is an ancient discipline that 

stimulates and nurtures the healing 

of the body, balances emotions and 

clarifies the mind. The practice of 

yoga is about focusing on the strict 

alignment of the body, coordination 

of breath and movement, holding 

postures and meditation. Yoga 

enables us to direct our attention to 

the wholeness of the body and mind, 

to heal and neutralize the effects of 

daily stress. If you’re interested, consider 

trying the “Hatha Yoga 

Program for Interstitial Cystitis” currently 

available by video on the ICN 

site or refer to the ICN handbook for 

more complete information. 

Z 

ZZZZZZS 

Although sleeping can seem to be 

impossible during a flare, many IC 

patients experience measurable relief 

after sleeping for even short periods 

of time. Luckily, many medications 

can help improve sleep quality, such 

as the antihistamine Vistaril or the 

sleep aid Ambien. 

Your sleeping position might be 

part of the problem. Some patients 

like sleeping on their bellies because 

it seems to rotate their hips and take 

some pressure of the bladder. Others 

prefer laying on their sides or back. 

Exercise each day can help too! Try 

getting out of the house for a while, 

into the sunshine and fresh air. Try 

playing some soft background noise 

or, perhaps, an audiotape guided 

relaxation tape. Remember that caffeine 

& smoking can definitely make 

insomnia and an IC bladder worse! 

Read more sleep tips in our ICN 

Patient Handbook! 


Bladder Problems 

Enjoy everyday life, 

again! 

Some foods are keeping many people from doing the 

things they once enjoyed. Are you one of the many who 

avoid car rides, little league games, movies and family 

dinners because of the effects of acidic foods 

Many people are highly sensitive to food. For some, 

various foods can cause occasional heartburn, for others 

the "hidden irritant" in foods can exacerbate urinary 

problems or bowel distress. In most of these cases, the 

problem lies with the unsuspected acid in the foods. 

Prelief is a safe, effective over-the-counter product that 

can help you stay comfortable. Prelief works by taking the 

acid irritant out of foods, so these foods are less likely to 

trigger problems. With Prelief you can enjoy life again. 

Go ahead... 

take that long car ride, cheer 

on your favorite little leaguer and 

watch the entire movie. A trip 

to the grocery store won't have 

to include a map to the restroom; 

a family dinner can be long 

and lingering! 

Available in the antacid section at 

Albertson's, Eckerd, Long's, Meijer, 

Osco, Publix, Rite-Aid, Savon, 

Walgreen's and many other fine stores. 

Also available by phone or www.prelief.com. 

¨ 

Safe. Reliable. Effective. 

CALL 1-800-994-4711 

for literature and a coupon 

P0212 ©2005 AkPharma Inc.

Understanding IC Flares - Interstitial Cystitis Network

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