Dr. Jay Burstein Dekalb Clinic 217 Franklin St. Dekalb, IL 60115 815-758-8672 Dr. Jay D. Burstein is a Board Certified Urologist specializing in painful voiding syndromes and incontinence.

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Created: Feb 15, 2002

Q & A with Dr. Jay : Feb 2002

Please remember that Dr. Jay does NOT give personal medical advice via the web. Always review any information that you receive on-line with your personal medical care provider. Only your personal doctor can and should make medical recommendations to you.

In this issue:

186. Discomfort After Voiding. Is it IC?
187. Is there a connection between IC and antibiotics
188. Can a transvaginal ultrasound rule of bladder cancer or IC?
189. Can antihistamine use cause IC flares?
190. Using Grape Seed Extract for IC

186. For as long as I could remember I've had this "mysterious" uncomfortable feeling after voiding. It's not every time, but if I don't have to urinate very badly, I will have the discomfort. Once my bladder starts to fill again, the feeling goes away. It can last for a few minutes, or a few hours.... I don't know if it is interstitial cystitis or something else, but it is very frustrating! When I go to the doctor, the urine tests are negative. I just would like to know if that sounds like IC or maybe some other kind of condition.

A: It is important to remember that IC is a spectrum disease and that it can initially present with very mild symptoms, such as you describe. Do not wait for this to get out of control. Be sure to see a physician who has an interest in IC for a complete evaluation.

187. Have you seen a connection between interstitial cystitis and antibiotics, specifically minocin and other tetracyclines?

A: Many IC patients can refer to an initiating event causing the pain and symptom complex of IC. These are usually traumatic events such as a severe urinary tract infection or bladder catheterization done for an unrelated procedure such as d&c. Antibiotics are not known to be a causative agent of IC, but some individuals could be sensitive to and experience symptoms from filler materials used in compounding medications. At this time there is no direct connection between any specific antibiotic and IC.

188. Could you please verify if a Pelvic Ultrasound and a transvaginal Ultrasound could provide enough information to rule of bladder cancer or IC?

A: Ultrasound techniques do not have the specificity or sensitivity to be used routinely to detect or screen for bladder tumors or IC. IC can only be diagnosed by obtaining a careful history, ruling out other possible causes of frequency and pain and then confirming the findings by the typical appearance of glomerulations seen on cystoscopic examination.

189. I have allergies and have discovered that I get IC flare whenever I take Allegra D or Claritin D. What do you think is the connection?

A: These are combination antihistamine medications that are very effective for seasonal allergic symptoms and they do not cause as much drowsiness as more typical medications such as Benadryl. The "D" stands for "decongestant" and these formulations contain pseudaphedrine that cause shrinkage of the nasal blood vessels that then decreases nasal "stuffiness". Unfortunately, a similar effect occurs at the funnel portion of the bladder causing the bladder muscles to contract that makes it more difficult to urinate. Many men with symptoms of prostate blockage really suffer when they take this kind of medication. In your case, the extra force needed to urinate when your bladder is under the influence of Sudafed causes imbalances and flair occurs. Definitely refrain from any medication that contains Sudafed.

190. Hello, I have heard that the Herb "Grape Seed Extract" is good for the Immune System. 1st of all, do you agree? 2nd, I was wondering if it is ok for me to take since I have Interstitial Cystitis?

A: Grape seed extract contains anti-oxidants such as the flavenoid quercitin (the active component of Cysta-Q) and tannins such as proanthocyanidins that prevent certain bacteria from attaching to the bladder wall and is often suggested in the form of cranberry for those suffering recurrent urinary tract infections. Studies have not defined distinct immune enhancement by grape seed extract, but studies have shown a moderate dose to decrease postoperative wound.swelling. The procyanidins that are isolated from this extract have been shown to stabilize capillary walls to prevent increased permeability (leakage). This reduces edema (swelling) and theoretically would help stabilize bladder blood vessels and limit leakage of toxins that are currently theorized to cause the symptoms of IC. I have no experience in the use of this supplement but no health hazards or side effects are known by the use of proper therapeutic doses.