While you may think of your seasonal allergies as affecting only your sinuses, they can also affect your bladder and your bowel. IC patients are more likely to have asthma and seasonal allergies than the general population.  IC patients with allergies are also much more likely to have bladder flares when pollen counts begin to rise(1). Allergy  medications seem to curb the flare in allergy symptoms and in the bladder.(2)

Reduce Your Exposure

Pollens from grasses, trees and flowers fluctuate throughout the year. Odds are, you already know which time of year is the worst for you but, if not, it’s very helpful to use an on-line pollen map. They will notify you when pollens are rising in your neighborhood and also give you a bulls eye view of what’s happening throughout the country. But it’s not just pollen that you have to monitor. High winds make allergies much worse because they spread pollens far and and wide.

  • On windy days, limit your time outside as much as you can and keep windows closed in your home and vehicles.
  • Avoid outdoor activity in the morning when pollen counts are their highest. If possible, have someone else mow the lawn and/or pull weeds when allergies are intense. If you must be outside, wear a pollen mask. Even a simple cloth face mask might help a bit.
  • Wear a hat to help keep pollen out of your hair and sunglasses help keep pollen out of your eyes.
  • Remove your clothes before you walk into your house. Wash immediately in warm or hot water. Be sure to dry them in a clothes dryer. Don’t dry clothes outside because pollens can stick to their surface.
  • Leave your shoes outside to avoid tracking dirt and pollens into the house.
  • Wash your hair before going to bed to get rid of any pollen in your hair.
  • Wash your bedding in hot, soapy water weekly. If you have outdoor pets, you may need to limit close contact. (3)

Consider Medication

Over-the-counter

Clinicians usually advise staying ahead of allergy season by using medications early. Many antihistamines are available over-the-counter as well including loratadine (Claritin, Alavert), cetirizine (Zyrtec Allergy) and fexofenadine (Allegra Allergy).(6) Be careful or wary of allergy medications containing decongestants such as pseudoephedrine, which can act like caffeine and cause IC flares.

Nose sprays are also available to help manage allergy symptoms. Nasal corticosteroids (for example, Flonase and Nasacort) reduce swelling in the nose to alleviate stuffy, runny and itchy noses and nasal allergies.(3)  A saline nasal spray (Ocean) can also help clear out your sinuses in a more natural way.(4) Nose sprays will not influence the bladder, however.

Prescriptions

Urologists have been using anti-histamines to treat IC for years — even in patients who don’t have allergies. Hydroxyzine HCL (Atarax) and hydroxyzine pamoate (Vistaril) are, in fact, Step Two Treatment Options in the AUA Guidelines that have helped numerous IC patients, especially those with a history of allergies. They will calm allergic reactions throughout the body, including the sinuses and in the bladder.(4)

 Montelukast (Singulair) is another viable option for patients who also struggle with asthma, according to Dr. Robert Evans. Montelukast is an oral anti-inflammatory that prevents asthma attacks by targeting leukotrienes, which are chemicals the body releases in response to allergens.(5)

Maintain good bladder habits

Any time you are at a higher risk for an IC flare — like during allergy season — stick with good bladder habits. Hydrate well to avoid your urine becoming too acidic and increasing your symptoms. If you struggle with Hunner’s lesions or bladder wall driven foods, your diet matters. Consume only foods and beverages you know are bladder friendly for you.  If you aren’t sure exactly what your individual food triggers are, check out the IC Diet and stick with items marked “usually safe.”

Keep your house clean

This is less about clutter and more about dust, mold, pollen and, during fire season, smoke and ash. Check the filter in your heating and cooling system. Replace it with a HEPA filter designed to reduce allergens and other airborne irritants like pet dander and dust mites.(4) Consider buying air purifiers to use at night in bedroom/or home offices, especially if you live in fire zones and struggle with intense smoke at times.

Set a cleaning routine that helps remove dust, pet dander and any other allergens.(7) If you are unable to do some cleaning yourself, ask for help from a friend or family member, as long as they wear masks and, ideally, have had the COVID vaccine.  Definitely pace yourself as you work so you don’t end up in a worse flare.

Know when to see an allergist.

If you have allergy symptoms that aren’t responding to medication or are otherwise uncontrollable, an allergist can help you determine what exactly you are allergic. Allergy testing can also be done through simple blood tests and this is much more comfortable for patients who have central sensitization and sensitive skin. The other method that can be used is a simple skin prick test. They place a droplet of a possible allergen on your skin and then prick it with a needle. If the allergen is something you’re allergic to, then you will develop redness, itching and swelling in that spot within 15 minutes. This be done on your back or your arms. We suggest the back because it’s much harder to scratch. The itching and discomfort can be intense so you may need some pain medication or topical corticosteroid cream to get through the next 24 or 48 hours. This test alone doesn’t diagnoses an allergy and cannot predict the severity of an allergy. But a negative test does usually mean you aren’t allergic to the allergen.(8)

If you aren’t yet following pollen.com, we suggest that you sign up for their emails so that you can be forewarned when irritating pollens start to fly and smoke begins to drift.

References

  1. Javed I, et. al. Does Pollen Trigger Urological Chronic Pelvic Pain Syndrome Flares? A Case-Crossover Analysis in the Multidisciplinary Approach to the Study of Chronic Pelvic Pain Research Network. J of Urol. April 2021 Volume 205, No. 4.
  2. Hughes C. Pollen levels might trigger flares of urologic chronic pelvic pain. Wolters Kluwer. Jan. 5, 2021.
  3. Asthma and Allergy Foundation of America. Allergy Treatments. March 2018.
  4. Osborne J. Allergies, Hayfever and Interstitial Cystitis. IC Network. May 29, 2014.
  5. Shannon S. A Popular Allergy Medicine May Help IC Symptoms. IC Network. Oct. 26, 2018.
  6. Mayo Clinic Staff. Seasonal allergies: Nip them in the bud. Mayo Clinic. April 16, 2020.
  7. Asthma and Allergy Foundation of America. Improve Indoor Air Quality to Set Up a Healthier Home Environment.
  8. Asthma and Allergy Foundation of America. Allergy Diagnosis. Oct. 2015.