DEAR DR. DONOHUE: What is interstitial cystitis? Is it due to damaged nerves or bacteria in the bladder? How come doctors can’t treat it? It is very painful. — A.B.

ANSWER: Frequent bathroom trips to empty the bladder (sometimes as many as 50 times or more in one day), pain on urinating, urgency to get to the bathroom in a hurry to prevent an accident and pelvic pain are signs of interstitial cystitis. It’s not a nerve problem. It’s not a bacterial infection. It has to do with damage to the protective layer of the bladder.

It happens to men and women, but female patients outnumber males. The typical story of an IC patient is years and years of misdiagnosis. Doctors think that the patient has a bladder infection, and course after course of antibiotics is given. Antibiotics do nothing for it. Finally, a doctor thinks of IC. Usually a urologist then looks into the bladder with a scope, and that provides more evidence to make a correct diagnosis.

The bladder’s lining has a protective coat that prevents urine from bathing it. When that coat is lost, urine washes against the bladder lining and irritates it. This is one theory to explain IC.

One treatment is Elmiron. Its exact action isn’t clearly understood, but it restores the protective bladder coat and controls IC symptoms. Other treatments are available. Sometimes, modifying the diet goes a long way in restoring bladder integrity. Those modifications include eliminating acidic foods and lessening the amount of carbonated and caffeinated beverages consumed.

If you want more information, the latest on treatment and the support of fellow sufferers, contact the Interstitial Cystitis Association at 800-HELP-ICA or on the Internet at www.ichelp.org.

DEAR DR. DONOHUE: I am 77, and for the past 30 years, my thyroid has not been working well. My doctors haven’t a clue how to treat it. One said to take the medication any time of day. Another said to take it first thing in the morning and not to eat for an hour. Please help me and my hypothyroidism. I take Synthroid. What kind of foods should I be eating? — B.R.

ANSWER: A low output of thyroid hormone usually can be successfully managed by providing the hormone in pill form. Synthroid is the most popular prescription medicine for hypothyroidism. Foods have little bearing on this condition.

The pill should be taken in the morning on an empty stomach, and you need to wait 30 to 60 minutes before eating breakfast. If that’s too long a wait, set your alarm for an hour before you usually get up. Put the pill and a glass of water next to your bed. Take the pill when the alarm goes off, and go back to sleep for another hour.

Overactive and underactive thyroid glands are common ills. The thyroid booklet describes both and how they are treated. To obtain a copy, write: Dr. Donohue — No. 401, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: Can you tell me anything about Reglan, whose generic name is metoclopramide? How long should a person take it? — O.M.

ANSWER: Reglan stimulates digestive-tract muscles. It’s used for GERD, gastroesophageal reflux disease, or, more simply, heartburn. The medicine causes the sphincter muscle at the lowermost part of the esophagus — right before it enters the stomach — to contract. That prevents stomach acid from splashing up into the esophagus. It’s also used for gastric paresis, a condition in which the stomach takes way too long to empty itself of food. More common side effects include headaches, nausea, drowsiness and fatigue. Rare but more serious side effects are tardive dyskinesia, Parkinson’s-like signs, a rise in blood pressure and worsening of congestive heart failure. Tardive dyskinesia is involuntary muscle movements, often of the facial muscles, like repetitive thrusting out and then retraction of the tongue. Twelve weeks is the usual length of time for using the drug.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

Copy the Story Link