DEAR DR. ROACH: What can you tell me about interstitial cystitis? A friend of mine was recently diagnosed with this. What is the prognosis? She is only in her 30s. — D.S.

ANSWER: Interstitial cystitis is an inflammation of the lining of the bladder. Its cause is unknown. Its major symptom is pain, which can be anywhere from mild to severe, along with increased urinary frequency and discomfort, and sometimes pain during sex.

Depression is commonly associated with this condition, probably because of the chronic pain. Many more women than men have this disorder.

Diagnosis is difficult, and there often is a long delay from the time someone complains about symptoms until the time it is correctly diagnosed. Often, there have been many treatments with antibiotics for presumed but not proven urinary infections.

The prognosis is mixed. On the one hand, interstitial cystitis doesn’t increase the risk of cancer or progression to worse diseases. However, the pain can be disabling, and the treatments aren’t always effective. One specific treatment is pentosan (Elmiron). Other treatments include antidepressants like amitriptyline, which can reduce pain. Most people with interstitial cystitis find that certain foods tend to aggravate the problem, especially acid foods.

The interstitial cystitis association at www.ichelp.org has many useful suggestions.

DEAR DR. ROACH: My 18-year-old son has a lymph node in his neck that’s been swollen for a couple of months. He does have wisdom teeth coming in. Does he need to worry or see an internist? — K.R.

ANSWER: Swollen nodes in the neck are common, but if your son’s was or is greater than 2 cm (about an inch) at its largest dimension for more than six weeks, it should be evaluated. Most often, it’s reactive, such as to an infection. A wisdom tooth coming in provides an entrance for bacteria to the system, and that certainly can cause an enlarged node.

DEAR DR. ROACH: I am a 61-year-old woman in good health. Earlier this year, I had a blood test for suspected Lyme disease (I did not have it), and one of the results in the blood test showed a positive ANA. My primary-care physician sent me to a rheumatologist, and it was explained to me that my result is a possible sign of scleroderma or perhaps lupus. I have no symptoms of any of these diseases, and have no joint or skin problems. The rheumatologist ordered some additional blood tests, and nothing else remarkable showed up. Should I be concerned? — W.T.

ANSWER: The ANA test is a test for anti-nuclear antibodies, which are common in autoimmune disorders, like the scleroderma and lupus you mentioned. However, a false-positive ANA test is very common. At least 5 percent of healthy people will have a positive ANA at any given time, and as we get older, that number goes higher, as high as 30 percent.

Since you took the test to look for Lyme disease and not because of suspicion of an autoimmune disease, it is even more likely that this is a false positive. Sometimes ANA tests turn positive months or years before symptoms of lupus or other autoimmune diseases start, but I think it is much more likely that this is not something to worry about.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or request an order form of available health newsletters or mail questions to P.O. Box 536475, Orlando, FL 32853-6475. Health newsletters may be ordered from www.rbmamall.com.

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