What does an IC flare feel like?
Depending upon the triggering event, an IC patient may experience a variety of symptoms during their flare.
- Frequency: During flares, 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. 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.
For many patients, flares can be the worst at night when there are fewer distractions and it’s much harder to ignore. Here’s a typical flare. A patient may go to bed at 10PM and by 11PM they’ve woken up with a strong need to urinate. They might actually empty their bladder of, say, 1/2 cup of urine. They return to bed, to awaken at forty five minutes later with another intense need to void. Their bladder may feel very full, but when they try to urinate, only a teaspoon or so of urine comes out. They then return to bed, and sometimes within minutes, have yet another sensation that their bladder is very full. But, when they actually urinate, nothing comes out. They then struggle with symptoms of frequency and/or pain for the rest of the night, often resulting in little, if any, sleep. Sound familiar?? You are not alone!
Perhaps the most frustrating symptom is the “false” sense of fullness that drives you to the restroom over and over and over. Your bladder may feel so full that you desperately need to urinate but when you try, there is little if any volume. You might strain and strain only to get a drop of urine. (Straining is BAD! Don’t do it!)
Why does this happen?? The bladder has two sets of nerves. One set controls urinary frequency (alpha afferent nerves) and the other, normally silent, nerves control pain signals (c-fibers). When the bladder becomes irritated, the first nerves that usually react and become irritated are the nerves that control frequency. Thus, when you have a flare, often the very first sign is increased frequency and a need to urinate. The pain nerves are much harder to activate but once they do turn on, they can cause overwhelming pain and discomfort. So… that “false sense of fullness” is really sign that you’re in a major flare and that your bladder is severely irritated. And, yes, if you drink coffee or soda at this time, you’re a fool because that will only irritate the nerves more.
