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Kind and straightforward
Hunner's ulcers, simply put are painful ulcers in your urinary bladder. These ulcers are inextricably linked to another disorder called the painful bladder syndrome or intestinal cystitis. They occur in 10 to 15 percent of people with interstitia cystitis. These, in fact, are red patches or lesions on the bladder wall which can stiffen tissue and cause reduced bladder capacity. Hunner’s ulcers bleed, ooze pus and can be of different sizes. The ulcers in the bladder can be extremely painful and uncomfortable.
These are called Hunner’s ulcers because they were first described by Dr. Guy LeRoy Hunner, a Johns Hopkins gynecologist, in 1915. Since Hunner’s ulcers are seen only in people with intestinal cystitis, it’s important to know more about this painful life-altering bladder disorder before we can even understand how to deal with them.
Interstitial cystitis (IC)
IC is also called painful bladder syndrome. Another important thing to know about IC is that it strikes more women than men. IC is a chronic disorder and there’s no cure for it. It causes recurring bouts of pain and pressure in the urinary bladder and the pelvic area. This is often accompanied by an urgent and frequent need to urinate. Sufferers may have to rush to the ‘loo’ as much as 40, 50, or 60 times a day.
Hunner's ulcers can only be accurately diagnosed by doing a cytoscopy which involves inserting a fibre-optic tube through the urethra to look at the bladder wall closely. During this procedure, a tissue sample from the bladder wall is usually also taken to rule out bladder cancer. Cytoscopy is usually done with hydrodistention under local anesthesia. This involves filling the bladder with a liquid for stretching it to provide a closer view of the bladder wall. Usually, a urologist performs this surgery along with a gynaecologist. IC and also Hunner’s ulcers are both a diagnosis of exclusion. This means that they’re diagnosed only after a number of other conditions have been ruled out.
Hence, the urologist will first take your thorough medical history, followed by a physical exam and a pelvic exam for women patients and perform tests for ruling out infection, and other disorders like bladder stones and cancer, kidney disease, multiple sclerosis, endometriosis, sexually transmitted diseases amongst others. Only after these tests are inconclusive or uncertain and if there is blood in urine, will the urologist go for cystoscopy.
There's no cure for IC, but Hunner’s ulcers can be cured by burning them off the bladder wall. Called fulguration, the process uses electricity or laser to burn the ulcers on the bladder wall. Resection is also used in which skin from around the Hunner’s ulcer is cut for removing both the ulcer and the inflamed tissue around it. The problem is that ulcers may recur in the same location.
So, managing IC becomes critical. Your doctor can try to treat the patient with one treatment or with a combination of treatment depending on the condition of the patient.
Pain medicines are the first line of treatment to manage Hunner’s ulcers and IC both, and many patients do go in for this. Patients also find relief by modifying their diet to remove foods and drinks like caffeinated beverages- tea, coffee, colas etc. Sodas, artificial sugars and fruit juices, especially Cranberry juice can trigger intense pain and discomfort, so these are usually contraindicated. Another important aspect is patient education about normal bladder function and tips on self-care and behavioural modifications like stress control to manage Hunner’s ulcers.
In case you have a concern or query you can always consult an expert & get answers to your questions!
I take Pantocid DSR every morning as prescribed by the doctor. If I do not take it by the afternoon I get acidity and heart burns. Endoscopy results have shown a light spot in my esophagus. I am facing gastric and acidity from a long time and have found no cure.
Acidity gives you tremendous discomfort. The stomach condition wherein acid levels of the gastric juices are much more than normal is known as hyperacidity. It causes uneasiness alongside symptoms like loss of appetite, heartburn, unexpected stomach pain, etc. According to Ayurveda, the main cause of this condition is the worsening of the Pitta Dosha (the fire element) in your body.
The reasons that worsen this dosha are:
- Having foods that don't match your constitution or which aren't supposed to be had like milk and salt or milk and fish
- Extremely spicy and sour beverages and foods
- White flour products
- Products made from white sugar
- Excessive intake of coffee and tea
- Having food even though you may be suffering from indigestion
- Controlling the urge to urinate or pass stool
- Prolonged exposure to heat and the sun
What happens to your digestive power?
The exacerbated Pitta worsens your digestive fire, causing your food to be not properly digested as well as influence the production of ama (toxins). When ama builds up in your various digestive channels, it brings about the problem of hyperacidity. The treatment focuses on calming down the irritated Pitta Dosha. For this, certain herbs are used to get rid of the toxins that block these channels. This automatically improves your digestive fire, bringing about better digestion.
What changes you're required to make?
To keep this problem at bay, there are certain lifestyle changes that you may have to make such as
- To curb the consumption of acidic foods like garlic, onions, ginger, vinegar, and tomatoes
- Avoid having curd/yogurt at night
- Practice yoga and Pranayam like Bhujangasana, Vajrasana, Shitkari Pranayam and so on
- Avoid fermented as well as processed foods
- Avoid coffee, tea, alcoholic or carbonated beverages
If you wish to discuss about any specific problem, you can consult an ayurveda.