Having a flare-up....questions on exercise, diet, ...

[bb]

Hi all, I haven't posted here in probably a year, though I read the board every day. I've been having a flare-up for the past 3 weeks or so (though my "flare up" is nowhere near as bad/debilitating as what a lot of you guys deal with every day!). As my signature shows, my symptoms are really just hyper-sensitivity in the tip of my penis and a feeling of some urine being "trapped" in the urethra after urinating (though I also dribble a bit, so in most cases that feeling is because there is urine trapped in there....the irritation seems to remain after it comes out, though). It's important to point out that I ONLY have symptoms after urinating; they typically disappear after an hour or two, and then I'm perfectly fine/normal until the next time I go. The longer I can sit around without pants on after urinating (and therefore avoid any irritation), the more quickly the discomfort goes away. Ejaculation does NOT seem to cause a problem. My background is a lot like everyone else's here....computer job, so I sit a lot everyday (though I do force myself to get up, move around, change position, etc.). Maybe more stress than normal right now....baby due literally any day, the economy is dragging business down, etc. I don't feel like these things are getting to me, but maybe they are.

Anyhow, I started getting these symptoms again about 3 weeks ago. I immediately stopped working out (weights and recumbent exercise bike probably 5 days a week) and modified my diet (no spicy food, no caffeine). I don't know that these help, but I figured it was a start. To date nothing has really changed; my symptoms are still there, though they wax and wane on pretty much a daily basis. I've searched and read the forum for the past year or two, but I've got a few specific questions that I couldn't find direct answers to:

1) Anybody else have pretty much identical symptoms to mine, where you basically feel fine EXCEPT for some period of time immediately after urinating? Again, I have no symptoms any other time. If so, I'd be curious what you've found as to causes, what helps, etc.

2) For those of you who determined that exercise was one of the causes of your symptoms, did you know this immediately? In other words, does exercising immediately increase the severity of your symptoms, and does stopping exercise reduce the severity pretty quickly? I hate not exercising, and since it's been 3 weeks with no noticeable improvement, I'm trying to decide if that's not actually a cause for me and therefore I can go back to it. Psychologically/emotionally I'll be much happier if I can start exercising again....I just don't want to do it if it's contributing to the problem.

3) Same question as above, but this time in regards to diet (whether it be caffeine, gluten, etc.). How quickly did you see an impact from eliminating something? Not necessarily that all your symptoms went away, but that you felt that things were somewhat better? I guess this is really a question about how long you need to try eliminating something (or adding it back in) before you know whether it's making a difference?

Thanks to all!

[webslave]

A few comments:

• For some men, having a baby is actually one of the biggest stresses they can experience, so your flare is not strange;
• Gluten is only worth excluding if you've noticed that you react in some way to it: for example, does it cause loose stools (diarrhea), or do you have to clear your throat a lot after eating gluten-rich foods like bread, or does it make you sleepy, or make you hiccup? etc
• Unless you have Chronic Fatigue Syndrome as well (and some men with UCPPS do have that as a comorbid condition), exercise is fine (in moderation — exhausting sessions will exacerbate the condition)

[bb]

Thanks webslave, I appreciate the comments. I don't notice any affect from gluten, so I won't experiment with that for the time being.

For anyone who has found food sensitivities, I'm still wondering how long it took to notice any change after eliminating it from your diet. Obviously everyone is different, but if typically most people notice a difference after a few days, then I'll assume 3 weeks is sufficient for my current experimentation.

[Silas1066]

I have the exact same discomfort after urinating that you describe. Do you find that it is worse in the morning--after the "big" initial urination?

I doubt gluten has anything to do with it--but who knows?

Back when this hit me in 2002, I started exercising hard-core. My symptoms subsided about 80% after a couple of months. Because exercise reduces stress and improves bodily health...

[graeme]

I'm just coming out of a flare and my symptoms are the same where urination causes me post pain and the first one in the morning is what sets it off. About an hour after peeing it gets about 50% better but with me pain still lingers and then picks up again on the next pee. No diet or caffeine etc make a difference and alcohol can make things worse.

I think I've come out of this 2 week flare by deep relaxation of the pelvic floor in a hot bath everyday for as long as I can. Passing urine sometimes in the bath while doing this as I'm so relaxed. As soon as my relaxation is broken weather it 5 mins or 20 then thats it for the day as its hard to get it back Also when taking a pee relax standing over the toilet for 2 mins letting every last bit come out with little effort as possible, this can help avoid a spasm you may get if you quickly rush of and clamp back up.

[bb]

I have the exact same discomfort after urinating that you describe. Do you find that it is worse in the morning--after the "big" initial urination?

I doubt gluten has anything to do with it--but who knows?

Back when this hit me in 2002, I started exercising hard-core. My symptoms subsided about 80% after a couple of months. Because exercise reduces stress and improves bodily health...

See my reply on your thread :)

I agree, I don't think gluten or diet has anything to do with it for me. I'm sure there are a lot of contributing factors, but I'm more convinced that a big one for me is sitting far too much every day.

Exercise I think cuts both ways....it definitely helps me reduce stress, and makes me feel better overall (I HATE not working out, I feel like more of a slug than usual if I don't get any exercise). But at the same time you don't want to do anything to add extra tension in your pelvis. Weight training doesn't seem to bother me, fortunately. But I do have a recumbent exercise bike I use a lot, and when I'm having a flare up that seems to make things worse. I don't think it's a cause necessarily, but once my body is pissed off at me the bike doesn't help :).

[BrettP]

bb,

I've found one of my main issues are onions, raw. They really screw me up, gas, pain, etc. Your symptoms are somewhat similar to what I experience at times. Try kicking onions. I also get problems if I take too much fiber supplement. It creates gas, puts internal pressure on bladder, etc, etc. So maybe try those things as far as diet. As far as stress goes, its the number one issue with me, and I'm terrible at controlling it. Just read my posts and youll see. But if you can manage it, you may have success. Congrats on the baby BTW. take care.

[bb]

Thanks for the suggestions and the congratulations. New baby = little sleep; I suspected it might make my symptoms worse, but thus far it hasn't (knock wood). I agree with you on the fact that it seems like a lot of gas can exacerbate things; I'm pretty careful about that now. I hadn't thought about an onion connection before, but I'm going to pay attention to it to see if that is a cause for me (not just in terms of more gas, but on its own).

[Jay]

Hi there,

You'd be surprised at what an onion can do! When I was a little kid, I used to get violently ill, seemingly at random. Terrible headaches, vomiting, etc. My parents eventually noticed that it would always happen when I ate a hamburger from McDonald's (one of my favorite things). So, they removed things from the hamburger until finally, I ate one without onion and nothing bad happened.

Turns out that I am violently allergic to onions and other things with high sulphur content, like wine. To this day, I can't have any of that stuff, even a small piece of raw onion.

[webslave]

Yes, I too have allergies to foods that I have had to investigate like a detective to uncover. We know that men with CP/CPPS have a higher rate of allergies than the general population, so this is a factor. The most commonly reported comorbidities with chronic prostatitis / chronic pelvic pain syndrome were allergies, sinusitis, erectile dysfunction and irritable bowel syndrome in men, and allergies, urinary incontinence, sinusitis and irritable bowel syndrome in women (IC/PBS).
viewtopic.php?f=4&t=3713&p=19397

In another study, associated conditions were found to be fibromyalgia, irritable bowel syndrome, multiple chemical sensitivities, temporomandibular disorder, interstitial cystitis, postconcussion syndrome, tension headache, and chronic low back pain (men) (study).

Here's a study postulating that interstitial cystitis might be one of the IgE mediated, mast cell driven allergic disorders of the urogenital system.

Allergy is an antecedent condition for IC/PBS.

CPPS is linked to IBS (as shown above), and IBS in turn is linked to allergy:
viewtopic.php?f=4&t=3121&p=15775

[bb]

Interesting in that shortly after my first flare up a few years ago I developed seasonal allergies for the first time ever. Not a big deal in terms of symptoms, but the timing is curious based on this information.

[JTC1]

bb -
We, in many ways, are identical chronic prostatitis / chronic pelvic pain syndrome patients... I suffer more perineum pain while sitting, mild ED, etc...but I like you am addicted to exercise and am at a loss as to push through chronic prostatitis / chronic pelvic pain syndrome while maintaining fitness. Likely I'll never know what caused it for me - but I was focused on intense ab work last spring (as well as cycling and upper body weights) and all of a sudden on a long car ride my perineum was burning. I think I over did it with the ab stuff - on top of the other pre-conditions I have. I am stupid intense, sit all day at work, my two wonderful but young boys push my buttons, etc and ...I get uptight easier than most. In summary and in hind-sight, a poster child for this disease.

Constipation is a killer for me - so I take a little Milk of Magnesia at bedtime. Exactly as was discussed, bloating from Metamucil is a problem.

When I weightlift I try to keep my pelvic floor relaxed - seems to help a little. I can't get it through my head that I should quit cycling - though I did for most of last summer. I was riding 125 miles a week before this arrived.

I guess I struggle with continuing to do the stuff that makes me feel positive and healthy while avoiding flares. I've not found the perfect workout yet. I would think swimming might work?

[housemzk]

I was diagnosed with prostatitis by a GP and a Uro back in November. I believe that riding a bike was the culprit. I immediately stopped and the symptoms gradually subsided. Around the middle of January I figured it was safe to ride again... I was wrong! I experienced almost an immediate flare up that I'm still dealing with. For me, I've ruled out riding completely.

[JTC1]

housemzk-
Did you do a lot of cycling prior to getting chronic prostatitis / chronic pelvic pain syndrome - or were you a once a week casual rider? What are you doing now to keep fit? We have very similar symptoms. Did the Uro or GP put you on any pain meds or muscle relaxants? What have they prescribed as a course of treatment?

[bb]

FWIW, I used to do a lot of cycling a few years ago, but ended up cutting back after moving to a new location. My symptoms started probably 18 months after I stopped cycling frequently, so it would seem that cycling was not a cause for me at least.