A lesion or ulcer is an area of profound inflammation in the bladder wall. It can have several shapes, from round to what look like cracks in the bladder tissue.
The cause of lesions have been one of the great mysteries of IC however recent research has linked it to two potential viral infections of the bladder wall - the polyoma BK virus and the Epstein Barr virus. This research help us to understand why lesions are known to recur.
The polyoma BK virus normally lives harmoniously in the urinary tract of most humans and is only turned "on" when that patient is immune comprised. In those cases, patients often develop hemorrhagic cystitis (aka blood in their urine). The Epstein Barr study was released in 2018 and is the first to imply that viruses normally found outside of the urinary tract can indeed be found there. Our own research on the ICN found that patients with Herpes also noticed more intense IC flares. We need much more research here.
Lesions respond best to lesion specific therapies, including: fulguration, laser therapy and triamcinolone injections. Hyperbaric oxygen therapy has also been found helpful. A new medical device, LiRIS, was developed to help control bladder pain. The researchers were stunned to see that it healed most Hunner's lesions in just two weeks of treatment. LiRIS is a soft, hollow noodle like structure that is filled with medicine, in our case Lidocaine, and placed inside the bladder for two weeks. It has, unfortunately, been reprioritized by Allergan, the company that currently owns the device.
Aside from working with your doctor and getting a proper diagnosis, the single most important thing for you to do is to stop drinking or eating any foods or beverages that contain high amounts of acid and caffeine, such as: coffee (Decaf & Regular), black tea, green tea, all sodas, artificial sugars, fruit juices. Learn more about the IC diet here!
YES! Your job is to create an environment in your bladder that will support healing. When you have open wounds, such as lesions, acid on that wound every day will not only prevent it from healing, it will probably make it worse. In our experience, the patients who drink just one cup in the morning often suffer the most intense and prolonged pain because their bladder simply cannot withstand that daily acid assault.
At this time, we know of no holistic method which has reduced or removed Hunner's lesions from the bladder wall. That said, anything that you can do to reduce inflammation in your body is helpful, such as reducing your consumption of sugar, eating healthy, organic foods and drinks, reducing stress can all help you become more healthy. If it is confirmed that lesions are viral in some patients, that would explain why lesions recur. Anti-virals may be a future treatment.