Hunner's Ulcers occur in 5 to 10 percent of people who have the bladder disease Interstitial cystitis. They form on the wall of the bladder and, like any ulcer, they can bleed, ooze, and may vary in size. They were first described by Dr. Guy LeRoy Hunner, 1868–1957, a Johns Hopkins gynecologist, in a paper delivered to the Boston Medical Society in 1915.[1]
Hunner's Ulcers can only be accurately diagnosed via a cystoscopy with hydrodistention. The procedure is performed while the patient is under general anaesthesia and is listed as a day surgery.
Treatment
The ulcers can be removed through fulguration (burned off with the use of electricity or a laser) or resection (cutting around the ulcer, removing both the ulcer and the surrounding inflamed tissue). Some ulcers may recur in the same location.
Many patients choose to live with the ulcers and treat the symptoms associated with them through bladder instillations or/and pain medication/therapy.
Patients with interstitial cystitis may find relief by modifying their diet to remove foods and beverages that trigger symptoms. Caffeinated beverages, particularly coffee (regular and decaf), tea, green tea, soda, artificial sugars and fruit juices. Cranberry juice may also trigger intense pain and discomfort. However, studies about the impact of specific foods and drinks on Hunner's ulcer symptoms are limited.
Prevention
The drug Elmiron helps to prevent the formation of Hunner's Ulcers by coating the bladder wall, thus making it harder for the acid in urine to irritate the bladder wall lining, which can lead to ulceration.
^J. P. MacDermott, G. L. Charpied, H. Tesluk and A. R. Stone. Histological changes in interstitial cystitis. International Urogynecology Journal, Volume 4, Number 4, 1993, 246-249.
