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» LymeNet Flash » Questions and Discussion » Medical Questions » Urinary Urgency as Herx?

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Author Topic: Urinary Urgency as Herx?
canbravelyme
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Hi,

I recently started doxycycline treatment, and am now experiencing urinary urgency - often not needing to actually urinate.

This is very uncomfortable [cussing]

Anyone experience this beginning with abx treatment?

Best wishes,

[ 05-19-2010, 08:51 PM: Message edited by: canbravelyme ]

--------------------
For medical advice related to Lyme disease, please see an ILADS physician.

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treepatrol
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Not a herx.

Herx's are very painful in many ways but having to pee not one.

The Herxheimer Reaction
This phenomenon, first described by Herxheimer in cases of syphilis treated with mercury, also occurs in diseases due to organisms more complex than bacteria when drugs that kill the causative organism in the tissues are administered. This "Herxheimer reaction" is due to the liberation of irritant and antigenic substances from the dying organisms and is not observed in healthy persons or in rheumatoid patients given antibiotics. Its occurrence in rheumatoid disease (including those of autoimmune lesions) treated with various antiamoebic drugs proves that a causative pathogenic amoeba is present in the affected tissues. [Since anti-amoebic medication is also known to kill friendly bacteria, increased accumulations of acetaldehyde byproducts from population explosions of Candida albicans could also account for what was thought to be a Herxheimer reaction. Ed. S.C.] After administration of antiamoebic drugs (especially 5-nitroimidazoles), evidence of rheumatoid disease activity usually completely disappears in both joints and extra-articular tissues within 3 to 6 months. Therefore, autoimmune lymphocytic and humoral reactions are not the primary disturbance in rheumatoid and autoimmune diseases; they are the cellular-antibody response to infection and its antigens and contribute to the tissue damage.
http://flash.lymenet.org/ubb/Forum5/HTML/000572.html

Lyme Disease
What is a Herxheimer Reaction?
By Donna Herrell
Founder, Lyme Disease Information Resource
Overview:


The herxheimer reaction, nicknamed "herx", otherwise referred to as Jarisch-Herxheimer (J-H) is a phenomenon originally observed in the treatment of Syphilis, but later found in other illness [1]. In general terms, it is described as a temporary increase of symptoms when anti-syphilitic drugs (antibiotics) are administered.

What is known or speculated about Lyme disease herxheimers are based heavily on the reactions seen in Syphilis. [2-3] This is due to the fact both diseases are caused by a bacteria known as a spirochete, the former being Treponema pallidum, the latter Borrelia burgdoferi (B.b). However, the herxheimer reactions in Lyme disease are not identical to those seen in Syphilis, especially in terms of timing, frequency and duration as noted below. [1-5]

In Lyme disease it is thought that the cause of herxheimers are the result of endotoxin release. [2,5] That is toxin(s) within the spirochete that are released as the B.b are killed or broken down. This may be a result of the toxin(s) itself or the body's immune response to such.

Symptoms:

As mentioned, the general description is a temporary increase in symptoms, but also included is the development of new ones. More specifically the most common events include: increased joint or muscle pain, headaches, chills, fever (usually low grade), hypotension, uticaria (hives) and rash. [1-5] A multitude of other symptoms have been described.

Worth noting is that hives and rash are sometimes mistaken for an allergic reaction. [2] It is up to one's physician to determine this. However, with close observation and proper treatment (see Treatment) may prevent unnecessary cessation of therapy.

In more severe cases of J-H, a reduction of the dosage or temporarily cessation of the treatment has been recommended [5].

Timing, Frequency and Duration:

This is individualistic and herxheimers can occur within days to weeks after the institution of antibiotic therapy. In some patients they occur only once or twice (if at all) and with others continue throughout the course of treatment, usually lessening in severity.

They can occur and are more often described in cycles (example: every 4 weeks) and have been reported to last from days to weeks. It can be very beneficial to document any exacerbation. Some physicians use this as a guideline for treatment. Further, it may help differentiate herxheimers from the normal symptoms or progression of Lyme disease.

Treatment:

Herxheimer reactions can be very difficult on patients and affect compliance with therapy so supportive measures should be sought or utilized to lessen discomfort if needed. The use of aspirin, NSAIDs (non-steroidal anti-inflammatory drugs), pain medication, muscle relaxers, hot baths or others remedies can be appropriate. Of note, some have found Benadryl helpful even in the absence of rash or hives.

The good news is that the herxheimer is thought to indicate that the antibiotics are indeed working and that following each worsening may bring about more improvement. Though the lack of a herxheimer reaction should not cause anxiety if symptoms are improving.

Other considerations:

Something often overlooked but can present with similar symptoms is Candida (yeast) infection. Treatment with acidophilus and if needed prescription medications such as Nystatin or Diflucan can be utilized.

Sources of Information:

Lyme Disease 1991 - Patient/Physician Perspectives from the U.S. and Canada The Jarisch-Herxheimer Reaction James H. Katzel M.D.
Managing Lyme Disease 1996 Joseph J Burrascano M.D.
Principles and Practice of Infectious Diseases 4th Ed. Mandell, Douglas and Bennett
Seronegative chronic relapsing neuroborreliosis. Lawrence C, Lipton RB, Lowy FD, Coyle PK Eur Neurol 1995;35(2):113-117
The New Lyme Disease 1998 Joseph J Burrascano M.D.
See Jarisch-Herxheimer / Jarisch-Herxheimer-like Reactions
Lyme disease, Tick-borne Relapsing Fever and Allergy
Document and reference collection (in progress) November 15, 1999 http://www.x-l.net/Lyme/abstracts/herx/herx.collection.html

__________________________________________________________________________

This document is for informational purpose only and not written by a medical professional. This article may be copied for personal use. For republication in any format please contact the author at [email protected]

Copyright 1997
Lyme Disease Information Resource http://www.x-l.net/Lyme/HERX.html

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Theres a couple explanations.

--------------------
Do unto others as you would have them do unto you.
Remember Iam not a Doctor Just someone struggling like you with Tick Borne Diseases.

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treepatrol
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http://flash.lymenet.org/scripts/ultimatebb.cgi?ubb=get_topic&f=1&t=021202#000021

yeast similarities

--------------------
Do unto others as you would have them do unto you.
Remember Iam not a Doctor Just someone struggling like you with Tick Borne Diseases.

Newbie Links

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lauriemay1
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Actually, my daughter gets this as a symptom. The urgency to pee and pressure in her bladder - and it does get worse after taking antibiotics. Her LLMD says that lyme toxins love to stick to the bladder and this is why you feel the pressure. It's not an infection, she did not have an infection and it comes and goes. To us, it is a Herx reaction and it is caused by the dieoff. I'm not a doctor and if you want you can get a urine test but our LLMD did not deem it necessary at all.
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psr1
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I had this as a troubling symptom months before I got acutely ill. It has disappeared with treatment.
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Lymetoo
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It COULD be an infection... yep!

I found great help by taking D-Mannose with CranActin. It keeps me from getting infections.

--------------------
--Lymetutu--
Opinions, not medical advice!

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baileypup
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I've had this problem too, and feel it is exacerbated by die-off.
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sammy
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You might be experiencing bladder irritation from a food, medication, or supplement.

I experienced this with Burbur drops (part of Cowden protocol). Took me awhile to figure it out because I started several new things all at the same time.

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bcb1200
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Okay...I TOTALLY have this. I just started my Doxy treatment last week. Never had a bladder issue before. And woulnd't you know it, almost every day I have had a "moment" where it suddenly feels as if I need to pee..really badly. It then subsides after a minute or two.

I totally think this is something Lyme related, not food / medication related.

Can't say if it is a herx or not. But I never had this before starting Doxy. It has gotten better in the last 2 days.

--------------------
Bite date ?
2/10 symptoms began
5/10 dx'd, after 3 months numerous test and doctors

IgM Igenex +/CDC +
+ 23/25, 30, 31, 34, 41, 83/93

Currently on:

Currently at around 80% +/- most days.

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canbravelyme
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@Tree: Good to see you! I haven't seen you in so long! Hope you're very well.

@bcb: Yep. This is indeed the case with me. No problem. Go on doxy: Problem. Go off doxy: No problem. Back on Doxy: Problem.

I've switched to a different brand of doxy; I'll let you know whether there is an irritant in one of the non-active ingredients of the brand I'd been taking which was causing a reaction.

Best wishes,

--------------------
For medical advice related to Lyme disease, please see an ILADS physician.

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bcb1200
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The only reason why I think this is Lyme is because of the "irritable bladder" symptom that is listed. I assumed that is what this was.

--------------------
Bite date ?
2/10 symptoms began
5/10 dx'd, after 3 months numerous test and doctors

IgM Igenex +/CDC +
+ 23/25, 30, 31, 34, 41, 83/93

Currently on:

Currently at around 80% +/- most days.

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canbravelyme
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It may very well be. I will let you know how it goes on the new doxy; if the condition ceases, I suggest you try a different brand as well.

The urgency kept me up until 3-4AM last night!

Best,

--------------------
For medical advice related to Lyme disease, please see an ILADS physician.

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Faith6
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I've had this symptom on and off for the last year also. I can't relate it to anything I do or take.

--------------------
"His faithful love endures forever." Psalm 136

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karenl
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I have urgency problems since started minocycline.
In my case it is not an infection or irritation,
I just have to run real fast.
Never had this before, so I am sure it has to do with minocyclin.

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lauriemay1
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I was told by my LLMD that it is due to die off - the dead toxins cling to your bladder especially when you start a new antibiotic.
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canbravelyme
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Hi All,

Thanks for your responses.

Well, it wasn't the brand of doxy; I switched to a different kind and I was up until 4AM this morning again due to the urgency!

What did you guys do for relief?

Best,

--------------------
For medical advice related to Lyme disease, please see an ILADS physician.

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bcb1200
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I haven't had it in a few days. ANd mine really only lasted for 5-10 seconds. Not sure if you are male or female, but if male could it be prostate?

--------------------
Bite date ?
2/10 symptoms began
5/10 dx'd, after 3 months numerous test and doctors

IgM Igenex +/CDC +
+ 23/25, 30, 31, 34, 41, 83/93

Currently on:

Currently at around 80% +/- most days.

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canbravelyme
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Female. Glad to hear it went away.

It seems to happen at night; and it was pretty well constant (well with 1-4 min breaks) for hours!

--------------------
For medical advice related to Lyme disease, please see an ILADS physician.

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Lymetoo
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If you need tips on how to get some sleep, etc.. go to:

www.ichelp.org
or
www.ic-network.com

There are meds you can take, there are foods to avoid...etc.

I know my IC was caused by Lyme.

--------------------
--Lymetutu--
Opinions, not medical advice!

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canbravelyme
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Thanks, TuTu

I didn't know that IC existed!

We all know far too much.

[group hug]

--------------------
For medical advice related to Lyme disease, please see an ILADS physician.

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baileypup
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lauriemay wrote;
quote:
I was told by my LLMD that it is due to die off - the dead toxins cling to your bladder especially when you start a new antibiotic.
I have had this symptom, on and off, since before my diagnosis. After my first round of IV clindamycin (7 days), had to use the bathroom about 25 times in a day and a half. It was like my body was doing a major detox.

I still get the urgency in a much lesser degree now.

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canbravelyme
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I think it's inflammation; Advil seems to be helping...

--------------------
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jenny76
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I had this as a symptom before diagnosis and was actually diagnosed with IC. Now that I know I have Lyme and Co's it worsens during treatment and is helped by Advil as well. Inflammation it very well could be. My LLMD believes it is bartonella and will get better with treatment.

--------------------
Never, Never, Never give up!

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sickpuppy
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I too had this before diagnosis and treatment. Felt like I was gonna wet my pants! It has also happened several times on abx but less intensely and for shorter amounts of time. For me it always goes away.

It always felt like a nerve thing to me, the lyme irritating a nerve that effects the pee feeling. But I don't know.

I hope it goes away for you. And no shame wearing protection if it'll make you worry less.

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canbravelyme
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Yes, it appears to be a nerve issue.

As many of you know, seizures are a significant symptom for me.

Yesterday, the urinary urgency escalated into a seizure.

--------------------
For medical advice related to Lyme disease, please see an ILADS physician.

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nefferdun
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Bartonella also causes this. I felt I had to go every couple of hours, getting up 4-5 times every night, and when I treated bart I had pain in my bladder. With bart you feel like you have an infection but you do not test positive for anything.

I also experienced urinary problems as well as bowel problems when I started treatment for lyme. I went from having diarrhea to having constipation. And I would have an urgent need to urinate but not be able to go. I felt like my whole body just shut down. It got better after about a month of treatment. I do believe it is a herx.

--------------------
old joke: idiopathic means the patient is pathological and the the doctor is an idiot

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feelfit
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count me in. my dr. even noticed that i used the restroom 3 times at my appt. had me leave a urine sample....all clear.

the urge to pee comes and goes....right now it is with me....not dependent on a specific antibiotic either.

die-off? maybe. inflammation? maybe. bottom line? who knows!

good luck, glad that the anti-inflammatory seems to be working.

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WildCondor
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Just wanted to add how much D-mannose really works for bladder issues and how it can blatantly cure bladder infections within 24 hours.
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Rumigirl
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Thank you, WC! I had some that I hadn't opened, and I just realized last night that I am fighting a bladder infection. I've been taking the D-mannose, and it's helping. Whew, thank goodness.

I've been getting them a lot over the last many months again---definitely Lyme & co related, I think.

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karenl
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Rumi,
IC and bladder can be chlamydia pneumonia and you also react so much to mino...
please read cpnhelp.com.

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WildCondor
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Hey Rumigirl,

Take 1-2 caps/powder scoops every 2 hours for the first day, then 4x per day after that to keep it away!

D-Mannose works by pulling the bacteria off the bladder wall and flushing them out of the body.

It works awesome. It is also awesome to take it you get bladder infections from sex. Take one right before and one right afterward and it keeps infections away and is MUCH better than taking antibiotics! [Smile]

Drink lots of water too. I found that cranberry juice does absolutely nothing, but d-mannose...its da bomb! [Smile]

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canbravelyme
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Here is the culprit:

From: http://en.wikipedia.org/wiki/Parasympathetic_nervous_system

Pelvic Splanchnic Control

The pelvic splanchnic nerves, S2-4, work in tandem to innervate the pelvic viscera. Unlike in the cranium, where one PSN was in charge of one particular tissue or region, for the most part the pelvic splanchnics each contribute fibers to pelvic viscera by first traveling to one or more plexuses before being dispersed to the target tissue. These plexuses are composed of mixed autonomic nerve fibers (PSN and SN) and include the vesical, prostatic, rectal, uterovaginal and inferior hypogastric plexus. The preganglionic neurons in the neurons do not synapse in named ganglion as in the cranium but rather in the walls of the tissues or organs that they innervate. The fiber paths are variable and each individual's autonomic nervous system in the pelvis is unique. The visceral tissues in the pelvis that the PSN control include: urinary bladder, ureters, urinary sphincter, anal sphincter, uterus, prostate, glands, vagina and penis. Unconsciously, the PSN will cause peristaltic movements of the ureters helping to move urine from the kidneys into the bladder and move feces down the intestinal tract and upon necessity, the PSN will help you excrete urine from the bladder or defaecate. Stimulation of the PSN will cause the detrusor muscle (urinary bladder wall) to contract and simultaneously relax the internal sphincter urethrae muscle to relax allowing void of urine. Also, PSN stimulation to the internal anal sphincter will relax this muscle and allow you to have a bowel movement. There are other skeletal muscles involved with these processes but the PSN play a huge role in continence.

Another role that the PSN play in the pelvis is in sexual activity. In males, the cavernous nerves from the prostatic plexus stimulate smooth muscle in the fibrous trabeculae of the coiled helicene arteries to relax and allow blood to fill the corpora cavernosum and the corpus spongiosum of the penis, making it rigid to prepare for sexual activity. Upon emission of ejaculate, the sympathetics participate and cause peristalsis of the ductus deferens and closure of the internal urethral sphincter to prevent semen from entering the bladder. At the same time, parasympathetics cause peristalsis of the urethral muscle, and the pudendal nerve causes contraction of the bulbospongiosus (skeletal muscle is not via PSN), to forcibly emit the semen. During remission the penis becomes flaccid again. In the female, there is erectile tissue analogous to the male yet less substantial that plays a large role in sexual stimulation. The PSN cause release of secretions in the female that decrease friction. Also in the female, the parasympathetics innervate the fallopian tubes which helps peristaltic contractions and movement of the oocyte to the uterus for implantation. The secretions from the female genital tract aids in semen migration. The PSN (and SN to a lesser extent) play a huge role in reproduction.[2]

--------------------
For medical advice related to Lyme disease, please see an ILADS physician.

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