Diet's impact on Interstitial Cystitis

Anyone suffering from interstitial cystitis will tell you they may look fine on the outside but on the inside they are experiencing extreme discomfort.  Interstitial cystitis (IC), also known as painful bladder syndrome (PBS) or bladder pain syndrome (BPS) is a chronic condition consisting of recurring pelvic pain, pressure or discomfort in the bladder and pelvic region.  It is often associated with urinary frequency (needing to go often) and urgency (feeling a strong need to go) along with frequent nighttime voiding, painful intercourse and premenstrual and perimenopause hormonal pain.  Symptoms range from moderate to excruciating pain for reasons unknown with the symptoms tending to wax and wane.  It’s estimated about 12 million people are affected which includes 8 million women and 4 million men. 

Isn’t IC the same thing as a urinary tract infection?

Interstitial cystitis is not the same thing as a urinary tract infection (UTI).  In IC, the urine contains no bacterial infection like would be present in a UTI.  The main problem is a damaged bladder lining but another possible factor could be genetic susceptibility. Since many doctors are not trained in diagnosing IC, it may take several years before a correct diagnosis is made. In the meantime, while waiting for a diagnosis, people experiencing IC often have other health issues such as depression, anxiety, irritable bowel syndrome, migraines, and weight gain in addition to social and relationship challenges. 

The role of diet in IC

Several treatment methods can be used for IC ranging from medication, physical therapy, to even removing the bladder as a last resort.  Diet modification is now being recognized as a first line of defense in treating IC by eliminating certain foods and beverages to treat and alleviate symptoms of IC.  In 2004, there was an online survey of IC patients with 92% reporting that certain foods or beverages made their symptoms worse and over 84% reported some symptom relief by modifying their diet.  Here are the top foods that tend to trigger IC symptoms:

·         Coffee and most tea

·         Cranberry juice

·         Soda (particularly diet)

·         Alcoholic beverages

·         Citrus fruits and juices

·         Tomato products

·         Soy

·         Artificial sweeteners

·         Hot pepper and spicy foods

·         Chocolate

Notice cranberry juice is one of the triggers for IC.  Cranberry juice is often recommended for treating a urinary tract infection (UTI).  However, if a person has IC but has been misdiagnosed as having a UTI, then the problem is intensely exacerbated. 

It is important to determine what foods appear to trigger IC symptoms.  What foods trigger IC flare-ups in one person with IC may not trigger symptoms in another as it can vary among individuals.  It is important to keep a food and symptoms diary to figure out what certain foods are causing the potential problem.  Once you have that answered, than you can avoid those foods.

What about using artificial sweeteners?

It is advised to NOT use artificial sweeteners as they are likely a trigger substance.  This would include saccharin (Sweet’N Low), acesulfame K, aspartame (Equal, Nutrasweet),  sucralose, and sugar alcohols.  Stevia and other “natural” sugar substitutes like honey, date sugar and agave are probably okay to use. 

What to expect when using nutrition as a means of intervention for IC

Once diagnosed with IC, it is important to ask for a referral from your physician to be seen by a registered dietitian to discuss dietary ways of gaining better control of IC symptoms with the goal to reduce bladder flare-ups as much as possible.  Here is what to expect at a first visit:

·         In-depth, individualized nutrition assessment

·         Instruction on keeping a food/symptom diary to track what foods and beverages cause bladder flare-ups

·         Development of diet plan with restriction of trigger food and beverages

·         Other strategies for reducing bladder flare-ups

·         Label reading to address what ingredients to look for

·         Fluid needs

·         Possible inclusion of probiotics and adequate fiber

·         Possible additional supplementation options

 Where to find additional information

You do not need to suffer needlessly with IC when there is help available. Below is more information on IC, getting diagnosed correctly and how to get started on the best treatment methods for you:

NutraConsults: www.ic-diet.com – this website also has a very comprehensive chart listing foods and beverages under “bladder friendly”, “try it” and “caution” based on emerging research of IC patients experiences. 

Interstitial Cystitis Association: www.ichelp.org

Interstitial Cystitis Network: www.ic-network.com