In 2009, the RAND Interstitial Cystitis Epidemiology study reported that about 3 to 8 million women and 1 to 4 million men suffer with painful, frequent and often urgent urination--cardinal symptoms of the bladder disorder known as interstitial cystitis, or IC. Although patients and clinicians have observed for decades a connection between what patients eat and the severity of symptoms, the first empirical confirmation of this correlation was published in 2007. That report, based on work done at Long Island University, confirmed that more than 90 percent of IC patients experienced symptoms with greater intensity after consuming certain foods and beverages.
Foods to Avoid
Scientists are just beginning to investigate why certain foods trigger symptoms in an IC bladder. Three possible mechanisms include intense nerve stimulation of the bladder and pelvic floor, allergic or inflammatory responses to certain foods, and extremes in urine pH, both alkaline and acidic.
Until more research is completed, an IC diet is considered a food-sensitivity diet and should be customized to preserve the nutritional quality of an individual patient’s diet. Several foods seem to create problems for almost all IC patients. These include coffee, tea and other acidic or caffeinated products, chocolate, citrus fruits and juices, tomatoes and tomato products, alcoholic beverages, carbonated beverages, soy products, artificial sweeteners, artificial preservatives and flavor enhancers such as monosodium glutamate, or MSG. Cranberry juice, often used to help prevent classic bacterial cystitis, is paradoxically abrasive for the wounded bladders of IC patients. Patients should read food labels carefully to find hidden sources of these trigger foods.
An Elimination Diet
If removing these core trigger foods from the diet does not sufficiently manage symptoms, a patient may want to do an elimination diet to help pinpoint personal trigger foods. The simplest way to do this is to keep a detailed food diary and track symptoms along the way. Symptoms can manifest up to 24 hours after a person consumes a food, and a food diary helps most patients detect the patterns in their eating behaviors that could be affecting their symptoms.
For more complex cases, a patient could implement a more detailed elimination and reintroduction process standardized by the leading IC diet experts, including representatives of the leading IC organizations, IC diet researchers and IC diet authors. This process eliminates all foods that could possibly cause symptoms until the patient experiences symptom relief, then a person adds foods one at a time deliberately.
Soothing Foods
Just as a number of foods can intensify symptoms, certain foods may have a soothing effect on an IC bladder. Although scientists still need to confirm these anecdotal observations before they can figure out why they may be helpful, it is worth mentioning that patients often report that eggs and other high-quality protein foods, dairy products, plain starches such as rice and pasta, and chamomile and peppermint teas seem to calm their fussy bladders.
Food Substitutes
To improve dietary compliance, patients should find acceptable substitutes for the foods they need to avoid. Various herbal teas and coffee substitutes can replace the more abrasive coffees and teas. White chocolate, caramel, vanilla and butterscotch desserts and beverages can go a long way to helping satisfy a chocolate craving, and white or pesto pasta sauces are terrific alternatives to tomato-based sauces on pasta and pizza. Patients can also use pear or blueberry juice instead of vinegar in salad dressing recipes, and they can use lemon oil or zest to impart a citrus flavor in foods without the acidic juice of the lemon itself.
What if Diet Doesn't Work?
In reality, most IC patients will need a treatment combination that not only includes dietary modification, but also stress management, a variety of oral medications and medications that can be instilled directly into the bladder to promote healing and halt the worst symptoms. Patients should always work closely with their personal medical care provider to create an effective and individualized treatment plan.
