Monday, May 6, 2013

Living with Interstitial Cystitis: How Diet Can Help


Personalized diet changes may help relieve symptoms of IC
 This is a guest post written by Janelle Schleicher.

What is interstitial cystitis?

Interstitial Cystitis (IC), or painful bladder syndrome (PBS) as it has been referred to, is a condition of unknown cause that presents with chronic inflammation of the bladder, possible bleeding, and occasional, but not as common, ulcers on the bladder wall. IC is characterized by recurring pain in the bladder and surrounding pelvic region. It also may result in frequent urination and/or a strong feeling of the need to urinate (1). To put it simply, IC feels like having a urinary tract infection, but is it chronic, meaning it does not go away! IC is a relatively common diagnosis affecting approximately 3-8 million women and 1-4 million men in the United States. It most commonly affects women in their forties, but men and children have also been diagnosed (2).

Symptoms vary from case to case and may include:

- Mild discomfort, pressure, tenderness, or intense pain in the bladder and pelvic area

- Urgent need to urinate

- Frequent need to urinate

- Pain during vaginal intercourse

- Increased pain during menstruation (1)

How is IC diagnosed?

There is no definitive test used to diagnosis IC because IC has an unknown cause and symptoms are similar to a number of other conditions. Therefore, a diagnosis is usually determined through two criteria

1. The presence of pain related to the bladder, usually accompanied by the urgent and frequent need to urinate

2. Ruling out other conditions, such as urinary tract infections, bladder cancer, and endometriosis (1)

How Does Diet Affect IC?

As with the symptoms of IC, foods may affect each individual with IC differently. There are no specific foods or food groups that cause IC, however dietary intake has been shown to affect symptoms. Foods that affect a patient’s symptoms are often referred to as trigger foods, and each trigger food may impact symptoms differently (2).

Important Tip: Citrus and Acidic Foods

Many people suffering from interstitial cystitis find that acidic foods such as oranges and tomato products may worsen symptoms. It is important to note that just because one acidic food may be a trigger food for an individual; this does not mean that all acidic foods will be (4)! So what does that mean? In the elimination diet, discussed in the next section, it is important to introduce each acidic food back separately to identify which specific foods cause symptoms.

The IC Diet

The majority of individuals suffering from IC find that certain foods and beverages affect their symptoms. With input from patients suffering from IC first hand as well as experts in IC research, the IC diet was developed and the IC Food List was compiled (2). The IC diet is a three-column system divided into the following categories:

1. Bladder friendly foods: foods that rarely bother IC patients

2. Try it foods: foods that are generally well tolerated but may bother sensitive IC bladders

3. Caution foods: food that commonly cause bladder discomfort (3)

Click here to access the IC Diet Foods List!

How can you use the IC diet?

The first step is to eliminate all foods from your diet except for bladder friendly foods (3). The idea of eliminating foods may seem scary and overwhelming at first, but it really is the best way to identify trigger foods and the three-column list is a great tool to help you on your journey!

Once your symptoms have improved (this may take a few weeks, just keep at it!), it is time to begin testing for trigger foods by adding back foods from the “Try it” list (3).

The rules for testing foods:

1. Test one food at a time

2. Try a small portion of the food the first time (such as half of a piece of fruit)

3. If the small portion does not trigger symptoms, try a larger portion the next time

4. If symptoms are still not triggered, multiple portions of the food can be consumed the third day

5. If symptoms still do not increase, the food can be added back in and not considered a trigger food!

6. If symptoms are triggered while testing a food, return to bladder friendly foods until you experience relief (3)


References:

1. (2011, September 27). Interstitial cystitis/painful bladder syndrome. U.s. department of health and human services. Retrieved from http://kidney.niddk.nih.gov/kudiseases/pubs/interstitialcystitis/

2. Beyer, J.A. (2010). Interstitial cystitis: A guide for nutrition educators. Auburn Hills, MI: NutraConsults, LLC.

3. Beyer, Julie. The IC diet food list and elimination diet (2012, August 11). Retrieved from: < http://www.ic-diet.com/IC%20Diet%20and%20Food%20List.html>

4. Friedlander, J. I., Shorter, B. and Moldwin, R. M. (2012), Diet and its role in interstitial cystitis/bladder pain syndrome (IC/BPS) and comorbid conditions. BJU International, 109: 1584–1591. doi: 10.1111/j.1464-410X.2011.10860.x


Janelle Schleicher is a senior Nutrition Management major at Rochester Institute of Technology. She is excited to take her next step towards becoming a Registered Dietitian and will begin her Dietetic Internship at the University of Maryland Medical Center in Baltimore, Maryland in September. Janelle has a love for any form of exercise (especially when it is outdoors!), food, coffee, reading, and her incredibly supportive family. She hopes to gain as much experience as possible in the field of nutrition in the next few years and ultimately open a private practice specializing in disordered eating and/or sports nutrition.