Monday, July 21, 2014

Living with Interstitial Cystitis (IC): Diet for the Painful Bladder

Interstitial Cystitis (IC) is not well understood but the link between food and the occurrence of pain episodes is very clear.  The list of foods that can irritate the bladder and thus cause pelvic pain in patients with IC is long.  The important point is that not every food on the list will be an issue for every patient.  As in the case of most situations, every person is unique and will respond differently to different foods.  I tell patients to follow the Interstitial Cystitis (IC) diet in a strict fashion for two weeks. At that point evaluate their body’s response.  If there is no change in your pain level, then diet may not have a significant impact in your case.  However, most patients with IC will notice a change.   Most patients with Interstitial Cystitis will notice a significant decrease in pain severity and episodes after following these diet rules.  If this occurs then you have confirmation of the diet link to your pain.

Once you have established that there is a dietary component to your pain, the next step is figure out which foods are the culprits.  At this point, I suggest adding one food item per week back to your diet.  Start with the food that you miss the most.  If your pain is exacerbated by this item, then you know that in your case this food item should be avoided.  If you have no recurrence of pain, then this item is likely ok for you.  Continue this process weekly until you have clearly established which foods you should avoid. 

With all that said, here is the list:

Fruits:
Allowed:  Bananas Coconuts, dates, blueberries, melons and pears
Avoid:  All other fruits and juices (especially acidic and citrus fruits)
Special note:  While Cranberry juice can help to prevent bladder infections it can worsen interstitial cystitis pain and flair ups.  Avoid cranberry juice.  The acid is a strong bladder irritant.

Vegetables:
Allowed:  Most vegetables except those listed below
Avoid: Tomatoes and tomato sauces (ketchup, pasta etc.), onions, soybeans, fava beans, tofu

Beverages:
Allowed: decaffeinated tea or coffee.  Flat soda
Avoid:  Coffee, tea, carbonated drinks, alcohol, fruit juices (especially citrus and cranberry

Dairy:
Allowed:  Milk, American cheese, cottage cheese, white chocolate
Avoid: Yogurt, sour cream, soymilk, aged cheese, chocolate

Carbohydrates:
Allowed:  Pasta (avoid tomato based sauce), rice potatoes
Avoid: Rye and sourdough bread

Meat:
Allowed:  chicken, fish
Avoid:  processed, aged, canned, cured or smoked meat

Nuts/oils:
Allowed: most oils, almonds cashews and pine nuts
Avoid: other nuts

Seasonings/condiments:
Allowed:  Garlic
Avoid:  Mayonnaise, miso, soy sauce, vinegar, spicy foods  (especially Chinese, Mexican, Indian and Thai)

Preservatives
Avoid: Benzyl alcohol, citric acid, MSG, NutraSweet, saccharin.  Any food with preservatives and artificial ingredients or colors.

Tips for dining out:
Ask for “ no tomatoes or onions”
Have a plain baked potato rather than loaded with condiments
Ask for salad dressings and other possible trigger items on the side
Look for plain non marinated steak or chicken (spices will throw you off)

Quick Synopsis:  This was a lot of information.  Here is the short and sweet version.   Avoid:

  • Citrus fruits
  • Tomatoes and tomato based sauces
  • Coffee
  • Tea
  • Carbonated and alcoholic beverages
  • Spicy foods

Last tip:  If you just have to have something you know will cause a problem use “Prelief”.   Prelief is an over the counter neutralizer that if taken 30 minutes before eating can help to decrease the occurrence of pain.  I hope that this helps.  Diet alone will not solve the problem and there is no known cure for Interstitial Cystitis.  Diet along with the other therapies and interventions can offer significant relief to those suffering from the pain and bladder symptoms associated with Interstitial cystitis. 

Melvin L. Ashford, MD
Minnesota Women’s Care
OBGYN and Pelvic Specialty Care Center