Diet and its role in interstitial cystitis/bladder pain syndrome (IC/BPS) and comorbid conditions

Abstract

What ' s known on the subject? and What does the study add? Nearly 90% of patients with interstitial cystitis/bladder pain syndrome (IC/BPS) report sensitivities to a wide variety of dietary comestibles. Current questionnaire-based literature suggests that citrus fruits, tomatoes, vitamin C, artifi cial sweeteners, coffee, tea, carbonated and alcoholic beverages, and spicy foods tend to exacerbate symptoms, while calcium glycerophosphate and sodium bicarbonate tend to improve symptoms. At present we recommend employing a controlled method to determine dietary sensitivities, such as an elimination diet, in order to identify sensitivities while at the same time maintain optimal nutritional intake.We review current literature with regard to diet ' s effect upon IC/BPS and common comorbidities (irritable bowel syndrome, fi bromyalgia, chronic fatigue syndrome, neuropathic pain, vulvodynia, and headache) with a focus upon questionnaire-based investigations. We discuss the pathologic mechanisms that may link diet and IC/BPS related-pain, concentrating upon specifi c comestibles such as acidic foods, foods high in potassium, caffeine, and alcohol.

CUA guideline: Diagnosis and treatment of interstitial cystitis/ bladder pain syndrome

“…15,59 Based on survey studies, common food triggers include coffee, tea, citrus fruits, carbonated and alcoholic beverages, bananas, tomatoes, spicy foods, artificial sweeteners, vitamin C, and wheat products. 15,59,60 Only one placebo-controlled, randomized, controlled trial (RCT) on the effect of diet in IC/BPS has been published, which failed to report any significant association. 61 Dietary modifications, such as a steady intake of water to dilute urine and reduce constipation, 62 and an elimination diet trial have been advocated.…”

“…No standardized protocol exists, but common practice is to instruct patients to avoid all foods on the list for a period varying from one week to three months and then methodically re-introduce one item at a time, with a waiting period of three days to identify potential offenders. 60,62 …”

Treatment effectiveness in interstitial cystitis/bladder pain syndrome: Do patient perceptions align with efficacy-based guidelines?

“…The therapies most often used by clinicians are usually generic and funding for evaluating such treatments is almost non-existent. Some of the best approaches include conservative management such as diet manipulation 8 , exercise 9 , improving coping skills and even cognitive behavioural therapy 9 ; all treatments never rigorously evaluated. One recent exception is pelvic floor physiotherapy in which the benefits suggested by early small uncontrolled studies have now been confirmed by NIH randomized controlled trials.…”

Nutritional Considerations for Patients with Interstitial Cystitis/Bladder Pain Syndrome

“…Other chronic conditions often accompany IC/BPS, such as irritable bowel syndrome (IBS), fibromyalgia, and chronic fatigue syndrome. 12,13 Many patients with IC/BPS struggle with constipation. 14 Pelvic floor dysfunction, vulvodynia, and sexual dysfunction are frequent in this population.…”