Interstitial cystitis (IC), also known as painful bladder syndrome, is a chronic condition characterized by pelvic pain, pressure, and, in some cases, frequent urination. While there's currently no cure, various treatment plans can help manage symptoms, including dietary adjustments and natural remedies. This article explores these approaches in detail.
Understanding Interstitial Cystitis and the Role of Diet
Interstitial cystitis is a condition that causes recurring discomfort, tenderness, pressure, or intense pain in the bladder and surrounding pelvic area. The symptoms of IC are notoriously variable and can differ from one person to another, or for one person from day to day. People with IC usually have an urgent and frequent need to urinate. This pain often intensifies as the bladder fills and may be exacerbated by sexual intercourse.
Dietary management can be an effective treatment plan for interstitial cystitis, as certain foods can worsen bladder pain. These trigger foods can intensify symptoms of interstitial cystitis by changing the potassium content of urine and activating pain receptors in the bladder. According to the American Urological Association, dietary changes can help people manage or avoid interstitial cystitis flare-ups.
A 2023 study assessed diet sensitivities among people with interstitial cystitis or other pelvic pain and a control group without the condition. The study found that about 70% of people in the interstitial cystitis group had more than one food sensitivity. People with symptoms of interstitial cystitis were more sensitive to certain beverages and spicy foods than other groups. Compared with white participants, Black participants with interstitial cystitis reported greater sensitivity to non-caffeinated and alcoholic drinks and a higher rate of urinary urgency.
It is important to note that trigger foods may vary for each person. Experts recommend avoiding potential triggers such as caffeine and citrus juices. Health experts recommend that a person take note of their symptoms after every meal to find out what irritates their bladder.
Read also: Comprehensive guide to the IC diet and food list.
Foods to Include in an Interstitial Cystitis Diet
A person with interstitial cystitis can include the following foods in their diet:
- Certain fruits: Avocados, bananas, blueberries, melons, pears, apricots, dates, prunes, and raisins.
- Some vegetables: Asparagus, celery, bell pepper, broccoli, beets, eggplant, peas, mushrooms, and spinach.
- Grains: Oats and rice.
- Proteins: Beef, eggs, pork, lamb, poultry, and fish.
- Nuts: Almonds, walnuts, cashews, macadamia nuts, and pistachios.
- Nut and seed butters: Peanut butter, almond butter, cashew butter, and sunflower seed butter.
- Some dairy: Cream cheese, cheddar cheese, and low fat and nonfat milk.
- Herbs and spices: Basil, garlic, thyme, and rosemary.
- Beverages: Water, pear juice, blueberry juice, grain-based coffee substitutes, and chamomile or peppermint tea.
Foods to Avoid with Interstitial Cystitis
Consuming certain foods can increase a person’s risk of interstitial cystitis symptoms. According to the Global Interstitial Cystitis/Bladder Pain Society, dietary modification is a vital treatment plan for people with food sensitivities. This may include limiting or excluding foods and drinks that change the pH of the urine, such as:
- Certain fruits: Oranges, grapefruits, lemons, pineapples, and strawberries.
- Some vegetables: Tomatoes and tomato products, pickles, chilli peppers, and sauerkraut.
- Processed sandwich meats: Bologna, ham, salami, and cold cuts.
- Soy foods: Tofu, edamame, tempeh, and soybeans.
- Cultured dairy products: Yogurt.
- Chocolate: Chocolate bars, chips, and candies.
- Condiments: Chiles, vinegar, horseradish, salad dressings, soy sauce, Worcestershire sauce, and ketchup.
- Beverages: Alcohol, coffee, carbonated drinks, and citrus juices (including orange, grapefruit, cranberry, and pineapple juice).
- Food additives: Monosodium glutamate (MSG) and artificial sweeteners.
Common bladder irritants include carbonated beverages, caffeine in all forms (including chocolate), citrus products, and food containing high concentrations of vitamin C. Consider avoiding similar foods, such as tomatoes, pickled foods, alcohol, and spices. Artificial sweeteners may aggravate symptoms in some people. Health experts recommend that a person take note of their symptoms after every meal to find out what irritates their bladder.
Sample Interstitial Cystitis Diet Menu
On an interstitial cystitis diet, a sample menu could include the following:
- Breakfast:
- Omelette with mushrooms and spinach
- Oatmeal with bananas, nut butter, and blueberries
- Avocado toast with hard-boiled egg
- Lunch:
- Rice, asparagus, and baked salmon
- Brown rice, grilled chicken, and broccoli
- Wrap with cream cheese, chicken, avocado, and spinach
- Dinner:
- Pork chops with mashed potatoes and green beans
- Tuna salad sandwiches
- Stuffed bell peppers with ground beef
- Snacks:
- Sliced apple with peanut butter
- Celery sticks with peanut butter and raisins
- Almonds with low fat cheese
Natural Remedies for Interstitial Cystitis
Many people with interstitial cystitis rely on alternative treatment because the condition currently has no cure. In addition to dietary adjustments, stress management, acupuncture, lifestyle changes and physical therapy are the best options for natural treatment.
Read also: Managing IC with Food
Here are some additional natural remedies that may provide relief:
- Aloe Vera: Aloe vera supplements are thought to soothe the burning sensation associated with Interstitial Cystitis and lower the frequent urge to urinate.
- Corn Silk: A common bladder and kidney herb that possesses anti-inflammatory properties.
- Marshmallow root
- Uva ursi
- Heat Therapy: Applying a heating pad or taking warm baths can help relax pelvic muscles and provide relief from bladder pain and pressure. A pelvic floor flare-up - generally the result of sexual intercourse, sitting for a long time, horseback riding, or riding a bike - can be soothed by placing a frozen water bottle wrapped in a protective layer to the urethra.
- Pelvic Floor Exercises: Strengthening the pelvic floor muscles through Kegel exercises can help improve bladder control and reduce episodes of urgency and frequency. Physical therapy for the pelvic floor centers around techniques to reduce pelvic floor muscle restriction including manual therapy to pelvic area, exercises, and biofeedback. Self-care and self-massage are two natural remedies that can enhance physical therapy treatment for Interstitial Cystitis.
- Acupuncture: Acupuncture, a traditional Chinese medicine, may help relieve bladder pain and improve overall pelvic health.
- Bladder Training: Bladder training involves gradually increasing the intervals between bathroom visits to retrain the bladder and reduce the urge to urinate frequently. Bladder training involves timed urination - going to the toilet according to the clock rather than waiting for the need to go. You start by urinating at set intervals, such as every half-hour - whether you have to go or not.
- Stress Management: Reducing stress levels will ultimately relieve inflammation of the bladder and pelvic muscles. Stress and anxiety can exacerbate bladder symptoms. Stress management techniques, such as yoga and meditation, may offer benefits similar to guided imagery.
- Guided imagery: Preliminary evidence suggests that guided imagery may help some women with IC. In one study, listening to a script designed to heal the bladder, relax the pelvic floor muscles, and quieten the nerves involved in IC showed some benefits.
- Vitamin and Mineral Supplements: Certain vitamins and minerals may help reduce inflammation and support bladder health.
- Probiotics: Probiotics, or "good" bacteria, can help promote a healthy gut and may also positively impact bladder health. Some people with IC/BPS, especially those who also have irritable bowel syndrome (IBS), report that probiotics help keep their gastrointestinal symptoms in check.
- Antioxidants: The increase of fruits and vegetables high in antioxidants can help reduce inflammation. Antioxidants are compounds that naturally occur in foods such as blueberries, green peppers, spinach, kale, and walnuts. The three major antioxidants in foods are vitamin C, beta carotene and vitamin E. Studies show that eating foods high in antioxidants can improve your immune system and relieve inflammation.
- Arginine: The amino acid arginine helps the body make nitric oxide, which relaxes smooth muscles like those found in the bladder. Based on this mechanism, arginine has been proposed as a treatment for IC.
- Quercetin: Quercetin is a bioflavonoid that may have anti-inflammatory properties. A small, double-blind, placebo-controlled trial found that a quercetin supplement reduced interstitial cystitis symptoms.
Other Treatment Options
No simple treatment eliminates the signs and symptoms of interstitial cystitis, and no one treatment works for everyone. Other treatment options include:
- Oral Medications:
- Nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve), to relieve pain.
- Tricyclic antidepressants, such as amitriptyline or imipramine (Tofranil), to help relax your bladder and block pain.
- Antihistamines, such as loratadine (Claritin, others), which may reduce urinary urgency and frequency and relieve other symptoms.
- Pentosan polysulfate sodium (Elmiron), which is approved by the Food and Drug Administration specifically for treating interstitial cystitis.
- Transcutaneous electrical nerve stimulation (TENS): With TENS, mild electrical pulses relieve pelvic pain and, in some cases, reduce urinary frequency.
- Sacral nerve stimulation: Stimulating these nerves may reduce urinary urgency associated with interstitial cystitis. With sacral nerve stimulation, a thin wire placed near the sacral nerves sends electrical impulses to your bladder.
- Bladder distention: Bladder distention is the stretching of the bladder with water. If you have long-term improvement, the procedure may be repeated.
- Botulinum toxin A (Botox): Botox may be injected into the bladder wall during bladder distention.
- Medications instilled into the bladder: In bladder instillation, your provider places the prescription medication dimethyl sulfoxide (Rimso-50) into your bladder through a thin, flexible tube (catheter) inserted through the urethra.
- Surgery: Doctors rarely use surgery to treat interstitial cystitis because removing the bladder doesn't relieve pain and can lead to other complications.
Diagnostic Tests
Your health care provider may ask you to describe your symptoms and to keep a bladder diary, recording the volume of fluids you drink and the volume of urine you pass. Other diagnostic tests include:
- Pelvic exam: During a pelvic exam, your provider examines your external genitals, vagina and cervix and feels your abdomen to assess your internal pelvic organs.
- Urine test: A sample of your urine is analyzed for signs of a urinary tract infection.
- Cystoscopy: Your provider inserts a thin tube with a tiny camera (cystoscope) through the urethra, showing the lining of your bladder. Your provider may also inject liquid into your bladder to measure your bladder capacity.
- Biopsy: During cystoscopy under anesthesia, your provider may remove a sample of tissue (biopsy) from the bladder and the urethra for examination under a microscope. This is to check for bladder cancer and other rare causes of bladder pain.
- Urine cytology: Your provider collects a urine sample and examines the cells to help rule out cancer.
- Potassium sensitivity test: Your provider places (instills) two solutions - water and potassium chloride - into your bladder, one at a time. You're asked to rate on a scale of 0 to 5 the pain and urgency you feel after each solution is instilled.
When to Seek Medical Advice
If symptoms do not improve after making dietary changes to manage the condition, a person should contact a healthcare professional. Also, a person should speak with a healthcare professional immediately if they experience any of the following symptoms:
- Chronic pelvic pain
- Vaginal pain
- Testicular pain
- Frequent urination during the day and night
It's important to note that while natural remedies can be helpful, they should not replace conventional medical treatment for painful bladder syndrome.
Read also: Foods to Avoid with IC
Additional Tips for Managing Interstitial Cystitis
- Wear loose clothing.
- Reduce stress.
- If you smoke, stop.
- Exercise.