Management of interstitial cystitis (IC)

Interstitial cystitis (IC), also referred to as painful bladder syndrome (PBS) or bladder pain syndrome (BPS), is a chronic inflammatory condition affecting women, men, girls and boys, regardless of age or race. Most IC patients have recurring pelvic pain, pressure, or discomfort in the bladder and pelvic region, which is associated with urinary frequency (needing to go often) and urgency (feeling a strong need to go).

The severity of the condition varies – it can range from fairly mild symptoms to experiencing chronic pelvic pain. The sudden urge to urinate can cause excruciating pain and may also be accompanied by abdominal pain, pressure or spasms. Pain can be in the abdominal, urethral or vaginal area and can be so extreme that it can wake the sufferer up in the night. Pain can be aggravated by stress/anxiety, travel and sexual intercourse.

How can diet trigger interstitial cystitis flares?

Irritation to the bladder wall

One theory is that a layer of the bladder wall is damaged, which may allow substances found in the urine to seep into the sensitive layers of tissue which make up the bladder wall. When urine that contains these substances hits these parts of the bladder, they become irritated, causing pain and discomfort after eating bothersome foods and beverages.

Inflamed nerves

Other scientists propose that substances in certain foods and beverages may excite sensitive nerve endings found in the bladder, resulting in bladder symptoms.

Increased nerve sensitivity

People with painful bladder syndrome appear to have higher levels of pain receptors that are sensitive to certain compounds in foods. For example, they may have more receptors for capsaicin, the substance found in peppers. While bell peppers contain very small amounts of capsaicin and so usually don’t exacerbate IC, hot peppers contain higher amounts and may trigger IC flares.

Organ cross-talk

Researchers have also proposed that IC bladder pain is caused by cross talk from the colon to surrounding organs. The pelvic organ nerves (the bladder, colon and prostate) are bunched together like telephone wires and plug into the same region of the spinal cord near the tailbone. People with interstitial cystitis have bladder nerves that are constantly transmitting pain signals to the spinal cord. When the colon is irritated, colon nerves also send pain signals to the same area on the spinal cord and this amplifies the pain.

Help for relieving interstitial cystitis symptoms

Diet

While research into the link between painful bladder syndrome and foods/beverages is limited, it has shed light on certain foods and drinks that a broad number of IC sufferers have found trigger flare-ups. Changes in diet help many sufferers control their symptoms but studies have found there is a lot of variability from one IC patient to another. Thus, figuring out what to eat (and not to eat) can be stressful.

Along with avoiding common food triggers, a food elimination diet can be helpful, as well as identifying food sensitivities and keeping a food and symptoms diary. There are also a number of supplements which can help support integrity of the bladder lining and help reduce inflammation and pain, both issues implicated in IC. 

Lifestyle

• Exercise - the health of your bladder depends on good blood flow to the area, and on having flexible and strong muscles around your bladder and other pelvic organs to protect and support them. Thus, exercise such as low-impact aerobics or yoga may be beneficial.
• Stress - most people with IC recognise that stress plays a part in exacerbating symptoms or triggering flare-ups. Learning basic relaxation techniques, meditation or EFT (also known as tapping) are evidence-based tools that can help manage stress.
• Smoking - research has shown that cigarettes irritate the bladder and may worsen interstitial cystitis symptoms of frequency, urgency and pain. Thus, quitting smoking may help reduce the severity of your IC symptoms.