Interstitial Cystitis Diet: Western Vs. Eastern

Interstitial Cystitis Diets:

Eastern vs. Western

Interstitial cystitis (IC) is a chronic bladder condition resulting in recurring discomfort or pain in the bladder or surrounding pelvic region. People with IC usually have inflamed or irritated bladder walls, which can cause scarring and stiffening of the bladder. Symptoms vary from case to case but may include any or all of the following: mild discomfort, frequent urination, urgency to urinate, pressure, tenderness, or intense pain in the bladder or pelvic region, severe lower abdominal pain that intensifies as the urinary bladder fills or empties. The cause(s) of IC is currently unknown. Its diagnosis is often made only after excluding other urinary or bladder causes. IC affects men and women of all cultures, socioeconomics and ages. However, it is more common in women than in men. In this paper IÐ"­m going to discuss the basics of IC from a western medicine perspective, their take on the IC diet, then compare it to what Western medicine says.

IC is frequently misdiagnosed as an acute urinary tract infection (cystitis), a disorder that can be successfully treated with antibiotics. A cystoscopy with hydrodistention under general anesthesia is required to make a diagnosis of interstitial cystitis. The bladder is distended to check for pinpoint hemorrhages on the bladder wall that is the hallmark of IC.

A number of other diseases must be ruled out, such as bladder infection, bladder cancer, sexually transmitted diseases, neurological disorders, kidney disease, and vaginal infections.

Treatments that can successfully relieve symptoms in many patients include diet modification (a diet low in acidic foods, and avoiding beverages such as coffee, tea, carbonated and/or alcoholic drinks, can be helpful in reducing IC symptoms), stress reduction techniques (such as biofeedback and pelvic floor relaxation exercises), bladder hydrodistention, Elmiron (pentosan polysulfate sodium) - oral medication specifically for IC, other oral medications such as tricyclic antidepressants (used for their anti-pain properties), antispasmodics, anti-inflammatories and antihistamines, opioid analgesics - for severe IC pain, DMSO (dimethyl sulfoxide) - medication instilled into the bladder, specifically for IC electrical nerve stimulation: TENS (transcutaneous electrical nerve stimulation), sacral nerve root stimulation devices, and surgery is a last resort.

In the majority of IC patients, IC is not a progressive disease. There is little evidence to suggest that IC symptoms and characteristics of IC pain tend to worsen with time. It is thought that the earlier a diagnosis of IC is made, the better the chance of treatment response. For many IC patients, symptoms tend to wax and wane, and some IC patients experience remissions for extended periods of time. In a small percentage of patients, IC can worsen rapidly, causing the bladder to decrease in size, reducing its ability to hold a normal volume of urine.

Though a few people with IC have bladders that are not sensitive to food, for the overwhelming majority, what they consume plays a significant role in how severe their symptoms are. While it's true that some common trigger foods, such as coffee or cranberry juice, provoke IC symptoms for nearly everyone, it's also true that each of us has a different tolerance level for many of the trigger foods. For instance, some IC patients may comfortably eat a small quantity of a specific food, yet if they eat more, they will have an IC flare. Others, to their great frustration, may not be able to tolerate even a single bite of that same trigger food without suffering increased symptoms. Still others may be able to consume all they want of that food with no trouble at all.

IC patients usually spend their first six months to a year discovering the ways in which their IC food triggers are similar to others', and the ways in which their bladder reacts differently. They do this either through random trial and error, or via a systematic approach with an elimination diet. The most problematic foods that are recognized by the Interstitial Cystitis Association are as follows: aged cheese, aged and/or processed meats, anchovies, apples, apricots, aspartame, avocados, bananas, beer, berries (except blueberries and blackberries), caffeine, cantaloupes, carbonated drinks, cherries, chocolate, citric acid, citrus fruit and juice, coffee, corned beef, cranberries and juice, fava beans, grapes, Ð"«hotÐ"­ spices, lima beans, mayonnaise, miso, MSG, nectarines, peaches, pineapples, plums, pomegranates, raw or green onions, red wine, rhubarb, rye and sourdough bread, soy sauce (low sodium okay), strawberries, tea, tofu, tomatoes, vinegar, yogurt.

These foods are notorious for exacerbating bladder symptoms, and often cause Ð"«flares.Ð"­ A Ð"«flareÐ"­ is what we call those periods when the IC symptoms worsen. Not everyone has dramatic Ð"«flares,Ð"­ and some are so severe that they canÐ"­t recognize ups or downs. While it hasn't been scientifically established exactly why the foods on the IC diet list cause flares, urologists and IC researchers have proposed some credible explanations based on what we currently know about the foods and about IC.

If you recall the physiology of IC then you understand that IC involves mast cells in the bladder. These mast cells are not unlike the mast cells that line our sinuses and give us hay fever symptoms. Many of the foods on our IC Diet list are quite high in histamine, an irritating substance that can provoke mast cells.

Another problem IC patients may have is increased nerve sensitivity in the bladder. Some of the items on the diet list actually stimulate and sensitize nerves, and that's not something we want to do to an already oversensitive bladder.

Dr. Lowell Parsons, a renowned IC researcher at the University of San Diego, has noticed that several foods on the list contain large amounts of potassium. Because some patients' bladders are known to react when potassium salts are instilled in the bladder, Dr. Parsons has suggested that for those patients, part of the problem may be the foods' potassium.

Many people have noticed that some foods on the IC diet list, particularly fruits and tomatoes, contain a substantial amount of acid. Food acids and their potential effect on IC symptoms have been the focus of much discussion over the years. While we don't have any concrete answers yet to questions of why these foods bother IC patients, IC researchers do know that certain explanations for the acid food effect are not credible.

Sometimes