Many people with bladder conditions such as interstitial cystitis or IC (also known as painful bladder syndrome and bladder pain syndrome) notice that certain foods appear to worsen symptoms of urgency, frequency, and pain. The first published research about which foods irritate the bladders of patients struggling with IC symptoms was done in 2007; however, long before that patients had began to formally and informally compile lists of foods that are safe and ones that appear to exacerbate IC symptoms.

Based primarily on anecdotal evidence, diet modification became an essential therapy for many patients struggling with IC. Unfortunately, a wide variety of conflicting diet lists have circulated through the patient and physician community, creating confusion and poor eating habits. Also, there appears to be great individual variation in the effect of foods and drinks on IC symptoms. How much, how often, and the specific combination of foods and drinks varies for each person.

Patient advocacy groups and key opinion leaders, concerned that the lack of clarity about what to eat was impacting nutritional health, conducted a series of meetings aimed at reaching consensus on “safe foods” and developing standardized diet recommendations. The ad hoc consensus development committee included registered dietitians working within the IC field, patient advocacy leaders, and cookbook authors.

Drawing upon both published research and anecdotal evidence, the committee developed a universal food list in an easy-to-understand, three-tier system with foods that many IC patients report to be :

• Least bothersome (Bladder Friendly)
• Okay to eat (Try It)
• Most bothersome (Caution).

The list is not a standardized meal plan, but guidelines for making healthy foods choices. One hope is that these universal dietary guidelines will spark more formal research on how diet choices may help control bladder pain and urinary frequency and urgency. An additional goal is to garner formal acceptance of the IC diet as a medical nutrition therapy.

Robert Moldwin, MD, notes, “Various foods and beverages appear to affect the symptoms of most interstitial cystitis (IC) patients. Therefore, dietary modification has become one of the cornerstones of conservative IC management. Unfortunately previous "IC diets" have been very restrictive, making specific foods taboo while others "acceptable." Early on, we realized that this was simply not the way to go, as many IC patients tolerated foods in the "avoid" column; and some even became malnourished by following these diets to the letter. That's why I am so delighted to see these new guidelines. These guidelines offer guidance that is based upon scientific information, expert clinical experience, and patient reports. In addition to updated information, there are no "permissible" and "avoid" columns, simply suggestions. My hat's off to the ad hoc committee of registered dietitians, patient advocacy leaders, and cookbook authors. This will be of tremendous value to all of our patients!”

The new guidelines are posted online at:

• www.ic-diet.com (Confident Choices)
• www.ichelp.org (Interstitial Cystitis Association)
• www.ic-network.com (Interstitial Cystitis Network)
• www.smithinstituteforurology.com (Smith Institute for Urology)