Elimination Diet

An elimination diet is your first step to figuring out which foods and beverages may trigger your interstitial cystitis/bladder pain syndrome (IC/BPS) symptoms and helps keep you from limiting more foods than is necessary.

The goal of an elimination diet is to determine trigger foods
It is vital that you follow the diet for one month

To identify your potentially bothersome foods and beverages you must strictly follow the elimination diet and your plan exactly as designed during these four weeks. You cannot make any exceptions. Eating even one trigger food (sneaking a cup of coffee, or sharing a few sips of alcohol, for example)  may affect the outcome of the elimination diet. If you currently consume caffeinated drinks, you may experience caffeine withdrawal symptoms when you eliminate these beverages. Read tips on kicking the caffeine habit.

The reintroduction phase of the elimination diet may take several months. For the best results, follow this step exactly. Also, if you have a history of severe bladder flares, talk with your doctor before adding potential trigger items back into your diet. Ask about medical strategies to help minimize flares during the reintroduction phase.

It is also important while you are on an elimination diet to try to minimize stress, not change your physical activity routine, or start new medicines.

Foods to Restrict

For the elimination diet, make a list of the foods you think cause your bladder to flare. Add to that list the items that are most bothersome for those with IC/BPS. If you have other health conditions that require dietary restrictions, add those foods and beverages to the list of foods to eliminate.

My Suspected Trigger Foods

Write down any foods that you think may trigger your IC/BPS.

Most Bothersome Foods

•    Alcohol, coffee and tea (caffeinated and decaffeinated), carbonated drinks  (cola, non-cola, diet, and caffeine-free)
•    Cranberry juice, grapefruit and grapefruit juice, lemons, oranges and orange juice, pineapple and pineapple juice, strawberries
•    Chili peppers, pickles, sauerkraut, tomato and tomato products
•    Processed sandwich meats (salami, bologna), soy products
•    Yogurt
•    Chili, horseradish, ketchup, salad dressings, soy sauce, vinegar, Worcester sauce
•    Chocolate
•    Indian food, Mexican food, Thai food, pizza, spicy foods
•    Artificial sweeteners (Equal® (sweetener), NutraSweet®, Saccharin, and Sweet’N Low®)
•    Monosodium glutamate (MSG)

Some of the items on your “Foods to Restrict” list may be things you used to consume regularly. Think about potential alternative options to eat and drink during the elimination diet. See list of least bothersome foods.

Don’t expect your symptoms to improve right away. It can take weeks for bladder flares, associated with specific foods and beverages, to calm after starting the elimination diet. It can be hard to be patient, but your bladder needs time to heal.

Adding Foods Back into Your Diet – The Reintroduction Phase

After one month of bladder-friendly foods, slowly reintroduce the foods and beverages you restricted. The goal is to be able to tell if that specific item is a problem. How quickly a food or beverage may cause a flare varies.  Some individuals note that symptoms appear within a few minutes of eating. Others find that it takes 20 minutes to 4 hours before a food or beverage triggers a flare.

Add back one item at a time. For each item go slowly, using the following three-day approach. Also, wait until you have tested all of the trigger foods before adding any of them back regularly into your daily diet.

• Day one—try a very small (partial) portion.
• Day two—if no symptoms appear, consume a slightly larger amount.
• Day three—if again, no flares, test a regular size portion.

Record Your Findings – Use a Food Diary

As you try each food and beverage, write down how you respond.  After you have tested all of the items:

• Add back the foods that did not trigger symptoms.
• For the other items, note the severity of your reaction.
• If the food or beverage appeared to cause a flare, you may need to eliminate it long-term from your diet.
• If you want to retest a problem item, you can try it again. Use the same three-day approach.
• Create a list of your trigger foods and beverages.

Based on the outcome of the elimination diet, you may find it helpful to revise recipes, as needed, to eliminate trigger items. Also, bring your list of trigger foods with you when you go grocery shopping. Read food labels and check for bothersome ingredients before you purchase. Different brands have different ingredients, so look for a brand that is best for you.