IC/BPS Diet FAQs

Does an alkaline diet help control interstitial cystitis/bladder pain syndrome (IC/BPS) symptoms?

Barbara Shorter, EdD, RD, CDN, says, “There is some controversy here, but we don’t have any proof that it’s the acid or the alkaline that makes a difference in the bladder.” The alkaline diet aims to reduce flares associated with IC /BPS by balancing intake of acid and alkaline foods. Proponents of the alkaline diet believe that you can control the urine pH—and prevent your body from becoming too acidic—by limiting intake of animal protein, sugar, caffeine, and processed foods. The theory is that by eating a diet of primarily alkaline foods, you can neutralize the acid that is causing your IC/BPS symptoms.

There are no clinical trials supporting the alkaline diet theory for IC because it is a difficult study to design. So far, all of the research has been lab-based and there is no data on the impact of this diet on people.

At this time, ICA does not recommend an alkaline diet for IC/BPS. Getting the nutrients you need to keep your body healthy is very challenging with the alkaline diet; it limits large groups of foods, such as grains, protein foods (like meats, fish, and poultry), sugars, and dairy products. The alkaline diet puts you at risk for many nutritional deficiencies.

Should I restrict “acidic” foods?

An acidic food is one that lowers the pH (increases the acidity) of your urine. A basic, or alkaline food is one that raises the pH (increases the alkalinity) and reduces the acidity of your urine. Giving up acidic food may seem like common sense; however, the effect of the food on your urine may be quite different from the acidity of the food itself.

For example, orange juice is an acidic food with a low pH. After your body metabolizes the OJ, the pH of your urine is elevated. Orange juice (which triggers IC/BPS symptoms in many patients), reduces the acidity of your urine and is included on some alkaline diet food lists. High protein foods such as meat, fish, and poultry—which are not acidic by nature—lower the pH of your urine (make it more acidic). Most IC/BPS patients do not find that these protein foods worsen their symptoms.

Your body has a built in system for controlling pH and automatically self corrects to maintain a stable pH. So even if you change the acidity of your urine, dietary choices do not change the acidity of your blood.

Do vitamins and minerals cause IC/BPS flares?

There is limited research on the effect of vitamins, minerals, and dietary supplements on IC/BPS symptoms and flares.

However, some very small pilot studies have found that certain nutritional supplements may reduce the intensity of IC/BPS symptoms. Also, in the ICA’s 2009 Complementary and Alternative Medicine (CAM) Survey, many IC/BPS patients noted that specific supplements appeared to help keep their IC/BPS in check.

Before taking vitamins, minerals, or dietary supplements, talk with your IC/BPS doctor or other healthcare provider. Ask about medical or health issues that you need to consider before adding a supplement to your diet, as well as any known risks associated with specific supplements such as interfering with any current medications you are taking. Remember that eating real foods are always the best way to stay healthy. Here are some general tips to keep in mind when buying supplements:

• Supplements are not regulated, so you need to be a well-informed consumer when buying them.
• If using supplements, buy from large, well-known companies. Major store brands or manufacturers of FDA-regulated drugs are most likely to adhere to quality standards.
• Look for a quality seal: USP (US Pharmacopia).

Do probiotics help IC/BPS?

At this time, there is limited evidence supporting the use of probiotics in IC/BPS. And, the available information is contradictory. Some IC/BPS patients report that foods naturally containing probiotics—fermented and unfermented milk, miso, tempeh, and some juices and soy beverages—may bother their IC/BPS Other patients shared in ICA’s 2009 Complementary and Alternative Medicine (CAM) Survey, that probiotic supplements appear to help reduce IC/BPS symptoms.

Research on probiotics and IC/BPS is lacking. We need to study them more to gain a better understanding about their safety and appropriate use. However, we’ve looked at which ones may help, and why. Learn more in the Winter 2011 ICA Update.

Can I use artificial sweeteners?

The Long Island study found that many people with IC/BPS reported that artificial sweeteners triggered IC/BPS symptoms. The specific products included in the study were Equal® (sweetener), NutraSweet®, Saccharin, and Sweet’N Low®. So for the vast majority of those with IC/BPS, artificial sweeteners are not recommended.

What brand of protein shake is best for IC/BPS?

Researchers have not evaluated the effect of protein shakes on IC/BPS symptoms. However, here are a few tips in choosing a protein shake:

• Homemade shakes with whole foods are the best for your health and are least likely to bother your bladder. You can whip up your own shake with skim milk, fresh fruits, and vegetables.
• When choosing a ready-made shake, look for one with the least amount of ingredients. Some people cannot tolerate protein shakes. They may experience gas, bloating, and diarrhea, which for an IC/BPS patient, can also cause a flare.
• As with any new food item, follow the reintroduction phase of the elimination diet. Start with a small amount and see how you do.