Snapshot of Research on IC/BPS and Diet
ICA remains a key player in conducting, facilitating, and encouraging researchers to explore the connection between foods, beverages, and supplements on IC/BPS flares.
Research on IC/BPS Diet
Research links a handful of foods and beverages to interstitial cystitis/bladder pain syndrome (IC/BPS) flares, including:
- Coffee, tea, soda, alcohol, citrus juices, and cranberry juice
- Foods and beverages containing artificial sweeteners
- Hot peppers and spicy foods
The effect of diet on IC/BPS is a topic of great interest. ICA remains a key player in conducting, facilitating, and encouraging researchers to explore the connection between foods, beverages, and supplements on IC/BPS flares. Below is a snapshot of research findings on the topic:
MAPP Focus Group Findings (2015)
A group of researchers with the National Institutes of Health (NIH) Multi-disciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network conducted eight focus groups of women with IC/BPS. The 57 participants ranged in age from 19 to 77. The groups included both women who were newly diagnosed and those who had struggled with IC/BPS for many years.
The focus group discussions explored the onset of flares and their impact on the lives of women with IC/BPS. In response to situations that trigger flares, meal times became a topic of conversation. Participants noted that many of the usual suspects provoked IC/BPS symptoms:
- Coffee, tea, caffeinated soda, decaffeinated coffee, and chocolate
- Alcoholic beverages
- Tomatoes or tomato sauce, citrus fruits and juices, and spicy foods
- Multivitamins and vitamin C
In addition, the individual differences with food and beverage sensitivities emerged as a theme. For example, the amount of a particular food and beverage and specific brands varied among group members. For most of the women, a food or drink directly caused an IC/BPS flare. For some, however, consuming these items provoked IBS symptoms, which can also lead to an IC/BPS flare.
USF IC/BPS & Diet Study (2010)
A cross-sectional study conducted by the University of South Florida found that an interstitial cystitis/bladder pain syndrome (IC/BPS) diet does NOT have to be as restrictive, as once believed.
Employing a web-based questionnaire, researchers asked members of the Interstitial Cystitis Association (ICA) about the effects of 344 foods, beverages, and supplements. Almost 600 patients responded—and though nearly all (96%) answered that certain foods and beverages made their IC/BPS symptoms worse, respondents also reported that they did not have a problem with most of the items on the questionnaire.
IC patients may need to avoid only a handful of foods and beverages:
- Citrus fruits
- Carbonated and alcoholic beverages
- Spicy foods
Researchers Stuart Hart, MD, and Rene Bassaly, DO also concluded that people with IC may be able to reduce food sensitivities by consuming baking soda or Prelief before eating one of the trigger foods.
This study about IC and diet was on the agenda of the 2010 American Urogynecologic Society (AUGS) Annual Meeting and published in early 2011: Bassaly, Renee DO; Downes, Katheryne MPH; Hart, Stuart MD, “Dietary Consumption Triggers in Interstitial Cystitis/Bladder Pain Syndrome Patients,” Female Pelvic Medicine & Reconstructive Surgery, 2011: Jan/February; 17(1): 36-39.
ICA Complementary and Alternative Medicine Study (2009)
Some 2,100 people with IC responded to a survey conducted by the Interstitial Cystitis Association (ICA) on complementary and alternative medicines (CAM). Diet topped the list of helpful CAM treatments. ICA distinguished between looking for and eliminating individual food triggers and strictly eliminating all the foods on a given “IC Diet” food list. Results were the same in both cases, strongly suggesting that you can eat happy and healthy with a wide variety of items in your diet and still keep your symptoms at bay. The survey also found that newly diagnosed patients find diet changes significantly more helpful than long-standing IC patients.
- Results of the CAM survey were presented at two medical conferences.
- Survey findings are also summarized in the Summer 2009 ICA Update Special Issue—Complementary and Alternative Medicine.
Long Island Study (2007)
A landmark study linking interstitial cystitis (IC) and diet conducted by Robert Moldwin, MD, and Barbara Shorter, EdD, RD, CDN was published in peer-reviewed literature: “Effect of comestibles on symptoms of interstitial cystitis,” Journal of Urology. 2007 Jul;178(1):145-52.
Drs. Moldwin and Shorter developed a valid and reliable questionnaire that was administered to 104 IC patients. The survey presented general questions and a list of 175 different foods and beverages, asking whether or not or how each item affected symptoms. Patients also completed two standard IC assessment tools—the O’Leary-Sant Symptom and Problem Index (OSSPI) and the Pelvic Pain Urgency/Frequency (PUF) Questionnaire.
More than 90 percent of the women in this study reported that certain foods and beverages bothered them. The most problematic items were coffee, tea, soda, alcohol, citrus fruits and juices, artificial sweeteners, and hot peppers. Tomatoes weren’t far behind. The paper, published in the Journal of Urology, listed 35 items that averaged at least “slightly bothersome.” In an interview with the ICA Update, Dr. Shorter said that “We also found that women who had the worst symptoms were the ones who had the greatest food sensitivities.”
The research team did a similar study in men with chronic pelvic pain. Although a much lower proportion of men were affected, the most bothersome foods were essentially the same.
Drs. Moldwin and Shorter also found that people were affected differently by foods and some might react to a certain food but not react to another closely related one. Dr. Shorter, who has IC, said, for example, that “Some IC patients can’t have black beans, but I can. One patient could not eat blackberries but could eat raspberries.”
Most Bothersome Foods for IC Patients:
- Caffeinated and decaffeinated coffee and tea
- Citrus fruits and juices
- Alcoholic beverages
- Carbonated beverages
- Foods containing hot peppers
- Certain artificial sweeteners
- Pineapple/pineapple juice
- Cranberry juice
- Pickled herring
ICA Interstitial Cystitis and Diet Survey (2004)
Some of the earliest findings identifying the link between diet and interstitial cystitis (IC) stems from self-report surveys conducted by patient groups. The Interstitial Cystitis Association (ICA) has surveyed patients a number of times throughout the years and has concluded that by making changes to their diets, many patients can help control their IC symptoms. The IC and Diet Survey was conducted by ICA from December 1, 2003 to February 12, 2004. About 560 patients responded to this mail-based, self-report questionnaire, which provided some of the first patient insights into the relationship between food and IC symptoms. Findings highlight the positive role that diet modifications play in controlling IC symptoms for some patients.