Interstitial Cystitis - The Basics and Healing With Food

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Interstitial Cystitis - aka: IC, is a chronic, inflammatory condition of the bladder involving the nervous system, and the immune system, leading to significant, and debilitating pain. It is much more common in women, and so often - women just 'live with' the fact that they have to pee up to 50 times a day, and have chronic pain in their lower abdomen and pelvis. I'm here to encourage you to see someone about this if this is you, and to let you know that there are things that can help manage your symptoms, reduce your pain, and even repair the damage in your bladder!

the basics

SYMPTOMS:

  • Recurrent "UTI" like symptoms - increased urinary frequency and urgency and night time urination
  • Pain above the pubic bone, in the pelvis, or in the abdomen 
    • Worse with a full bladder
    • Better when bladder is empty
  • Symptoms worse during or around your menses or after intercourse
  • Symptoms often flare then decrease - usually not consistent

theoretical causes:

There are multiple theories around what causes IC - which can be frustrating for patients as there is no "one thing fixes all" type of treatment. Some theories include: 

  • Bladder epithelial permeability
    • aka: the cells lining the bladder are 'leaky'
  • Mast cell activation
    • these cells are part of your immune system - and are thought to be 'overactive' in the bladder in a lot of patients with IC. This causes inflammation leading to damage and irritation of the lining
  • Autoimmune causes
    • pre-existing autoimmune conditions leading to damage and inflammation in the bladder
  • Hormonal imbalances
    • IC has been linked to decreased estrogen levels, making it common among peri-menopausal and menopausal women
  • Other Inflammation 
    • Any inflammation can trigger the disruption of the lining of the bladder, leading to symptoms
  • Infections
    • Some patients are mis-diagnosed with IC and they actually have chronic UTI's (stay tuned for my upcoming post on chronic UTI's)
  • Pelvic Floor Dysfunction
    • I highly recommend seeing a physiotherapist that focuses on the pelvic floor if you have IC! 
  • APF in the Urine
    • APF is also called - anti-proliferative factor, and it inhibits the growth of the cells along the wall of the bladder, impairing healing.

related conditions: 

Interstitial cystitis is commonly associated with other health conditions and it is important to rule these out with a health care provider if you are symptomatic of them - these include: 

  • Irritable Bowel Syndrome (IBS) - most commonly
  • Fibromyalgia
  • Endometriosis
  • Vulvodynia
  • Hay Fever
  • Migraines
  • Hyperthyroidism
  • Autoimmune conditions

OTHER INVESTIGATIONS: 

Once a patient has had the whole gammet of testing done through their medical doctors (ie: urine analysis, urine culture, cystoscopy & biopsy) - there are a few other things I recommend depending on the case including: 

  • Keeping a bladder diary: Track everything for 1-2 weeks including- 
    • Food and fluid consumption 
    • Urine timing 
    • Any symptoms and when they occur 
    • Intercourse timing
    • Time of the menstrual cycle and any menstrual symptoms 
  • Food Sensitivity Testing & candida testing (see below) 
  • Salivary or Urinary Hormone Testing
Contact me for more information on the types of testing I can run as a Naturopathic Doctor!

TREATMENT OPTIONS

STAY TUNED FOR MORE TREATMENT OPTIONS IN PART 2!

LIFESTYLE

STRESS MANAGEMENT

We all know by now that stress, and our mental health take a toll on and influence our physical health. Patients with IC are not exempt from this - in-fact, stress is a very common trigger for women with IC! I often see IC correlating with anxiety, therefore though this post isn't about managing stress or anxiety, I believe it is a very important component to treatment if this fits your picture! 

NUTRITION

I truly believe in starting with forming excellent dietary habits. What we eat and absorb reflects so much in our health. I start with optimizing digestive health in almost all of my patients - and this is no different with patients with IC. This is even more pertinent with IC because so often patients have concurrent digestive issues, specifically IBS.

ELIMINATE TRIGGERING FOODS: 

One option is to eliminate foods that commonly trigger IC symptoms. Unfortunately - a lot of these foods are the most delicious ones (🤦🏻‍♀️ ) BUT, eliminating them can significantly reduce symptoms in some women, making it totally worth it.  These include: 

  • Coffee and caffeine
  • Chocolate
  • Alcohol
  • Sugar
  • Soda 
  • Dairy products
  • Citrus fruit
  • Tomatoes and other acidic veggies
  • Spicy foods
  • Artificial sweeteners (xylitol / stevia - usually okay) 

Some patients are able to eliminate them for a period of time, and then introduce them one at a time (every 3 days) to determine which foods trigger them specifically. 

anti-inflammatory vs inflammatory foods:

Since inflammation is a component of IC - emphasizing foods in your diet that help to reduce inflammation, and eliminating foods that cause inflammation may help your symptoms. Simply put - I like to recommend patients eating a whole food diet and eating mostly plants. Some ideas include: 

  • Have 1/2 of your plate full of colourful vegetables - focus on dark leafy greens
  • Incorporate wild salmon into your diet 2-3 x / week 
  • Focus on mostly plant based meals - keep red meat to 1-2x / week
  • Emphasize healthy fats - ie: avocado, extra virgin olive oil, coconut oil
  • Reduce dairy - choose milk alternatives (ie: almond, coconut, cashew etc.) more often than cows milk
  • Keep grain consumption to 0.5 cups / day or less 
  • Incorporate ginger and turmeric into your cooking liberally
  • Reduce gluten consumption 
  • Eliminate fried and processed foods 
  • Eliminate sugar. 

FOOD SENSITIVITIES:

For some patients - eliminating the 'common triggering foods' or 'common inflammatory foods' just isn't enough. These patients usually significantly benefit from an IgG food sensitivity test to determine which foods are causing their immune system to over - react and promote inflammation. Contact me if you want to learn more about food sensitivity testing! 

CANDIDA / YEAST:

There are some patients that have IC and concurrently increased candida levels (a naturally occurring yeast in our body that can over grow due to stress, antibiotic use, and much more!). For these patients, removing yeast promoting foods and following a candida elimination protocol can significantly reduce symptoms in my experience. The nice thing, is that the food sensitivity test that I use also tests your immune systems reaction to candida! Contact me if you want more information on this.


Making some lifestyle and dietary tweaks can do wonders for some patients with IC - but sometimes patients just need more assistance. Stay tuned for my next article with even more treatment options! Feel free to contact me if you have questions, or want to learn more 💗