DIET AND INTERSTITIAL CYSTITIS

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DIET AND INTERSTITIAL CYSTITIS

• CAN DIET PLAY A ROLE IN TREATING SYMPTOMS?

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Effect of Comestibles on Symptoms of Interstitial
Cystitis

• 104 patients surveyed on 175 items of food and
  beverages
• 90 indicated certain food and beverages
  exacerbate symptoms
• Patients who noted a relationship between foods
  and symptoms tended to have a high symptom index
• Shorter B, Lesser M, Moldwin RM, Kushner L. 2007

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WHICH FOODS SCORED HIGHEST?

• Coffee and tea
• Alcoholic beverages
• Citrus fruit and juices
• Tomatoes and tomato products
• Spicy foods, chili
• Artificial sweeteners
• Carbonated drinks
• Vinegar, MSG

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Often problematic

• Coffee
• Decaf coffee
• Tea
• Herbal teas
• Green tea
• Chocolate

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Alcohol

• Most problematic
• Beer and Wine
• Less problematic
• Spirits

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Fruit and Juices

• All fruit juices
• Cranberry juice
• Citrus fruit
• Stone fruit
• Pineapple
• Kiwis
• grapes

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ACIDS?

• Fisher et al found no decrease in urinary pH
  after ingestion of acid foods. 1993
• Nguan et al found no statistically significant
  differences in pain scores between neutral and
  acidic solution bladder instillations. 2005
• Bologna et al. 70 reported a reduction in pain
  and 61 a reduction in urgency when taking an
  alkalinizing agent. 2001

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Vegetables

• Tomatoes
• Tomato sauces
• Tomato juice
• Raw onions

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Spicy foods

• Chili
• Horseradish
• Mustard
• Hot curry

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Artificial Sweeteners

• Diet fizzy drinks
• -especially with caffeine
• Better choice Sucralose (Splenda)

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OTHER POSSIBLE TRIGGERS

• ARYLALKYMINES tryptophan, tyramine, tyrosine,
  phenylalanine
• SULPHITES preservatives (fruit)
• NITRITES preservatives (meat)
• MSG flavour enhancer 621
• ARTIFICIAL COLOURS

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ELIMINATION DIETS

• Simple Exclusion Diet easy to use
• Quick results
• Empirical Diet use where most foods are
  suspected
• Few Foods Diet most drastic
• Dietitian recommended

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SIMPLE EXCLUSION DIET

• Keep a one week voiding diary
• Eliminate suspected foods - washout
• Wait for symptoms to diminish 1-3 weeks
• Add one food back slowly over 1 week
• Keep a symptom score diary
• Repeat washout period
• Test another food

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EMPIRICAL DIET

• Only foods considered safe for IC patients are
  eaten for 1-3 weeks
• Suspect foods are reintroduced one at a time
  while keeping a symptom diary
• Other food intolerances need consideration

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FEW FOODS DIET

• Only low allergen foods for 10-20 days
• Nutritionally inadequate
• Foods added one at a time while keeping a symptom
  diary
• Supervision by a dietitian recommended

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ADVANTAGES OF DIET FOR IC

• Self controlled
• Effective
• Low cost
• Low risk treatment
• Healthy unprocessed diet

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CONSTIPATION
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CONSTIPATION AND IC

• Medications
• Fluid intake
• Activity and exercise

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MEDICATIONS

• Antacids containing aluminum or calcium
• Antispasmodics
• Antidepressants
• Antipsychotics
• Calcium supplements
• Diuretics
• Iron salts
• Opioids
• Oxybutinin and similar drugs for incontinence

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FLUIDS

• Maintain an adequate fluid intake when on a high
  fibre diet
• 6 -8 cups including fluid foods drink when
  thirsty.