IC & IBS Patients Share Many Diet Restrictions

Heather Van Vorous, author of First Year IBS, has written some fabulous articles for her website www.helpforibs.com. In one of her “Ask Heather” columns, she answered the question “What’s the Worst Drink for IBS Ever?“ Given the fact that IC and IBS are common in patients and require similar dietary changes, let’s compare diet recommendations. Will my “worst drink for IC/BPS” be the same as hers for IBS? Read on!

Obviously, diet modification is crucial for those IC patients with profound bladder ulceration and/or sensitivity. Why? If you had a wound on your hand, what would happen if you poured lemon juice on it? It would, of course, sting. Thus foods high in acid can be particularly irritating. But the other reality of IC and IBS is that the nerves in the bladder and the bowel become very hypersensitive (aka functional somatic syndrome, central sensitization) thus we must also avoid those foods which are neurostimulatory, such as caffeine. Since many you, like me, struggle with both IBS and IC, finding the right balance between these lists can be quite a challenge yet is well worth the effort.

COFFEE (IBS & IC Diet Lists Agree)

The high acids found in both regular and decaf coffees are well known to irritate sensitive stomachs, heartburn, acid reflux and, of course, our IC bladders. Caffeine is a nerve stimulant which, in my case, makes my heart race and my body tremble if I drink it. But did you know that coffee contains an enzyme that is an extremely strong GI tract irritant? Patients who rely on coffee in the morning to trigger their bowels may note that it can cause more cramps and rebound diarrhea. For the IC patient, coffee in the morning can trigger a day of frequency, urgency and/or pain. Coffee is an absolute NO for patients with IC and IBS! If you’re addicted to caffeine and struggling to stop, at least drink a low acid, decaf coffee (i.e. Simpatico) to minimize the risk of irritation and flares.

SODA POP (IBS & IC Diet Lists Agree)

Heather wrote “the only IBS-safe ingredient in soda pop is the water” which is also true for IC. Besides the obviously high levels of citric acid found in most sodas, high fructose corn syrup can also be a problem. Fructose is a difficult to digest sugar that can cause cramping, diarrhea, bloating and gas. Diet sodas with artificial sweeteners are even worse. Nutrasweet/aspartame is metabolized into aspartic acid, phenylalanine, methanol and formic acid. The acids alone could traumatize our tender, wounded bladders but did you know that diet sodas are a proven cause of obesity? (What Diet Soda Does To Belly Fat) IC patients who drink sodas daily or weekly may be triggering profound irritation in their bladder which could prevent some therapies from working effectively. If you are looking for something similar to soda that isn’t too irritating, we suggest making yourself an Italian Soda or Infused Spa Water instead.

DAIRY (IC Friendly, IBS Challenging)

For IBS patients, dairy products (cheese, cream, milk, ice cream) can be a trigger due to the fat, lactose and the proteins whey and casein. Yet, for IC, dairy products are usually bladder friendly. Heather rightly encourages IBS patients to avoid dairy altogether and to try some of the non-dairy substitutes on the market. If you happen to be struggling with both IC and IBS symptoms, dairy is one of the first food groups suggested that you remove in an elimination diet. However, if you don’t have IBS and/or struggle with lactose intolerance, diary products are usually bladder friendly. The ultimate bladder friendly treat could be a Vanilla Milkshake  or Vanilla Horchata!

ALCOHOL (IBS & IC Diet Lists Agree)

Alcohol is well known for its GI irritating and a potential carcinogenic effect on the bowel. Heather says that “alcohol is more likely to trigger IBS attacks on an empty stomach, so some folks can drink a bit when they’re generally stable and have just eaten.” On the other hand, alcohol triggers bladder symptoms in the vast majority of patients who try them simply because it is irritating to the wounds found in the IC bladder. In 2010, the ICN conducted a survey of patients asking what alcohols they could tolerate. Only 21% of patients reported that they could drink wine without triggering an IC flare. Lower acid wines were better than high acid or high histamine wines with chardonnay and merlot the popular favorites. 39% of patients could enjoy mixed drinks depending upon the mixers used. IC patients avoided all citrus mixers and prefered water, ice and milk. 44% of patients could tolerate beers with a preference towards light rather than dark ales. A surprising 65% of patients reported that they could tolerate a straight alcohol drink, usually focusing on light or clear alcohols. Tequila was the most bladder irritating while rum and vodka drinks seemed to be the most bladder friendly.

BLACK TEA (IBS & IC Diet Lists Agree)

The tannic acids in black tea can irritate the stomach, trigger heartburn and, of course, irritate the bladder. While IBS patients may tolerate decaf green teas IC patients cannot. Due to its high acid content, green teas are notorious for triggering IC flare! On the other hand, herbal chamomile or peppermint teas are well known for their calming and soothing effect on the bladder and the bowel. Patients with GERD usually can’t do mint teas. The chamomile, on the other hand, is ideal for both IC and IBS.  Some brown rooibos teas are also mild and well tolerated. I love Harney and Son’s Pumpkin Spice Herbal Tea!

MEAL REPLACEMENT DRINKS

In addition to high levels of dairy, soy, fructose, artificial flavors, colorings and even caffeine, most meal replacement drinks (i.e. Ensure, etc.) don’t work for either IC or IBS. Throw in the often high levels of vitamin C and/or B6, as well as chocolate flavorings, many of these popular drinks provoke a sensitive bladder or bowel. As an alternative, why not make yourself a smoothie or milk shake with your favorite FRESH ingredients. If you need extra protein, consider using dried, pasteurized egg whites!

So what’s the worst drink for IC/BPS ever?

I totally agree with Heather and nominate the numerous ENERGY DRINKS lining checkout stands at supermarkets around the country. Most contain coffee or green tea combined with a massive extra addition of caffeine guaranteed to make your urinary frequency, urgency and pain skyrocket. Throw in numerous artificial sweeteners, colorings, preservatives, vitamins, herbs, chocolate and more, and that one impulse purchase could lead to days of discomfort and a huge IC flare. The only way to make it worse is to add alcohol, which several companies currently do.

 There are many beverages that you can drink when you have a sensitive bladder and/or bowel. Check out the IC Chef Cookbook for dozens of recipes that you can use to create bladder friendly cold and hot drinks!

Learn more about Heather Van Vorous and sign up for her newsletter at: http://www.helpforibs.com