Fifteen years ago, I was at my wits’ end with my bladder. After a nearly lifelong struggle with IC, my symptoms had gotten significantly worse and nothing I tried helped. I hadn’t done an elimination diet, because I knew my triggers were citrus and caffeine. Easy enough. Besides, I already had to deal with this bladder stuff. Wasn’t that enough? Did I have to give up other foods, too?

Thanks to the encouragement of my husband, I decided to do an elimination diet. On day three, I sat at my computer and sobbed because I was so hungry and couldn’t figure out what to eat. In desperation, I posted in the IC Network Patient Support Forum. Dietician and ICer Julie Beyer quickly responded, encouraged me and suggested some food I could add in. I had cut my diet down too far. Once I added in some more safe foods, it got better. I learned I can eat cooked tomatoes without a problem but not ketchup. Fresh mild salsa in small amounts was fine, but jarred salsa made my bladder angry. After some trial and error, I learned that food with vinegar also triggered my IC symptoms.

Doing that elimination diet helped me figure out my trigger foods. Now I know to what foods that my bladder doesn’t tolerate and avoid them. I also figured out foods I can handle in smaller amounts only. These days, I can have some barbeque sauce on my sandwich at lunch (along with some Prelief) as long as I avoid another vinegar product at dinner. I’ve found all sorts of alternatives that work for me. Honey is great for dipping chicken nuggets or strips in. Chip dip works as a hamburger topping in place of traditional condiments.

But I’d have never figured out any of those things without doing an elimination diet. Simply eliminating the additional trigger food improved my symptoms significantly. All these years later, I still have improved symptoms based on what I learned from that elimination diet.

How common are dietary triggers in IC patients?

Some patients are confident their diet doesn’t affect their bladder symptoms. While they may be correct, research shows that 90% of IC patients are food sensitive. (1) In fact, dietary triggers are so common for IC patients that numerous studies have been conducted looking at them. And none of the studies have found that the exact same food bothers each patient the same way. The best they can offer is the certain foods are more likely to bother patients. That’s how the list of dietary recommendations for IC patients, often referred to as the IC Diet, came to be.

Researchers have found what I did: avoiding your food triggers can help your bladder feel better. One study showed that dietary changes improved symptoms in IC patients for at least a year. (2) The study was only a year long, but I’d guess the relief continued as long as the patients continued their individual diet plans.

What is an elimination diet?

Simply put, an elimination diet is removing certain foods from your diet and then adding them back in slowly to see if they affect you. While an elimination diet works well for IC, there are many other reasons people do an elimination diet as well. They can help identify food sensitivities, food allergies and food triggers for other health conditions such as Irritable Bowel Syndrome, fibromyalgia or migraines — all of which are common among IC patients.

Elimination diets are short-term, usually five to six weeks, and are not for the purpose of losing weight. (3) Elimination diets require some effort and planning, but plenty of available resources make the process easier. Start by looking through the IC food list, which lists foods based on how safe they typically are for ICers. This list gives you a good idea of what to start with. You can identify foods that are usually safe and then work your way up to more bothersome foods to see whether they bother you. Doing an elimination diet allows you to personalize your own IC diet.

The IC Network has a great elimination diet resource page that outlines various ways to do an elimination diet along with a plethora of suggestions. You can also find some free resources on the elimination diet and recipes from IC nutritionist Julie Beyer on her site, Confident Choices.

No matter which way you choose to approach your elimination diet, the more your track your food intake and your symptoms, the easier it will be to identify your trigger foods. Some are probably obvious to you. Others might be more sneaky, which is why keeping track of how you feel and what you eat is so important. Look for a food and symptom tracker app or use a notebook. Do whatever works for you. It takes some effort, but it can be worth it.

What are the benefits of an elimination diet?

Improved symptoms

The biggest and perhaps most important benefit of an elimination diet is improving your IC symptoms. Within two weeks of starting the elimination diet and removing all risky foods, my symptoms eased down and I felt better. That was a great indicator to me that what I was eating or drinking impacted my symptoms. Feeling better motivated me to keep going on the elimination diet to figure out what was bothering me. Who doesn’t want to have their IC symptoms improve?!

Possibly reduced medications

Avoiding your dietary triggers can potentially help you reduce medications — both prescription and over-the-counter. (No medications should be changed without consulting your medical professional.) For me, eliminating and/or greatly reducing my trigger foods meant I was able to take just one prescription medication for my IC. My urologist stopped experimenting with different medications because I felt well enough I didn’t need them. After going through one medication after another and a variety of treatments, I was glad to not have to continue doing so.

More food choices

A third benefit of an elimination diet is that you will probably be able to eat a wider variety of foods. Looking at the IC food list, there are lots of foods that are typically safe, but there are also a lot that can be troublesome. Instead of having to avoid them all, you’ll know what bothers you. I was pleasantly surprised that cooked tomatoes didn’t cause any issues for me. I love spaghetti sauce and pizza sauce! Later I learned sauces made with alcohol make me flare, so not all pasta sauce is made equal. But I still am able to come up with my own recipes and know what brands work for me. If I had only gone by the IC food list, I wouldn’t have known that. I would have just completely avoided tomatoes. When all I needed to avoid was sauces made with alcohol or vinegar. You may be surprised by what you are able to eat.

A sense of control

Another great benefit of doing an elimination diet has to do with your mental health. IC can leave us feeling out of control. Flares can strike without rhyme or reason. None of us chose to have these overly sensitive bladders. We don’t get a say in it. Doing an elimination diet gives you some control. You’re not curing your IC, but you are being proactive about a disease that can take over your life, and that’s a great feeling.

In the end, an elimination diet is a low-risk treatment option that can have a big impact. It’s worth considering if you’ve never done one or if your symptoms are worse for no apparent reason.

 

References

  1. Shorter B, et. al. Statistical validation of the shorter-moldwin food sensitivity questionnaire for patients with interstitial cystitis/bladder pain syndrome. J Urol. June 2014 Volume 191, No. 6.
  2. Oh-Oka H. Clinical Efficacy of 1-Year Intensive Systematic Dietary Manipulation as Complementary and Alternative Medicine Therapies on Female Patients With Interstitial Cystitis/Bladder Pain Syndrome. Urology. August 2017 Volume 106.
  3. Raman R. How to Do an Elimination Diet and Why. Healthline. July 2, 2017.