An Interstitial Cystitis Elimination Diet: Eight Ideas for Keeping It Simple

If you are newly diagnosed with interstitial cystitis, or find yourselves in a flare with a painful bladder you can't quite get control of, it is important to stick with the bladder friendly column of the IC Food List, keeping your meals as plain and simple as possible. It is much harder to filter out which food is causing your bladder symptoms to flare if you are eating foods with many ingredients such as casseroles, soups, or stir-fries. Of course, keeping your foods simple is only part of it, and sometimes you are in so much pain or you are so frustrated that you can't think straight.

Trust me; I have been there. I know it takes a lot of energy to plan meals, shop for ingredients, cook the meals, and clean up. You have to consider not only your condition, but the schedules of your family members, and their food preferences. So I have come up with a short list here with some hints for keeping it simple at this stage:

• Make IC menu planning a family affair. Consulting with other family members about menu choices can increase their understanding of your condition and the foods you can and cannot have.

• Consider including foods that might be triggers for you, but that your family can eat. It was nearly a year before I realized that I had not been buying strawberries for my family just because I couldn’t have them!

• Stick to your grocery list. Often people walk through the grocery store waiting for inspiration to strike. A list insures that you have all the ingredients that you need for the week and helps prevent impulse buying, which can be tough on the wallet.

• Recycle your weekly meal plans like institutions do. Hospitals, schools, and nursing homes use “cycle menus” to simplify planning. Once you have developed a few weeks of menus that you and your family enjoy, go ahead and reuse them. Save the grocery lists, too.

• Do your grocery shopping from your computer. For a small charge, many stores now allow you to send a grocery order to a professional shopper who brings your order directly to your car or even to your house. This can be a great time and energy saver. 

• Make two batches of a meal and freeze one for later. Everyone has days when they are too busy or too tired to cook. It is nice to have something available that you can quickly reheat.  

• Involve everyone in mealtime activities. Establish this as a special time to spend with individual family members. Assign days when each person has a chance to help with breakfast or dinner. Have all the ingredients out for people to pack their own lunches. Even small children can help to set the table, measure ingredients, or stir batter. 

• Simplify cleanup. Use disposable plates and utensils on days when symptoms flare or energy is limited. Line baking dishes with aluminum foil or bake food in foil pockets. Use a slow cooker to bake a one pot, complete meal of meat, potatoes, and vegetables.

For more tricks and tips on how to implement the IC diet, see Customizing the Interstitial Cystitis Diet: A Confident Choices® Book. 

PS: Thank you so much to all of you who are making your Amazon purchases though the Confident Choices links. Here are some of the purchases people have made that help support this newsletter and other projects of ours! 

    

Julie Beyer, MA, RDN

Author, Speaker, Patient Advocate

www.ic-diet.com  

Need Some Guidance? Want More Recipes?

For step by step guidance for creating your own personal interstitial cystitis meal plan, see: Confident Choices^®: Customizing the Interstitial Cystitis Diet.

For some basic, family-style, IC bladder-friendly recipes, see: Confident Choices^®: A Cookbook for Interstitial Cystitis and Overactive Bladder

For health care workers:  Interstitial Cystitis: A Guide for Nutrition Educators 

Interstitial Cystitis Diet: No Citrus? No Strawberries? No Problem!

One of the most common concerns that I hear from my IC patients is how can they consume a balanced diet with interstitial cystitis and the limited, fruit selection on the IC Food List. The answer is simple! Many other bladder friendly fruits and vegetables are full of the same vitamins and antioxidants that a person might find in orange juice or berries.


In fact, even on an IC Diet, you can get a lot of vitamin C from foods that are not citrus. Check out this list of bladder friendly, high vitamin C options (all vitamin C amounts are for 100 g. servings):

• Red bell peppers (nearly 200 mg!)
• Parsley (130 mg)
• Broccoli (90 mg)
• Green bell peppers (80 mg)
• Brussels sprouts (80 mg)
• Kale (41 mg)
• Cauliflower (40 mg)
• Raspberries - if tolerated (30 mg)
• Spinach (30 mg)
• Cabbage, raw (30 mg)
• Butternut (winter) squash (21 mg)
• Spaghetti squash (20 mg)
• Potato (20 mg, but you usually eat more than 100 g of potato)
• Zucchini (19 mg)
• Yellow (summer) squash (17 mg)
• Blueberries (10 mg)
• Banana - if tolerated (9 mg)

Some IC patients can also take an alkalized Vitamin C supplement or a sustained release formula which keeps the excess Vitamin C from spilling into the bladder all at once, which is what causes the pain. One way or another, with just a little planning, you should be able to get plenty of C in your diet!

Julie Beyer, MA, RDN

Author, Speaker, Patient Advocate

www.ic-diet.com  

Looking for New IC Recipes?

For step by step guidance for creating your own personal interstitial cystitis meal plan, see: Confident Choices^®: Customizing the Interstitial Cystitis Diet.

For some basic, family-style, IC bladder-friendly recipes, see: Confident Choices^®: A Cookbook for Interstitial Cystitis and Overactive Bladder

For health care workers:  Interstitial Cystitis: A Guide for Nutrition Educators 

Yes! You CAN Have Salads! Bladder Friendly Low Acid Salads and Salad Dressings

Everyone knows that vegetables and salads are an important part of a healthy diet. But, if you are a person with interstitial cystitis or other acid sensitivity you are probably asking yourself, “What can I put on my salads?” My answer is, “Plenty!” The fact is, salads don’t have to be acidic at all. The trick is to build the salad itself with a variety of ingredients that appeal to all of your senses so that you aren’t relying solely on the salad dressing for that burst of flavor.

Are you ready to experiment? Here are some ideas to try:

• Use a variety of greens to add flavor and texture to your salad. The color variations of the greens signify different nutrients! 

• Toss chopped fresh herbs (cilantro, parsley, basil, oregano, fresh mint, or thyme) into the salad greens for a surprise burst of flavor in every bite.

• Add sliced avocado to salads. Not only does this add a creamy texture to the salads, it provides you will healthy fats. 

• Grow your own low-acid salad tomatoes. Ask your local nursery to suggest varieties that grow well in your area or visit local farmers' markets to sample different types. The small yellow pear tomatoes are a great start, low in acid and very sweet!

• Top your salad with roasted onions, corn, bell peppers, zucchini, mushrooms, or summer squash for extra flavor and color. The more color the better! 

• Boost your salad’s flavor and nutrition by adding fruit. Mild apple or pear slices, blueberries, and dried fruit are all tasty choices.

• Throw in some beans, legumes, nuts, or seeds for extra flavor, texture, added protein, and healthy fats.

• Substitute blueberry juice, pear juice, or peach nectar for vinegar in homemade salad dressings.

• Make creamy dressings starting with a base of mild yogurt or blended cottage cheese and adding fresh or dried herbs, garlic, onion powder, chopped fresh mint, lemon zest, and/or salt to taste.

• Try herb-infused oils  or nut oils (almond, walnut, and avocado are sweeter choices) to add flavor and variety to your salads.

• Finally, when in doubt, try using Prelief to lower the effect of the acidic foods on your body. But I promise you, once you get used to designing these flavorful, colorful, and nutritious salads, you will never go back to plain old iceberg lettuce and vinaigrette again!

Here are a couple of recipes from Confident Choices®: A Cookbook for Interstitial Cystitis and Overactive Bladder to get you started:

Pear and Honey Coleslaw

Ingredients:

1 hard (partially ripe) pear

2 c. shredded white and red cabbage

1/2 c. shredded carrots

1/2 t. finely chopped mint, if desired

1/2 c. pear juice

1 t. lemon zest

1 T. honey

1/2 t. sea salt

1/4 t. pepper

Peel, core, and grate pear to equal 1/2 cup. Combine with cabbage and carrots. Place mint, pear juice, canola oil, lemon zest, honey, salt, and pepper in blender and mix until well blended. Pour immediately over vegetables and toss. Refrigerate a minimum of 4 hours, stirring occasionally to blend flavors. May also be served as a hot salad by microwaving for 30 seconds per serving.

Basil Blueberry Non-Vinaigrette Salad Dressing

Ingredients:

1 c. frozen blueberries, partially thawed

1/2 c. organic, pure blueberry juice

1/2 c. olive oil

1 t. lemon zest

1/2 t. sugar

2 t. finely chopped fresh basil (may substitute thyme)

Pinch salt

Pinch white pepper to taste (as tolerated)

Place all ingredients in blender. Blend using one-second “pulses,” checking consistency after every couple of pulses. May also be made without using frozen berries. Simply increase juice to 1 cup.

Julie Beyer, MA, RDN

Author, Speaker, Patient Advocate

www.ic-diet.com

Just Tell Me What to Eat!

For step by step guidance for creating your own personal interstitial cystitis meal plan, see: Confident Choices^®: Customizing the Interstitial Cystitis Diet.

For some basic, family-style, IC bladder-friendly recipes, see: Confident Choices^®: A Cookbook for Interstitial Cystitis and Overactive Bladder

For health care workers:  Interstitial Cystitis: A Guide for Nutrition Educators 

Are You Becoming Nutrient Deficient on the Interstitial Cystitis Diet?

I frequently have interstitial cystitis/painful bladder patients contact me for symptoms of vitamin deficiency because they went "gluten-free" based on " information from the internet." These can be serious deficiency diseases we have not seen in this country for nearly 100 years. (Look up beriberi, pellagra, and megaloblastic anemia.) The reasons for these deficiencies are well known. Wheat flour is often enriched with vitamins that substitute flours (rice, amaranth, potato, etc.) are typically not. This is leaving a big hole in the nutrition of many people. In fact, I imagine there are thousands out there with the same problem. 

I know some people with IC say they are being helped by going gluten- or dairy-free, and if that is the case, I am thrilled for them. I am not against anyone trying something that they feel could help their painful bladder and frequency. But if you want to try it, I want you to KNOW going in that it is very difficult, especially when paired with the IC Food List that we already know works for 90% of the people (Documented, not made up....90% plus people with interstitial cystitis are actually helped with this IC Diet Food List). Trust me, the last thing you want to do is give yourself MORE problems than you already have. Gluten-free diets need to be taught and supervised, at least at first, by dietitians so that the patients can learn what they need to do to fill these nutrition holes in their diets. 

Nutrition is a science for a reason. Until we start enriching other non-gluten grains with the vitamins and minerals you are missing when you don't eat wheat, rye, and barley, you will have to watch your diet extremely carefully to be sure that you are getting all the nutrients you need. Keep in mind that IC patients can't supplement many of these nutrients with a multivitamin like someone with celiac (but no IC) can, because that hurts an IC bladder. It is tricky business at its best. 

My friends, you only have one life. Some of you are desperate to get well, I know that. I have been there. But don't get so frantic that you reach for everything out there and end up worse than before.

If you are new to IC and the interstitial cystitis diet, here is the plan I work from with my patients:

1. Start by eliminating the top offenders. Citrus, spicy hot foods, MSG, soy, caffeine, coffee, tea, sodas, alcohol, tomatoes, cranberry juice, chocolate. See how you do without changing anything else. Give it a couple of weeks to see if you improve. Be sure to keep a food and symptom diary to be able to "measure" your success. Not everyone can get their pain down to zero or their frequency to 4 times a day. However, if you lower your pain from an 8 to a 4, that is a success.

2. If eliminating the main offenders doesn't work, you can then use the Bladder Friendly list on the IC Diet. Again, keep the diary and follow for a few weeks to see if you improve. You might have to muster up some patience, but try. Eventually most people feel better.

3. Be sure to eat foods from all the food groups. Not all fruits are bad. Many IC safe vegetables provide similar nutrition to fruits. (See Interstitial Cystitis: No Citrus, No Strawberries? No Problem!) Eating a wide variety of foods is essential for good health.

4. Modify how you supplement nutrients. Consider a brand of multivitamin specific for painful bladder patients. Or, use a children's formula multivitamin, usually 25% of an adult's needs, taking one dose in the morning and one dose in the evening. The benefit here is that more vitamins will actually be absorbed since the body can only use so much at one time.

5. If you still don't feel better, remember that it isn't always food. Stress, physical activity, hormonal cycles, and sexual intercourse could be triggering your interstitial cystitis symptoms. Don't keep eliminating foods in your diet just because you "think" they are bothering you. Use your diary. Talk to someone else who might be able to see patterns. Try to approach this as scientifically as you can.

6. If you have faithfully tried everything else and you have a history of allergies, consider being tested for food allergies. Now and then an IC patient reacts to a "Bladder Safe" food and it is usually because they are not even aware that they have an allergy. I have seen patients allergic to dairy, corn, pears, eggs, and beef. All foods that are normally considered safe and even soothing for most IC patients. Unless you are allergic.

7. Finally, you could try the gluten-free or the casein-free diets, but that is much further along the line. A rule of thumb here is if you don't feel you are being helped within a few weeks of starting one or the other of these restrictive diets, you probably won't be helped. I also advise to eliminate one thing at a time. That way if you DO get better, you aren't trying to figure out which food group is hurting you.

As many have discovered, when you take a whole food group out of the diet, it becomes much more difficult to balance your nutrients. Those eliminations need to be approached cautiously and scientifically or you will create many more problems than you already have. It is extremely frustrating that "medical professionals" with only a teeny fraction of the nutrition training that dietitians have, pass out this information so freely.

Finally, don't waste your time and money frantically listening to everything you read on the Internet, and trying to assimilate each and ever suggestion you come across. If you want help, I want to help you. I CAN help you. I am working with groups of dietitians to help train more people who can help you, but that is going to take years. Until that happens, however, I try to accommodate as many people as possible into my schedule. If you want to have a private appointment with me, I do phone and video (Facetime/Skype) consultations for people. Please email me at NutraConsults@aol.com.


Julie Beyer, MA, RDN

Author, Speaker, Patient Advocate

www.ic-diet.com 

Just Tell Me What to Eat!

For step by step guidance for creating your own personal interstitial cystitis meal plan, see: Confident Choices^®: Customizing the Interstitial Cystitis Diet.

For some basic, family-style, IC bladder-friendly recipes, see: Confident Choices^®: A Cookbook for Interstitial Cystitis and Overactive Bladder

For health care workers:  Interstitial Cystitis: A Guide for Nutrition Educators 

Interstitial Cystitis: Is MSG Hiding in Your Food?

Monosodium glutamate, or MSG as it is commonly called, is a food additive used around the world. MSG is a sodium based salt of the molecule glutamate which is used to "enhance the flavor" of a variety of manufactured products. People can even buy the product Accent or similar seasonings which can be used on food prepared at home. The flavor sensation that MSG imparts is described as umami, or a slightly metallic flavor that can take the place of some salt (sodium chloride) since sodium that is combined with glutamate provides a similar burst of flavor with less sodium. MSG is often found in snack foods, condiments, gravy and gravy mixes, sauces, ramen and other Asian foods, soups, stocks, as well as bouillon cubes and granules. Although MSG is considered safe in general, many people react negatively to MSG including migraine sufferers, some with gastrointestinal problems, and interstitial cystitis/painful bladder patients. Because of these reactions, many manufacturers in previous years had reduced the use of MSG in their products, even promoting MSG-free foods for people who want to avoid it. Lately, however, there is a renewed interest in promoting umami flavors in foods and the use of such products in the marketplace is on the rise again.

Most IC patients know that they should avoid monosodium glutamate/MSG, but often they do not know that MSG can be "hidden" in an ingredient list or that there are other, similar ingredients that manufacturers can use that may be just as bad for a painful bladder. Have you ever heard of "disodium glutamate??" How about "potassium glutamate?"  In order to fully avoid the effects of consuming MSG, you need to really read your labels. 

Here are some things to look for:

• MSG
• MSG Monohydrate
• Sodium Glutamate Monohydrate
• Monosodium Glutamate
• Disodium Glutamate
• Sodium 2-Aminopentanedioate
• Hydrolyzed Vegetable Protein (HVP)
• Textured Protein
• Monopotassium Glutamate Monohydrate
• Monosodium Salt
• Hydrolyzed Plant Protein (HPP)
• Yeast Extract
• Glutamate or Glutamic Acid
• L-Glutamic Acid Monohydrate
• Autolyzed Plant Protein
• Yeast Food or Nutrient (not just plain yeast)
• Glutamic Acid
• Sodium Caseinate
• Autolyzed Yeast
• Vegetable Protein Extract

Do you read labels when you shop? It may take some time at first, but don't worry! Eventually you will re-learn what foods you can stock in your pantry and refrigerator that are bladder-friendly!

            

   

Julie Beyer, MA, RDN

Author, Speaker, Patient Advocate

www.ic-diet.com  

Helping Yourself Is the First Step to Getting Well

For step by step guidance for creating your own personal interstitial cystitis meal plan, see: Confident Choices^®: Customizing the Interstitial Cystitis Diet.

For some basic, family-style, IC bladder-friendly recipes, see: Confident Choices^®: A Cookbook for Interstitial Cystitis and Overactive Bladder

For health care workers:  Interstitial Cystitis: A Guide for Nutrition Educators

What Is Your Interstitial Cystitis "New Normal?"

Have you heard the phrase "new normal" which describes how a person experiences life after diagnosis and treatment for an illness or chronic condition? It started to be used decades ago among cancer survivors, and many times people with conditions like interstitial cystitis/bladder pain syndrome use it as well.

Simply put, "new normal" implies that you may never go back to the body or even mental state that you were in before you were diagnosed with interstitial cystitis, but you have reached a point in treatment where you feel better and have even developed coping skills that make navigating your painful bladder easier and maybe even automatic. 

For example, I am MUCH better than when I was first diagnosed with IC! I now look at the couple of years before and after my diagnosis as one long bladder flare where I had to learn to listen to my own body and not ignore what was happening. 

Obviously the IC diet is important, but I don't have to watch what I eat as much as I used to.  I still have several things I definitely cannot touch: Soy, cranberry juice (but I can have a few dried cranberries on a salad), strawberries, very spicy foods (although I can have a pinch of spice in something like guacamole), alcohol, any tea other than chamomile and mint (I never did drink coffee), and "too many" tomatoes or citrus. I am at a point where I can have one "bad" thing a day and do well. I am always on the hunt for new recipes, and meal planning isn't as frightening as it was 20 years ago.

If I start to feel some bladder twinges or increase in frequency above my "new normal," I go back to a strict IC diet, which for me involves a lot of water, eggs, toast, cottage cheese, and vegetables. I have learned that I need to get plenty of sleep. I watch my stress level  and have coping strategies for that also. I take Epsom salts baths when I need them (or just when I want them!), and I don't apologize for the medications I need to take occasionally because they improve my quality of life, something I lost for a few years! (There is a chapter on how to handle flares in Customizing the Interstitial Cystitis Diet: A Confident Choices® Book)

I still void more often than someone without IC/BPS (mostly in the morning), and about once a week my body reminds me what the feeling of urgency really is, but since my pain is controlled, I can live with those things and even manage them with a few tricks I have learned over the years. The most important thing is that I don't fixate on them and remember everyone gets something sometime. That is my "new normal." 

How about you? What is your "new normal" with interstitial cystitis? Respond to this email with ideas and let's help the newly diagnosed among us learn some ways to enjoy their lives again!

Julie Beyer, MA, RDN
IC Dietitian

Author, Speaker, Patient Advocate

www.ic-diet.com

See Also:

Helping Yourself Is the First Step to Getting Well

For step by step guidance for creating your own personal interstitial cystitis meal plan, see: Confident Choices®: Customizing the Interstitial Cystitis Diet.

For some basic, family-style, IC bladder-friendly recipes, see: Confident Choices®: A Cookbook for Interstitial Cystitis and Overactive Bladder

For health care workers:  Interstitial Cystitis: A Guide for Nutrition Educators

Interstitial Cystitis/Painful Bladder. Is It All In Your "Head?" Maybe...

My family is no stranger to chronic pain. In addition to my interstitial cystitis, my daughter suffers from endometriosis, a condition that causes her incredible pain and upsets her system enough to make her periods madly unpredictable. She is doing much better today, but after one of her surgeries she said something that really bothered me. She said she was glad to have proof that it wasn't all in her head. It killed me to hear that; but unfortunately almost every person with pelvic pain has heard that line at least once in their quest to get a proper diagnosis. 

The truth is that diseases like endometriosis and interstitial cystitis CAN be affected by the mind-body connection, also called "psychoneuroimmunology" or PNI. If this rattles you a bit or causes you to become defensive, think about this: We know that mental health conditions like depression and anxiety are often chemical in nature and can manifest themselves in headaches, backaches, and yes, even bladder-aches. We also know that chronic stress triggers the release of several hormones and other substances which actually help us react swiftly in actual emergencies, but when released chronically, can affect our health negatively. As you know, we can't eliminate stress entirely, and we often can't control whether we are depressed or anxious, especially if we have an unpredictable condition like interstitial cystitis. But we can minimize the effects of stress on the body with a few tricks and lifestyle changes. Here are some ideas to get you started:

1. Take three deep breaths. Fill your lungs completely with air then release it slowly. This relaxes the diaphragm and, in turn, much of the rest of the body. 
2. Don't procrastinate on tasks you need to do. Procrastinating can cause an unnecessary increase in stress when actually doing the task can reduce it. Create a to-do list and start crossing things off. Time yourself doing chores you have put off for a long time. You will become more motivated to get more tasks done once you realize it only took you 20 minutes to sort and clean the front closet or clean out the car.
3. Divide large works into smaller bites. Maybe you don't have the time or energy to go through all of the kitchen cupboard. I get that. But what about starting in one corner of your kitchen and doing one cupboard a day. Even if you are exhausted, you can clean out one cupboard each evening. Before you know it, your kitchen will be very well organized! 
4. Engage in a hobby or learn something new. Giving your mind a pleasant diversion can be a great way to reduce the unwanted effects of chronic stress. The sense of accomplishment you feel after completing a project can provide fuel for you to start work on the next thing on your list.
5. Exercise and move more. Take a walk, stretch, lift light weights. These activities help burn the calories released and they can neutralize the chemicals coursing through your body when you are under stress. 
6. Pray or meditate. Connect with your spiritual purpose. Even yoga can help create a state of relaxation several times a day.
7. Get more sleep. I know this is hard to do when you are in chronic pain, but your body needs sleep to heal. (See: Are You Sick and Tired of Being Sick and Tired?)
8. Talk it out or write it down. Putting words to your situation is one of the best ways to help sort out any stress or other mental anguish you may be experiencing. Talk to a trusted friend or family member, keep a journal of your experiences, reactions, and/or feelings, or make an appointment with a therapist or spiritual advisor. Just putting words to a situation is a great way to reduce the effects of stress on your body. 

In summary, the thing to remember is that even though your disease isn't really "all in your head," there is definitely a connection between a person's emotions/stress level and their IC symptoms. That doesn't mean a person with IC is imagining their symptoms. Rather, when a person experiences heavy emotions or stress, a cascade of chemicals is released that causes dozens of physical reactions in the body and we need to create healthy habits to reduce the effects on our health.

For more information about PNI and how emotions, hormones, and body chemistry are interrelated with disease states, check out these books:

Molecules of Emotion (Candace Pert's first book about PNI. A bit medical, but extremely interesting and really helps explain the body/mind connection.) 

Everything You Need to Know to Feel Go(o)d (Pert's recent book...much like Molecules of Emotion but easier to read. It also talks about her's and her husband's discovery of Peptide T, the closest thing we have for a cure for HIV/AIDS! Very very good!!) 

When The Body Says No—Understanding the Stress Disease Connection (Just like it sounds--helps make the connection between stress and disease.) 

You can also read more about PNI at the American Psychological Association website: Psychoneuroimmunology

JulieBeyer, MA, RDN

Author, Speaker, Patient Advocate

www.ic-diet.com  

Helping Yourself Is the First Step to Getting Well

For step by step guidance for creating your own personal interstitial cystitis meal plan, see: Confident Choices®: Customizing theInterstitial Cystitis Diet.

For some basic, family-style, IC bladder-friendly recipes, see: ConfidentChoices®: A Cookbook for Interstitial Cystitis and Overactive Bladder

For health care workers:  InterstitialCystitis: A Guide for Nutrition Educators