A book on Indian Diet for Interstitial Cystitis (IC), the first of its kind, hopes to serve as an easy-to-understand guide for patients and caregivers to help manage IC or Painful Bladder Syndrome. Here is an interview with the co-author Neelanjana Singh who is a Nutrition Therapist & Wellness Consultant.
Your book ‘Indian Diet for Interstitial Cystitis (Eat Healthy and Protect Your Bladder)’ was released last month. Could you tell us a little about it?
Interstitial Cystitis (IC), now known as Bladder Pain Syndrome (BPS), is a medical condition that is difficult to detect and diagnose, but it is prevalent worldwide. In fact, a large number of cases go undetected while patients suffer silently for years on end. Over the last many years of my practice, I have been acquainted with the extent of this condition. In many IC cases, patients are rebuffed and their problems are dismissed as ‘psychosomatic’ in nature.
Click here: It Took 19 Years For Interstitial Cystitis to be Diagnosed
Incidentally, most of the cases that are diagnosed properly happen to be in the Western countries. Therefore, there was a strong need to create awareness about this little known problem, and to provide solutions--dietary and lifestyle--that can be helpful for the Indian population. Although there are dietary guidelines available in the West, they are neither applicable nor palatable for our population.
This book is the first of its kind in the Indian market and hopes to serve as an easy-to-understand guide for patients and caregivers to help manage IC. Having a resource book for these patients to fall back on was needed to ease their anxiety and suffering.
You are a Nutrition Therapist & Wellness Consultant. How did you decide to write a book on Interstitial Cystitis (IC)?
When it comes to heart disease or bone disease, the resources and information are abundantly available. Although the bladder is an integral part of our body system, it has not been given the attention that it deserves. When there is bladder dysfunction, it causes pain and suffering just like any other disease state. But there is very little literature available on bladder dysfunction, which explains why IC is commonly referred to as an orphan disease. More importantly, diet plays a crucial role in the treatment of IC, which is why I strongly felt the need for such a book.
What is Interstitial Cystitis and what are its common symptoms?
IC is a condition where the bladder is unusually sensitive, causing intense pain and frequent and urgent visits to the bathroom. As a result, the day-to-day life of the person suffering from it is ridden with trauma and distress. Imagine not being able to step out of the house for the fear of needing to visit the bathroom very urgently and very frequently. Accompanying that, there could also be crippling pain. Therefore, in some ways, IC can paralyse you into doing nothing.
Is the book exclusively for patients with Interstitial Cystitis (IC) or does it have a wider reach?
Although the book deals with IC, it can guide just about any reader to adopt a healthy eating lifestyle in a simple and fuss-free manner. Therefore, this book is really one that deals with an overarching preventive strategy to remain disease-free and, at the same time, it helps people with the condition to plan their meals and manage symptoms.
Cover of the book below
Could you give us an overall idea of an IC diet? Which are the good and bad foods?
Making dietary modifications is an integral part of IC management, as the bladder is known to be affected by different food components. The mechanism by which the bladder is affected varies from person to person. For instance, in one person, it could be due to an inflammatory process that is triggered by a food, or a change in the pH of the urine, or due to a food component stimulating the nerve endings in the bladder. Therefore, a framework of general diet modifications is the starting point for any person needing the IC diet. But, each person affected by this condition requires a diet plan that is tailored and personalised and therefore unique. Very broadly, the prescription is to avoid heavily processed foods (with many chemicals and additives present), stimulating beverages like tea, coffee and cocoa, and hot spices-chillies being the most common offender among them.
Are there any foods that can trigger interstitial cystitis?
There is more than one mechanism by which the bladder is affected. It could be an allergic reaction to a food, or the metabolic product of the digested food that can lead to the inflammation of the bladder. Therefore it is difficult to identify particular foods that trigger the symptoms. For instance, the trigger could be tea for one person but the same tea could be totally innocuous for another IC patient. The generally known trigger foods I have mentioned above.
What food and drinks should be absolutely avoided during flare-ups?
The broad guidelines suggest avoiding chillies and caffeine in drinks, particularly during a flare-up. But this does not mean all of these have to be avoided blindly. Each patient has to understand and observe how they react to different foods and accordingly plan the diet.
Could you list out some bladder-friendly foods?
There are some components in certain foods that play a role in mitigating the symptoms of IC. Fibre is an ingredient that tops that list. Another beneficial component is derived from probiotic preparations. Aloe vera consumed orally in aloin-free preparations is known to reduce IC symptoms. The promising role of the salt--sodium bicarbonate or baking soda--is quite well established.
To what extent can strategic changes in your diet control IC symptoms? Could you give a few examples of how patients have benefitted?
The strategic changes typically vary from case to case. A patient had insisted that she was on a strictly clean, organic and healthy diet. While taking her history, I realised that she had included green tea in large amounts (several cups through the day) as a part of her healthy lifestyle. She had suddenly been plagued with IC symptoms. In her case, the strategic change was to simply eliminate green tea and it worked like magic.
Therefore, even a so-called healthy food (green tea, in this case) can precipitate symptoms.
What about when one is eating out…how does one make smart choices?
When eating out, one has to be alert to the hidden sources of food that could act as triggers. One needs to check on the sauces and spices that have been used to prepare the dishes. By and large, simple uncomplicated dishes work best when eating out.
How many Indians are affected by IC?
In India and other developing countries, the lack of awareness is a huge challenge, which is why diagnosis of this condition is limited. Therefore, the data for the Indian population suffering from IC is also limited. It is estimated that IC affects between 3 million and 8 million women, and between 1 million and 4 million men in the United States alone. The range of numbers comes from the varying diagnostic criteria along the lines of high specificity and high sensitivity. I expect similar numbers for the Indian population but there is no published data to confirm that.
IC was earlier known as a condition that affected mostly women over 40, but it is no longer so. More and more young people are getting affected and recently there was a case of an 8-year old girl diagnosed with this problem in the US.
Co-author Neelanjana Singh is a Nutrition Therapist & Wellness Consultant
