Interstitial Cystitis & Bladder Pain Syndrome
Interstitial Cystitis (IC) & Bladder Pain Syndrome (BPS)
Written by Kaitlin Boyer-Irvine (Masters’ student at Johnson and Wales University)
If you’ve ever experienced chronic pelvic pain, pressure, or discomfort that feels connected to your bladder, along with symptoms like urgency, frequent trips to the bathroom, or a feeling similar to a urinary tract infection (UTI) — you may have heard of interstitial cystitis (IC) or bladder pain syndrome (BPS).
In this post, we’ll walk through the who, what, and why of IC/BPS based on the latest research and clinical guidelines. Plus, we'll cover how dietary changes can make a real difference in managing symptoms.
What is IC/BPS?
Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS) is a chronic inflammatory condition of the bladder. While it's not considered life-threatening, it can dramatically affect a person’s physical, emotional, psychological, and social well-being (Li et al., 2022; Lim, Leslie & O’Rourke, 2024).
Unfortunately, there’s currently no known cure for IC/BPS, and its cause is still not fully understood. Researchers believe that several different factors, including immune, neurological, and environmental influences likely play a role (Li et al., 2022; Lim et al., 2024).
Traditionally, IC and BPS were thought to be identical. However, newer research suggests they may actually be different conditions depending on whether or not Hunner lesions (specific inflammatory sores in the bladder) are present (Homma et al., 2024).
With Hunner lesions: The bladder shows clear signs of inflammation.
Without Hunner lesions: There’s little to no bladder inflammation.
However, because the American Urological Association (AUA) clinical guidelines have not yet adopted this distinction, we’ll refer to IC/BPS as a single condition throughout this blog post (AUA, 2022).
Because IC/BPS can be complex, effective treatment often involves a team approach. Urologists may collaborate with primary care providers, nurse practitioners, registered dietitians, physical therapists, pain specialists, gastroenterologists, and gynecologists (AUA, 2022).
In this blog, we will focus particularly on how dietary modifications can help manage symptoms — but first, who is most affected by IC/BPS?
Who is Affected by IC/BPS?
Millions of people worldwide live with IC/BPS. It’s much more common in women than men, with a female-to-male ratio of about 5:1 (Li et al., 2022).
Researchers aren’t exactly sure why women are more affected, but theories include differences in anatomy, hormones, and healthcare-related factors, such as differences in healthcare-seeking behavior and the way doctors diagnose bladder conditions in men and women (Lim et al., 2024). Moreover, experts believe the number of men affected is underestimated, because IC/BPS symptoms can often be mistaken for chronic prostatitis or other prostate-related conditions (Lim et al., 2024).
IC/BPS typically shows up:
In women: Most commonly between ages 50–59.
In men: Most commonly between ages 56–74.
Why is IC/BPS Often Misdiagnosed?
Since there’s no universal screening tool for IC/BPS, diagnosis usually happens by ruling out other conditions first (Jarman et al., 2022; Li et al., 2022). Some conditions that share similar symptoms include:
Chronic prostatitis
Urinary tract infections (UTIs)
Endometriosis
Vulvodynia
Other pelvic floor disorders
Gynecologic and prostate diseases
After careful evaluation and testing, a healthcare provider may diagnose IC/BPS based on your symptoms. For most people (unless Hunner lesions are present), nonsurgical treatment is recommended as the first step (AUA, 2022).
How Can Diet Help Manage IC/BPS?
One treatment option is to identify and manage your dietary triggers (Almutairi, 2024; Jarman et al., 2022). A growing body of evidence shows that making certain changes to your diet can significantly reduce symptom frequency and severity (Jarman et al., 2022; Gordon et al., 2022).
For example, a recent pilot study explored how an anti-inflammatory diet (AID) could help women with IC/BPS. This plant-based, low-saturated-fat diet showed potential benefits for improving quality of life (Gordon et al., 2022). While more research is needed, these results are promising.
Another study found that 70% of people with IC/BPS reported at least one food sensitivity, compared to just 37% of those with other pelvic pain conditions (Jarman et al., 2022).
Not everyone should pursue this option, since folks with history of an eating disorder might find it triggering.
Key findings:
Patients with IC/BPS were more sensitive to acidic foods, spicy foods, and certain beverages.
Managing these triggers helped reduce flare-ups and discomfort.
Common Bladder-Irritating Foods and Drinks (Almutairi, 2024; Jarman et al., 2022).
Here’s a quick look at foods and beverages that are commonly linked to symptom flare-ups:
Beverages: Caffeinated and non caffeinated beverages, alcohol, carbonated beverages, citrus juices
Fruits: Oranges, lemons, cranberries
Vegetables: Spicy peppers, onions, tomatoes
Condiments: Vinegar, soy sauce, ketchup, hot sauce, horseradish
Sweets: Chocolate, artificial sweeteners (like aspartame)
Important Note:
Not everyone with IC/BPS will react the same way to the same foods. An elimination diet: temporarily removing certain foods and reintroducing them one at a time, can help you pinpoint your personal triggers (Jarman et al., 2022; Li, Yi & Ai, 2022).
Working with a registered dietitian who understands IC/BPS can be incredibly helpful in identifying which foods may worsen your symptoms and creating a dietary plan that works to manage your symptoms.
Final Thoughts
Living with IC/BPS can feel overwhelming, but adjusting your diet can help, though folks with a history of eating disorders should discuss the pros and cons carefully with a provider they trust before any changes are made. While research continues to uncover more about this complex condition, one thing is clear: you have options for managing symptoms and improving your quality of life.
If you suspect you may have IC/BPS, or if you’re looking for help managing your symptoms, talk to your healthcare provider, gynecologist, and/or urologist. If you have IC/BPS a registered dietitian can help you assess whether identify dietary changes are a good idea, and if so, help you identify ones that may improve your symptoms. and support your overall quality of life. Ask your dietitian if they feel comfortable with this condition.
References
Almutairi, S. (2024). Dietary Influence on Bladder Pain Syndrome: A Systematic Review. Cureus. https://doi.org/10.7759/cureus.69437
Diagnosis and Treatment of Interstitial Cystitis/Bladder Pain Syndrome (2022) - American Urological Association. (n.d.). https://www.auanet.org/guidelines-and-quality/guidelines/diagnosis-and-treatment-interstitial-of-cystitis/bladder-pain-syndrome-(2022)
Gordon, B., Blanton, C., Ramsey, R., Jeffery, A., Richey, L., & Hulse, R. (2022). Anti-Inflammatory Diet for Women with Interstitial Cystitis/Bladder Pain Syndrome: The AID-IC Pilot Study. Methods and Protocols, 5(3), 40. https://doi.org/10.3390/mps5030040
Homma, Y., Akiyama, Y., Tomoe, H., Furuta, A., Ueda, T., Maeda, D., Lin, A. T., Kuo, H., Lee, M., Oh, S., Kim, J. C., & Lee, K. (2020). Clinical guidelines for interstitial cystitis/bladder pain syndrome. International Journal of Urology, 27(7), 578–589. https://doi.org/10.1111/iju.14234
Jarman, A., Janes, J. L., Shorter, B., Moldwin, R., De Hoedt, A. M., Barbour, K. E., Kim, J., Freedland, S. J., & Anger, J. T. (2022). Food sensitivities in a diverse nationwide cohort of veterans with Interstitial Cystitis/Bladder Pain syndrome. The Journal of Urology, 209(1), 216–224. https://doi.org/10.1097/ju.0000000000002938
Li, J., Yi, X., & Ai, J. (2022). Broaden horizons: The advancement of Interstitial Cystitis/Bladder Pain Syndrome. International Journal of Molecular Sciences, 23(23), 14594. https://doi.org/10.3390/ijms232314594
Lim, Y., Leslie, S. W., & O’Rourke, S. (2024, October 7). Interstitial Cystitis/Bladder Pain Syndrome. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK570588/