Attention: Restrictions on use of AUA, AUAER, and UCF content in third party applications, including artificial intelligence technologies, such as large language models and generative AI.
You are prohibited from using or uploading content you accessed through this website into external applications, bots, software, or websites, including those using artificial intelligence technologies and infrastructure, including deep learning, machine learning and large language models and generative AI.
JU INSIGHT: Food Sensitivities in a Diverse Nationwide Cohort of Veterans With Interstitial Cystitis/Bladder Pain Syndrome
By: Aubrey Jarman, BS, RD; Jessica L. Janes, MA; Barbara Shorter, PhD, RD; Robert Moldwin, MD; Amanda M. De Hoedt, MS; Kamil E. Barbour, PhD, MPH, MS; Jayoung Kim, PhD; Stephen J. Freedland, MD; Jennifer T. Anger, MD, MPH | Posted on: 17 Jan 2023
Jarman A, Janes JL, Shorter B, et al. Food sensitivities in a diverse nationwide cohort of veterans with interstitial cystitis/bladder pain syndrome. J Urol. 2023;209(1):216-224.
Study Need and Importance
Interstitial cystitis/bladder pain syndrome (IC/BPS) is often underdiagnosed or misdiagnosed due to the overlap of symptoms with other pelvic pain (OPP) conditions such as chronic prostatitis, urinary tract infections, endometriosis, and vulvodynia. IC/BPS symptoms are incredibly burdensome, and prior research shows that certain foods and beverages can worsen symptoms in select patients. We sought to analyze the magnitude by which comestibles affect IC/BPS when compared to OPP and healthy control cohorts. We added novelty to our assessment by including a nearly 50:50 ratio of men and women and a larger proportion of racial minorities than any prior IC/BPS dietary research study to date.
What We Found
IC/BPS patients are significantly more sensitive to comestibles than those with other pelvic pain conditions and healthy people (see Table), including greater symptom severity and a higher number of sensitivities present. There were no differences by gender, and we only saw a slight trend toward Blacks being more sensitive to comestibles than Whites.
Limitations
One limitation is the reporting of symptoms in healthy controls. Bias may be present given that the questionnaire is intended for patients experiencing bladder pain symptoms, which healthy controls are presumably not experiencing. Another limitation of this questionnaire is that it captures participant responses on a Likert scale, as opposed to a sliding scale of symptom severity. We also lacked statistical power to show potential race-related differences in food sensitivity. It is possible that, with larger sample sizes, some of the effects observed here may have reached statistical significance.
Table. Food Sensitivity Outcomes Stratified by Cohort
| IC/BPS cohort (N=266) | Other pelvic pain cohort (N=68) | Healthy control (N=91) | P value | |
|---|---|---|---|---|
| Reported that certain foods and/or beverages worsen bladder symptoms, No. (%) | < .001a | |||
| No | 41 (15) | 27 (40) | 37 (41) | |
| Yes | 160 (60) | 16 (24) | 19 (21) | |
| Unknown/missing | 65 (24) | 25 (37) | 35 (38) | |
| If foods do worsen bladder symptoms, they…, No. (%) | ||||
| Make urine frequency worse | 122 (46) | 12 (18) | 15 (16) | < .001a |
| Make urine urgency worse | 107 (40) | 9 (13) | 9 (10) | < .001a |
| Make bladder pain worse | 120 (45) | 3 (4) | 3 (3) | < .001a |
| Has at least 1 food sensitivity, No. (%) | 185 (70) | 25 (37) | 29 (32) | < .001a |
| No. sensitivities | < .001b | |||
| Mean (SD) | 7.2 (8.1) | 1.9 (3.3) | 2.1 (4.2) | |
| Median | 5.0 | 0.0 | 0.0 | |
| Q1, Q3 | 0.0, 12.0 | 0.0, 3.0 | 0.0, 2.0 | |
| Sensitive to (food groups)…, No. (%) | ||||
| Acidic food (fruits and juices) | 110 (41) | 7 (10) | 8 (9) | < .001a |
| Spicy food or ethnic food | 94 (35) | 6 (9) | 6 (7) | < .001a |
| Alcohol | 103 (39) | 12 (18) | 18 (20) | < .001a |
| Caffeinated beverages | 143 (54) | 19 (28) | 25 (27) | < .001a |
| Noncaffeinated beverages | 94 (35) | 11 (16) | 19 (21) | .001a |
| Abbreviations: IC/BPS, interstitial cystitis/bladder pain syndrome; Q, quartile; SD, standard deviation. aχ2test. bKruskal-Wallis test. |
||||
Interpretation for Patient Care
IC/BPS patients experienced significant diet-related bladder symptoms compared to OPP and healthy control cohorts. We suggest that the presence of sensitivities could be indicative of IC/BPS. The food sensitivity assessment used in this study is an easy implementable tool that could be included in the initial clinical evaluation of patients suspected of having IC/BPS.
advertisement
advertisement