Bloating From Interstitial Cystitis (AKA “IC Belly”)

Introduction

One of the main complaints that we as Registered Dietitians investigate with our clients with interstitial cystitis (IC) is bloating.

Many refer to bloating from interstitial cystitis as “IC Belly”. While the exact cause of bloating related to interstitial cystitis is unknown, there are several possible sources of bloating in individuals with IC. If you are suffering from that unsettling feeling of fullness and gas, this blog post has some insight for you.

In this post, we will investigate potential sources of bloating from interstitial cystitis and how to combat those symptoms with simple at-home or OTC treatments. Sometimes medical assistance is needed to rule out other potential causes, like Irritable Bowel Syndrome (IBS), Small Intestinal Bacterial Overgrowth (SIBO), increased inflammation, and lactose intolerance. Let's take a look at each cause and its relationship to IC.

Potential Causes of Bloating

Irritable Bowel Syndrome (IBS)

IBS is a gastrointestinal disorder that affects the large intestine. It is characterized by a group of symptoms, including bloating, abdominal pain, diarrhea, and constipation.

Several studies have shown that there is a high prevalence of IBS in individuals with IC, with some estimates suggesting that up to 50% or more of individuals with IC may also have IBS. In addition, a review of the literature found that IBS was more common in individuals with IC than in healthy controls

Inflammation

Even though the link between IC and IBS is not fully understood, it is believed that the two conditions may share some common underlying factors, such as inflammation and abnormal immune function. A study published in PLOS One found that individuals with IC had higher levels of inflammatory markers compared to healthy controls, suggesting that inflammation plays a role in the development of IC.

If you suspect that you have inflammation or IBS, please consult with a medical professional. Although there is no definitive test for IBS, your doctor can help rule out other digestive disorders such as Ulcerative Colitis, Crohn’s disease, or food intolerance.

According to the National Institutes of Health, your doctor may order an upper GI endoscopy, stool test, blood test, or hydrogen breath test to rule out these and other disorders.

SIBO

SIBO is a condition in which there is an overgrowth of bacteria in the small intestine. This can lead to various gastrointestinal symptoms, including bloating, gas, and diarrhea. While the exact prevalence of SIBO in individuals with IC is unknown, some studies have suggested that there may be a link between the two conditions.

A study published in the Journal of Urology found that individuals with IC had higher levels of hydrogen and methane gas compared to healthy controls, which are both markers of SIBO (5). Another study published in the Journal of Clinical Gastroenterology found that individuals with IBS had a higher prevalence of SIBO compared to healthy controls (6)

If you suspect that you have SIBO, you should consult with your doctor for appropriate diagnostic tests and treatment. According to the Mayo Clinic, SIBO is typically diagnosed using a breath test for excessive hydrogen and/or methane gas or a more complicated but more accurate test of the contents of your small intestine. In this case, your doctor will perform an endoscopy into your small intestine to remove a small sample of fluid. The treatment of SIBO typically involves a course of antibiotics to kill the bacterial overgrowth.

Learn more about treating SIBO in this fascinating IC You podcast. Here, Callie interviews Katrina Cox, a Registered Dietitian who specializes in treating SIBO and IBS. Callie and Katrina dive into bloating, what procedures may be involved to diagnose SIBO, treatments available, and the root causes behind SIBO.

Lactose Intolerance

Lactose intolerance is a condition in which there is a deficiency of the enzyme lactase, which is responsible for breaking down lactose, a sugar found in dairy products. This can lead to various gastrointestinal symptoms, including bloating, gas, and diarrhea.

Lactose intolerance is common in the US and around the world. According to The National Institute of Health, 36% of Americans are lactose intolerant and nearly 68% of the world is missing the lactase enzyme to properly digest milk.

If you suspect you are lactose intolerant, you can ask your doctor for a hydrogen breath test or conduct an elimination diet with food challenges to test your tolerance to dairy.

Get Relief From Bloating and Interstitial Cystitis

Now that we have covered some of the potential sources of bloating, let’s dive into some solutions to ease that IC Belly. A Google search will bring up many suggestions, but let’s stick with the tried and true methods. These are the top 5 that we recommend for our clients struggling with bloating:

1. Teas: Peppermint and fennel teas are very soothing to the digestive system.

2. Essential oils: Peppermint oil capsules or peppermint oil rubbed on the abdomen.

3. Exercise: Gentle yoga poses or going for a walk can help get the digestive system moving and relieve bloating symptoms.

4. Mindfulness: Investigate your unique link between stress and bloating. Do you notice a change in bloating when you are more relaxed? Try eating with more intention and relaxation.

5. Chew your food: Do you speed through meals? Some bloating can be caused by indigestion of food or eating too fast and swallowing air. The digestion process starts in the mouth and therefore thoroughly chewing your food can help the rest of your digestive system do its job more effectively.

These are some temporary relief suggestions, however, it is advised if you do have chronic bloating, consult your doctor about testing for the potential other causes we discussed above.

Conclusion

In conclusion, bloating is a common symptom experienced by individuals with IC. There are several possible sources of this symptom, including IBS, SIBO, inflammation, and lactose intolerance. While the exact cause of IC is unknown, it is believed that inflammation and abnormal immune function may play a role in the development of this condition.

Similarly, the gut-bladder axis may play a role in the development of both gastrointestinal and bladder disorders, including IC and IBS. It is important for individuals with IC who are experiencing bloating to speak with their healthcare provider about their symptoms and to discuss possible treatment options, such as dietary changes and medication.

As always, the team of dietitians at Callie K Nutrition is here to help you navigate your journey to relief from IC. Learn more about the programs designed to help you get on the road to remission from your IC symptoms at callieknutrition.com.

Author: Beverly Leveque, RD

Edited by: Callie Krajcir, RD, owner of Callie K Nutrition