Why does it have to hurt when you pee and poop? Do bowel movements trigger your bladder pain? You are definitely not alone. Irritable Bowel Syndrome (IBS) and Interstitial Cystitis (IC) can be an unfortunate duo of pelvic chronic pain. According to the IC Association, one-third of IC patients also are diagnosed with IBS.
What Is The Pelvic Floor?
The pelvic floor is a hammock of muscles and nerves that integrate in many ways. Diet, stress and an overactive nervous system can bring on bathroom nightmares at the worst time. Even if you are not diagnosed with IBS, you may find that your IC flares are brought on by constipation or diarrhea.
IC/IBS Management
The good news is that the symptoms can be managed through lifestyle and diet. The bad news is that the IC diet and the IBS diet (low-FODMAP, gluten-free and/or lactose-free) combined often limit too many important nutritious foods and are nearly impossible to maintain long term. Furthermore, nutrition professionals typically do NOT recommend that these diets are combined. Eating a well-balanced and nutritious diet that satisfies is always the best practice for long-term success.
This probably leaves you scratching your head. What am I supposed to eat? What if the IC diet triggers my IBS symptoms? How do I manage all my symptoms? So where do I start?
An Important Practitioner - The Registered Dietitian
First and foremost, get a Registered Dietitian (RD) on your team of medical professionals. An RD will make sure that your meal plans are realistic, nutritious and satisfying. They are there to help you navigate your triggers one step at a time.
It's important to work with a nutrition professional to identify your unique IC trigger foods if able. Then you can work with an IBS Dietitian to manage a low-FODMAP or gluten/lactose-free diet.
Wow, two different dietitians, that may be a huge cost deterrent! This is totally understandable. Luckily there are many general RD's that can assist with IBS diets, our recommendation is to check with your insurance provider for coverage. For free IC diet resources, check here.
What if you already know your IBS triggers and want to investigate your IC triggers? Can you go on the IC diet while avoiding gluten and dairy? The answer is not one-size-fits-all. This is again where nutrition expertise is essential.
Many clients come to the Road to Remission (R2R) program already knowing that they are lactose intolerant or sensitive to gluten. In R2R we work closely with our clients to adjust the IC elimination diet to accommodate their needs.
PSA: The IC Diet Was NOT Intended To Be A Long-Term Solution
The IC elimination diet was intentionally designed to be a starting guide and never a long-term plan for sustainability. We monitor our clients meal plans on a weekly basis to ensure they are eating a balanced diet and not missing out on any essential nutrients. Once they have discovered their unique diet and stress triggers, they can then do a modified version of the IC diet which includes eating a wider variety of foods with confidence.
Other Ways To Manage IC/IBS
Don’t forget self-care, stress management and pelvic floor therapy as other tools to alleviate your symptoms.
Stress and anxiety activate the central nervous system, which in turn calls on the body to release hormones that shut down digestion to prepare your body for “fight or flight”. An amped up nervous system will eventually wreak havoc on your gut and digestive process. Finding ways to down regulate your nervous system will benefit both your IC and IBS symptoms.
Find out more ways to clear your mind with our recent blog post, The Role of the Nervous System in IC.
Pelvic floor physical therapy can also be an integral part of managing symptoms. Tight muscles and overactive nerves play a big role in certain subtypes of IC and IBS. To learn more about your specific subtype, please check out this informative podcast on the IC subtypes.
Need Some Help?
Looking for more guidance in managing your IC and IBS symptoms? Please check out how the Road to Remission program can help you live your best life with these chronic illnesses.
Written by Beverly Leveque, RD
Edited by Callie Krajcir, RD