Trying Elimination Diet Again -- Please Help!

[mongolian]

I was diagnosed with IC about two years ago. At the time I was experiencing periodic flares and frequent burning / urgency. Elmiron and hydroxyzine HCl kicked in after 8 months and I've had no flares since. (YAY!) When I was first diagnosed, I was told to try the elimination diet, but I'm a really adventurous eater and love food, not to mention that spicy foods are a part of my ethnic heritage. So I half-heartedly did it for a few weeks and when my mishmash of eating safe foods with liberal exceptions / treats / relapses didn't produce any meaningful data, I dropped the whole thing :bonk: I was silly and new to this and scared.

These days, I do sometimes feel mild pain after I eat, and in the mornings I can feel moderate pain, but I treat it by drinking tons of water and it usually passes. Still, I'm tired of not taking care of my own health. I've resolved to do the diet again, get a list of my own personal safe and trigger foods, and start making informed decisions. Whew. Sorry, that went kind of long. It's just such a relief to finally get all these thoughts out ... it's still a really scary process and I've been in denial for a while. That said, I have a lot of questions! Thanks so much for your help!

My doctor told me to avoid gluten and casein because they provoke an inflammatory response. A lot of IC food lists say that wheat and dairy are okay. Is it really necessary to go completely gluten- and casein-free?


I have Bev Laumann's IC cookbook. Would it be a good idea to just eat only recipes from the book for a few weeks and call that an elimination diet?


I read the section on elimination diets on the website. Why are there 2 versions of the "few foods" diet? Can I combine them?


How long do I need to be on the diet before introducing foods one at a time? Since I don't have major symptoms now, I'm not sure I'll know when things "settle down".


From what I read, I need to do a strict elimination diet for 10 to 14 days. Then, I add foods one at a time. First day, I eat a little bit. If no symptoms, then next day, eat a large portion. Wait three days to see if there are delayed effects. Then try another food. Am I crazy, or could this take a really, really, really, really, REALLY long time? The "few foods (version A)" diet has 2 vegetables, so just testing 10 vegetables will take 4 x 10 days = 40 days = almost 6 weeks! That's not even counting meats, fruits, grains, drinks, sweets, etc. I could be at this for a year! My boyfriend and I love to cook together and I'm only half-kidding when I say that he might dump me if we can only cook with such limited ingredients for this long. Is there another way to do this, or do I just suck it up?

I guess I just really need to plan this well and make it stick this time, because if I ask myself and my boyfriend to make all these sacrifices without obtaining results (again!), then that'll just be too depressing. Anyway, thanks for sticking with me this far, and thanks for all your help!

[kadi]

:welcome:
Hi there,
I'll try to answer your questions as best I can as a fellow IC patient:)

1. My doctor told me to avoid gluten and casein because they provoke an inflammatory response. A lot of IC food lists say that wheat and dairy are okay. Is it really necessary to go completely gluten- and casein-free?
Most IC patients can tolerate wheat and milk well. You might want to omit those foods, but only after seeing if you find relief without letting them go.


2. I have Bev Laumann's IC cookbook. Would it be a good idea to just eat only recipes from the book for a few weeks and call that an elimination diet? I have Bev's book and really like it, though there are some ingredients in it that are not ok for every IC patient. I think it's a really good resource once you figure out your trigger foods by doing an elimination or limited diet.

3. I read the section on elimination diets on the website. Why are there 2 versions of the "few foods" diet? Can I combine them? I'm not sure which two versions your're mentioning.

4. How long do I need to be on the diet before introducing foods one at a time? Since I don't have major symptoms now, I'm not sure I'll know when things "settle down". Many patients notice a difference after just a few weeks. It can take time for the bladder to calm down enough to notice the spikes in symptoms when responding to trigger foods. Most patients decide to try it for at least a solid month without cheating.

5. From what I read, I need to do a strict elimination diet for 10 to 14 days. Then, I add foods one at a time. First day, I eat a little bit. If no symptoms, then next day, eat a large portion. Wait three days to see if there are delayed effects. Then try another food. Am I crazy, or could this take a really, really, really, really, REALLY long time? The "few foods (version A)" diet has 2 vegetables, so just testing 10 vegetables will take 4 x 10 days = 40 days = almost 6 weeks! That's not even counting meats, fruits, grains, drinks, sweets, etc. I could be at this for a year! My boyfriend and I love to cook together and I'm only half-kidding when I say that he might dump me if we can only cook with such limited ingredients for this long. Is there another way to do this, or do I just suck it up?

What I did (and my mom did too when she got IC after I did) is to eat only out of the "bladder friendly" column for 3 weeks and then to do the one at a time testing on high nutrient foods in the "try it" column. After that you could test the less nutritious (more "fun") foods in the "try it" column. That will give you enough variety not to drive yourself & your boyfriend batty. You can also make meals that can be adapted for him - like you could roast a chicken & put barbecue sauce on the side for him. The hard part of that will be to not feel too tempted by the "additions". Here's a link to the 3 column IC diet cheat sheet. Just click on the button to download it. It's really helpful to put a copy on the fridge & highlight the foods that are ok for you & cross off the ones that are not. My dad & mom did this when she got IC & it made it much easier for him to grocery shop & cook for her.

One piece of very important advice about the diet is to become a very careful label reader. A food may be listed as bladder friendly, but not every brand of that food may be. Example: "cream cheese" is bladder friendly if it comes in the block form, but in the tub - it contains acidic preservatives that gave me a 3 day flare when I ate 2T of it.

I'm going to post a couple of grocery lists for you to look at. Even if you don't have a Trader Joe or Safeway nearby, the list may help you shop anyhow...

Following the diet is one of the best things you can do to restore your health with IC & the good news is it doesn't cost a lot (you have to eat anyhow!), doesn't have any side effects like medicines do, and is a positive step you can take starting today:)

Best,

[kadi]

Safeway Grocery List
Keep in mind that we're all different & don't all tolerate the same things...
But I'm very diet sensitive & these are things I can eat...
Hope you find the list helpful when shopping for IC friendly foods.

Produce:
Lettuce
Red bell peppers
Pears (all types)
Dates
Raisins (I'm ok with them, some IC patients are not)
Blueberries
Corn
Broccoli
Cauliflower
Zucchini
Potatoes (all types, including sweet potatoes & yams)
Carrots
Marie's Lite Creamy Ranch dressing (I use less than a teaspoon on the side of the salad, dip my fork into it before each bite of salad, & take Prelief with it)

Fresh carrot juice (I mix this with the pear juice & lots of ice)

Meats
The main thing here is to make sure the meat has not been injected with saline solution, broth, or lemon juice (or anything else for that matter!)
Chicken
Pork
Ground beef (93% lean)
Steaks

Deli Counter
Safeway Dinner Roast Turkey
Primo Taglio Roast Beef
Hormel Naturals oven roasted turkey or roast beef (you'll find these on the cold cuts shelves, not at the deli)

Cracker/Cookie aisle
Original Triscuits
Original Wheat Thins
Lund---- (can't remember how it's spelled) Brown Rice Cakes (plain)
Original Pringles
Original Fritos
Original Multigrain Sunchips
Classic Lays potato chips
Safeway Organics Microwave Popcorn (no flavors, just the plain one)
Pepperidge Farms Chessmen or Bordeaux cookies
Nilla Wafers
Teddy Grahams (cinnamon or honey flavor)
Nabisco Original Premium Saltines

Dairy
Nonfat milk
Knudsen cottage cheese (single serving containers only, the bigger containers sometimes have preservative)
Original Philly cream cheese--in the block, not tub (tub has acidic preservatives)
Tillamook or Kraft Mozzarella Cheese (Tillamook for slices, Kraft for shredded)
String Cheese (can't remember brand)
Land o Lakes Butter with Canola spread (be sure to get the one with the red top)
Eggland's Best eggs (have extra omega's in them, a plus)
Some IC patients can tolerate yobaby vanilla yogurt (wish I was one of them)
Kozy Shak Rice or Tapioca puddings

Cereals & Mixes
Quaker oats
Bisquick (get some pure 100% maple syrup to go with the pancakes!)
Jiffy corn muffin mix
Honey
Barbara's Shredded Wheat cakes*
Gorilla Munch cereal

*Do not get any cereals with BHA or BHT in the packaging or with added vitamins & minerals. This makes most major brands of cereal problematic for us unfortunately. I usually get my cereals at the health food store, but my Safeway has a small section of organic cereals & I buy the Gorilla Munch & Barbara's Shredded wheat from that aisle.

Baked Goods
I buy only the things in the special shelves for local bakeries that do not use preservatives or go to Trader Joe's!
SF Bay Area local bakeries
Grace Baking Company makes a great potato rosemary bread I'm fine with
SemiFreddi ciabatta or baguette
Whole Grain Natural Bread company makes a whole wheat bread & a white bread without problem ingredients like vitamin c ascorbic acid, vinegar.
Do check the labels for all these breads though, they have a lot of breads & not all are IC friendly.

Canned
Valley Fresh Premium Chunk White Chicken in Water
Del Monte Lite Pear Halves
Rice Dream Vanilla Classic rice milk
Canned green beans & corn (read labels to make sure the cans only contain the vegetable, salt & water)
Canned kidney & garbanzo beans (again read the labels carefully to avoid problem ingredients)

Freezer
Frozen green beans, broccoli, cauliflower, corn
Dreyers Vanilla ice cream (slow churned/less fat)
Dreyers Caramel Swirl ice cream (slow churned)
Ian's chicken nuggets or chicken patties
Steamfresh brown rice

Other
Werther's Original Hard Candies
PepOMint Lifesavers
Kit Kat White Chocolate

Teas & Coffees
Some IC patients are best off with just plain hot water & honey for a hot drink, but for those that can tolerate it, these are mild
Plain peppermint tea
Plain chamomile tea

[ICNDonna]

If you click on "Diet list" in my signature, you will find an updated food list that is printable and should be a huge help to you.

Donna

[GPat]

WOW Kadi! I love your grocery list. Thanks for taking the time to type it all out. I see many of my favorite foods on there and a few others that I may try. I live in Upstate NY so do not have a Safeway or Trader Joe's, but there are some larger grocery chains nearby that may carry a better selection of "gourmet" foods. I love Breyer's all natural vanilla ice cream (similar to Dreyer's?) with Smucker's Special Request Butterscotch Caramel topping. I find it only at Target and when I go there, I usually buy 3-4 jar so I don't run out!

[kadi]

Thanks:) I made it for my dad so he could grocery shop for my mom when she got IC. (She developed IC 18 months after I did.)

[mongolian]

Thanks for the tips and the shopping list! It looks like I have a lot of hard work ahead of me, but you guys here are making it so much easier. How do you record your foods and symptoms? I was thinking of making an Excel spreadsheet so that all my data (food, pain, voiding, stress, etc.) is in one place and I can graph things to see trends. What works for you? Thanks!

[kadi]

That sounds like a great idea! I wasn't that formal about it, I just crossed off anything I thought caused me pain. But your idea sounds very smart and might keep you from "giving up" on a food when a flare could be caused by a factor unrelated to what you ate. Let us know how it goes:)