(By Jill Osborne MA ) Heather Van Vorous, author of First Year IBS, writes some killer articles for her website newsletter (http://www.helpforibs.com). In her latest “Ask Heather” column, she answers the question “What’s the Worst Drink for IBS Ever?” Given the fact that IC and IBS are so similar and require similar dietary changes, I’d like to review her list, modify it slightly for the IC community and offer what I think is the worst drink ever for IC. Will it be the same as hers? Read on!

Obviously, diet modification is crucial for many IC patients, particularly those with profound bladder ulceration and/or sensitivity. Why? If you had a wound on your hand, what would happen if you poured lemon juice on it? It would, of course, sting. Thus foods high in acid can be particularly irritating. But the other reality of IC and IBS is that the nerves in the bladder and/or bowel often become hypersensitive thus we must also avoid those foods which are neurostimulatory, such as caffeine. So, let’s take a look at her list and compare it with our own. Since many you, like me, struggle with both IBS and IC, finding the right balance between these lists can be quite a challenge yet is well worth the effort.

COFFEE – The high acids found in both regular and decaf coffees are well known to irritate sensitive stomachs, heartburn, acid reflux and, of course, our IC bladders. Of course, caffeine is a nerve stimulant which, in my case, makes my heart race if I drink it. But did you know that coffee contains an enzyme that is “an extremely strong GI tract irritant?” Heather noted that patients who rely on coffee in the morning to trigger their bowels may note that it can cause more cramps and rebound diarrhea. For the IC patient, coffee in the morning will trigger a day of frequency, urgency and/or pain. Coffee is an absolute no no for patients with IC and IBS!

SODA POP – As Heather wrote, “the only IBS-safe ingredient in soda pop is the water” which is also true for IC. Besides the obviously high levels of acid found in most soda, the high fructose corn syrup can be a huge part of the problem. Fructose is a difficult to digest sugar that can cause cramps, diarrhea, bloating and gas. Diet sodas with artificial sweeteners are even worse, well known for triggering both IBS and IC symptoms but did you know that diet sodas are a proven cause of obesity? IC patients who drink sodas daily or weekly may be triggering profound irritating in their bladder which could prevent some therapies from working effectively.

DAIRY – For IBS patients, dairy products (cheese, cream, milk, ice cream) can be a trigger due to the fat, lactose and the proteins whey and casein. Yet, for IC, dairy products are usually bladder friendly. Heather rightly encourages IBS patients to avoid dairy altogether and to try some of the non-dairy substitutes on the market. If you happen to be struggling with both IC and IBS symptoms, dairy is one of the first food groups suggested that you remove in an elimination diet. However, if you don’t have IBS and/or struggle with lactose intolerance, diary products are usually bladder friendly.

ALCOHOL – Alcohol is well known for its GI irritating and a potential carcinogenic effect on the bowel. Heather says that “alcohol is more likely to trigger IBS attacks on an empty stomach, so some folks can drink a bit when they’re generally stable and have just eaten.” On the otherhand, alcohol triggers bladder symptoms in the vast majority of patients who try them simply because it is irritating to the wounds found in the IC bladder. Remember when your mother used to pour alcohol on a scraped knee? It burned horribly and that’s exactly how it can feel in an IC bladder. However, there are some beverages which have less alcohol than others.

The ICN conducted a survey of patients in 2010 asking what alcohols they could tolerate. Only 21% of patients reported that they could drink wine without triggering an IC flare. Lower acid wines were better than high acid or high histamine wines with chardonnay and merlot the popular favorites. 39% of patients could enjoy mixed drinks depending upon the mixers used. IC patients avoided all citrus mixers and prefered water, ice and milk. 44% of patients could tolerate beers with a preference towards light rather than dark ales. A surprising 65% of patients reported that they could tolerate a straight alcohol drink, usually focusing on light or clear alcohols. Tequila was the most bladder irritating while rum and vodka drinks seemed to be the most bladder friendly.

BLACK TEA – The tannic acids in black tea can irritate the stomach, trigger heartburn and, of course, irritate the bladder. Heather encourages IBS patients to try decaf green teas whereas for patients with a sensitive bladder, we strongly discourage all green tea use due to its high acid content. Green teas are notorious for triggering IC flare!

So what’s the worst drink for IC ever? I totally agree with Heather and nominate the numerous Energy Drinks liniing checkout stands at supermarkets around the country. Most contain coffee or green tea combined with a massive extra addition of caffeine guaranteed to make your urinary frequency, urgency and pain skyrocket. Throw in numerous artificial sweeteners, colorings, preservatives, vitamins, herbs, chocolate and more, and that one cheat could lead to days of discomfort and a huge IC flare. The only way to make it worse is to add alcohol. Ironically, in late 2010, the FDA sent warning letters to several companies selling alcoholic energy drinks to college students!

Take heart! There are many beverages that you can drink when you have a sensitive bladder and/or bowel. Check out the ICN Recipe section for dozens of recipes that you can use to create bladder friendly cold and hot drinks! And, of course, if you have drinks to recommend, please add them there!

Learn more about Heather Van Vorous and sign up for her newsletter at: http://www.helpforibs.com

– – – – –

So what bothers you?? Do you agree??? Is there a worse food?? I’d love to hear your thoughts! – Jill