Summer 2013/14 True Natural Health Magazine – Your Questions Answered
By Roger French
QUESTION: I’ve been diagnosed with interstitial cystitis and told to keep off foods that are high in salicylates. Could you please explain how these cause interstitial cystitis, as this kind of cystitis is not an infection, but a chemical response of some kind. Also, are there other foods that can counteract the effects of the salicylates? They occur in many otherwise very nutritious foods, such as red summer fruits.
Interstitial cystitis, or painful bladder syndrome, and irritable bowel syndrome often co-exist, indicating that the pelvic region is particularly prone to inflammation. In interstitial cystitis, the bladder is severely inflamed and very sensitive to any irritating substances.
Besides bladder pain, particularly when the bladder is full, another common symptom is urinary frequency, with ‘urgency’ to urinate perhaps every hour or less, and, of course, disruption to sleep.
In contrast to regular cystitis, which – as you say – involves bacterial infection, there are no organisms involved with interstitial cystitis, so doctors who understand the condition don’t prescribe antibiotics.
They say that no research has been done yet on dietary causes of interstitial cystitis, but natural therapists have had plenty of experience with dietary factors. Allergies, food intolerances and acidity of the system account for many inflammatory conditions.
Many sufferers find that certain foods and beverages contribute to bladder irritation and inflammation. Common ones are coffee (including decaf), tea, wine and other alcohol, chocolate, caffeinated soft drinks, hot spices, highly acidic foods and many fruits, especially oranges, cranberries and tomatoes. Some people also find that their symptoms worsen after consuming artificial sweeteners (aspartame and saccharin) or even vitamins.
Other foods that have been found to exacerbate symptoms in some sufferers include: most fruits (except blueberries, honeydew melon and pears), tomatoes, nuts (except almonds, cashews and pine nuts), seasonings containing MSG, soya products and yoghurt.
Salicylates are prominent among the many phytochemicals that can act as irritants or sources of intolerance. Research has found that when there is cystitis, the bladder wall is significantly more permeable to salicylates than normal. One theory is that injury to the bladder’s inner protective mucous lining allows leakage of urinary chemicals into the bladder, resulting in pain and bladder irritation. Studies have shown that with interstitial cystitis there is damage to the bladder lining.
The famous Dr Ben Feingold connected salicylate intolerance to ADD/ADHD and also to irritable bladder, so there is some weight in the concern over salicylates. Just why salicylates irritate, no-one seems to know. It may be that they are among nature’s natural pesticides and so are slightly toxic. Oxalic acid in spinach and solanine in potatoes, tomatoes and capsicum are other well known examples.
The conundrum with salicylates is that avoiding them rules out, as you say, a lot of highly nutritious foods, especially many of the all-important fruits and veggies, which keep the system from becoming too acidic. Excessive acidity in the system promotes inflammatory conditions, so this is a vicious circle.
Perhaps the best way through this challenge is to use trial-and-error. Test the high salicylate fruits and vegetables by consuming substantial quantities for a few days and watch for a reaction. If none, the food is probably OK. If there is a reaction, you just have to avoid it – at least for a while.
Here are lists of the high- and low-salicylate fruits and veggies:
High to very high salicylates: All dried fruits, oranges, grapefruit, mandarins, tangelos, pineapple, berries, cherries, grapes, apples, guava, kiwifruit, melons including watermelon, avocados, sugar bananas.
Low: Bananas, pears, limes, pawpaw, papaya, tamarillo.
High to very high: Alfalfa sprouts, tomatoes, zucchini, eggplant, chilies, peppers, capsicum, endive, watercress, radish, spinach, broad beans, broccoli, cucumbers, gherkins, sweet potato.
Low: Dried beans and peas, green beans and peas, Brussels sprouts, lentils, mung sprouts, onion, shallots, chives, Swede turnip, cabbage, celery, lettuce, asparagus, choko, potato.
Nuts and seeds
High to very high: Almonds, Brazils, macadamias, pine nuts, pistachios.
Low: Cashews, hazelnuts, pecans, sunflower seeds.