Cystitis and Vulvodynia: nutrition in 6 points

People suffering from cystitis or vulvodynia can derive significant benefits from monitoring their diet, but an overly strict approach can, paradoxically, prove counterproductive.
A very restrictive diet often makes those who follow it feel different, limited, depressed, and constantly unwell even when they feel fine. Depression lowers the pain threshold and releases substances that reduce immune defenses, promoting inflammation.

The specific treatment plans for each type of Cystitis developed by Cistite.info, thanks to over twenty years of experience working with women, can help you fight and prevent Cystitis.

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Consequently, a strict diet, instead of preventing Cystitis, could actually promote it. However, some foods are potentially inflammatory and could therefore hinder healing.

Deep dive: How to heal from Cystitis

• Sugars and carbohydrates
• Oxalates
• Processed and pre-packaged foods
• Acidic foods
• Irritants
• Make the food harmless

1. No to refined sugars and carbohydrates

Why avoid refined sugars and carbohydrates?

Refined sugars and carbohydrates (from foods like white flour, bread, pizza, pasta, etc.) raise blood sugar levels, which over time increases the risk of inflammation. Therefore, it is advisable to minimize the intake of these “nutrients” and prefer whole grains with a low glycemic index, and, if possible, gluten-free options (since gluten can be pro-inflammatory).

There are anti-inflammatory diets (such as the ketogenic diet or Low Carb High Fat) that involve almost completely eliminating cereals and seem to show significant results in chronic conditions. The advice is to try following these regimens for a period to evaluate their beneficial effects, then discuss with an expert how to proceed.

Read on the FORUM for more advice on nutrition and diets to prevent and relieve Cystitis (in Italian)

2. No to processed, refined, and pre-packaged foods

Why avoid processed, refined, and pre-packaged foods?

It is important to avoid all processed and pre-cooked foods, which are often rich in:

• additives
• preservatives
• flavor enhancers
• glutamate
• hydrogenated fats
• sugars

The basic rule for ideal grocery shopping is to stick to the perimeter of the supermarket without venturing into the central aisles.
Prefer organic fruits and vegetables, meat that does not come from intensive farming (where animals are treated with hormones and antibiotics), wild-caught fish rather than farmed, and eggs from free-range hens.
The less processing the food undergoes, the healthier it is.

Discover the other factors that contribute to triggering Cystitis.

3. No to foods that irritate the bladder

Which foods are irritating to the bladder?

A survey was conducted on 70 women suffering from recurrent Cystitis. They were asked if they noticed an increase or onset of symptoms in connection with the consumption of certain foods. The immediate impact of various foods on Cystitis is relatively limited. For example, chocolate—the most frequently mentioned—is irritating for only 18 out of 70 women, while for the other 52 it is completely harmless. Pizza (often demonized) actually seems to cause problems for only six women out of 70. The table therefore shows that the response to “trigger” foods is individual and less significant than one might think.

How can you find out if there are any irritating foods for you, and which ones they are? You’ll need to start with a diet that includes only a few definitely harmless foods for a few weeks and then gradually and slowly introduce all other foods—about one per week. If introducing that food does not worsen symptoms, you can continue eating it; if symptoms reappear or worsen, you’ll know for sure that the food is irritating for you.

4. No to foods high in oxalates

Why avoid foods high in oxalates?

What can irritate foods more or less immediately is the presence of oxalates.

Oxalates are substances found in foods that, under certain conditions (such as an acidic environment), tend to aggregate forming crystals. These crystals can scratch the mucous membranes, causing inflammation of the urethra and bladder and leading to pain. In turn, the crystals can also lead to kidney stones.

It is therefore important to limit the intake of foods high in oxalates and to alkalinize the urine to prevent the formation of calcium oxalate and uric acid crystals.

Discover which foods contain oxalates

5. No to acidic foods

Do you need to completely eliminate acidifying foods?

In an inflamed bladder, acidity causes an immediate worsening of symptoms (it does not cause anything if the bladder is healthy), just as tomatoes increase stomach pain in cases of gastritis. To avoid urinary acidity, acidifying foods should be limited and balanced by consuming alkalizing foods in the same meal to achieve a balanced diet.

Generally, carbohydrates (pasta, bread, pizza, etc.) and proteins (meat and fish) are acidifying foods, while fruits and vegetables are alkalizing. Don’t eliminate acidifying foods entirely because we also need them. Just balance them!

Deep dive: All acidifying and alkalizing foods

6. How to make an irritating food harmless

How do you make an irritating food harmless?

Once the risky foods have been identified, it is not necessary to eliminate them completely. They should certainly be avoided during the acute phase, when the bladder is inflamed and therefore very sensitive and irritable. Once this phase has passed, based on individual reactions, they can be eaten in limited amounts. Sometimes it is enough to reduce the quantities to avoid symptoms; in other cases, simply increasing the time interval between consuming these foods is sufficient.
During holiday periods and on occasions with rich meals to celebrate special events, don’t deprive yourself of the joy of sharing food with friends and family. On these occasional moments, it’s possible to avoid irritation of the bladder and vulva through two simple precautions:

1. by drinking plenty: hydration dilutes both oxalates and urinary acidity as well as any irritating substances present in the urine, and also allows them to be eliminated more quickly from the bladder;
2. by alkalinizing: taking an alkalinizing agent (sodium bicarbonate, Regobasic, or others) after the meal prevents the formation of uric acid crystals and reduces the acidity of the urine

Deep dive: How to measure urine pH at home

Bibliography

1. “Comparison of Two Diets for the Prevention of Recurrent Stones in Idiopathic Hypercalciuria” Borghi et Al, da New England Journal of Medicine, Volume 346:77-84 10 gennaio 2002, Number 2
2. “THP: una indice di calcolosi renale”, Ggismondi, Pub med
3. "Sani! Come il cibo influenza la nostra salute" C. Tomasi, ed. Athesia, 2017