Littérature scientifique sur le sujet « Interstitial cystitis – Diet therapy – Recipes »

Abstract Objectives IC/BPS is characterized by pelvic pain, pressure, or discomfort in the bladder and pelvic area coupled with urinary frequency and urgency. The cause is unknown. Dietary intake appears to exacerbate IC/BPS symptoms for many patients; however, the association is not well understood. The potential role of saturated fat and other inflammatory dietary components in provoking IC/BPS symptoms will be explored. Animal studies associate high dietary intake of saturated fats with activation of toll-like receptor (TLR4) cell signaling and pro-inflammatory responses. Saturated free fatty acids were linked to changes in the bladder on a cellular level. The goal of the AID-IC study is to investigate the efficacy of an anti-inflammatory diet (limits lipid intake and increases antioxidant intake) on symptom severity. Methods In a 22-week, crossover study, women with IC/BPS will be randomized into two groups. Group one will receive 10 weeks of a therapeutic anti-inflammatory diet that eliminates foods commonly bothersome for those with this condition; 5 days/week prepared, home-delivered meals were provided. Group 2 will receive counseling from a dietitian on standard IC/BPS dietary recommendations (control diet). After a two-week washout period, dietary interventions for the two groups will be switched. Primary outcomes include changes in inflammatory biomarkers (TNF-alpha and IL-1) and scores on three validated symptom severity surveys. Results We hypothesize that an anti-inflammatory diet that excludes foods commonly bothersome for individuals with IC/BPS will help manage symptomology for these patients. Furthermore, we hypothesize that the severity of symptoms will be mediated by the reduction of pro-inflammatory responses associated with the influence of a diet low in saturated fats and high in anti-inflammatory dietary components. Conclusions The feasibility of managing IC/BPS symptoms by influencing inflammatory activity via restricting lipid intake and increasing antioxidant-rich foods has not previously been investigated. The findings may offer preliminary data on a cost-effective, noninvasive therapy. Funding Sources Mountain West Clinical & Translational Research Infrastructure Network (National Institute of General Medical Sciences, NIH).

The World Health Organization estimates dysmenorrhea as the most important cause of a chronic pelvic pain. Its prevalence among adolescents and young women ranges from 40 % to 90 %, and varies, depending on age, country of residence and population density of the area. Primary dysmenorrhea is responsible for reducing the quality of life, absenteeism in the workplace or at school, refusing to participate in community and sporting events, changing of pain perception and sleep disturbance. There is evidence of its relationship with an early menarche, a family history, a length of the menstrual cycle, bad habits, poor sleep hygiene, an unbalanced diet, sedentary lifestyle and obesity. Characteristic features of a personality contribute in a certain way, making women prone to neuroticism and pain catastrophizing to be more at risk of developing dysmenorrhea. Irritable bowel syndrome, musculoskeletal pain and interstitial cystitis often accompany dysmenorrhea and respond to its treatment positively. Despite the proven validity of nonsteroidal anti­inflammatory drugs treatment there are resistant forms of menstrual pain, those make a search for alternative therapy relevant.

This article describes a practical framework for the evaluation and treatment of interstitial cystitis/bladder pain syndrome (IC/BPS), based on and expanding from the American Urological Association (AUA) guideline. The key points in evaluation are (1) to recognize confusable diseases or comorbid disorders that require separate treatments, and (2) to recognize patient subtypes that require specialized treatment approaches (eg, pelvic pain and beyond, polysymptomatic and polysyndromic types, and patients with Hunner lesions). Treatment begins with education, including diet, stress reduction, and other self-care strategies, which have proven efficacy and are first line in the AUA guideline. Second-tier treatments include oral and intravesical medications. Further, the AUA guideline states that physical therapy should be offered to patients with pelvic floor tenderness if a qualified therapist is available. For Hunner lesions, the initial recommended treatment is cystoscopy with fulguration or triamcinolone injection. Higher-tier treatments, which involve more risks, include hydrodistention, bladder botulinum toxin injection, sacral nerve stimulation, and oral cyclosporine A. The article includes a practical algorithm to help clinicians organize their thoughts while evaluating and starting therapy for patients with IC/BPS. This review contains 4 figures, 4 tables, and 64 references. Key Words: bladder pain syndrome, Hunner lesion, interstital cystitis, polysymptomatic, polysyndromic, pelvic floor dysfuction, vulvodynia