The Arthur Smith Institute for Urology, Department of Nutrition, New Hyde Park, NY, USA.
BJU Int. 2012 Jun;109(11):1584-91. doi: 10.1111/j.1464-410X.2011.10860.x. Epub 2012 Jan 11.
What's known on the subject? and What does the study add? Nearly 90% of patients with interstitial cystitis/bladder pain syndrome (IC/BPS) report sensitivities to a wide variety of dietary comestibles. Current questionnaire-based literature suggests that citrus fruits, tomatoes, vitamin C, artificial sweeteners, coffee, tea, carbonated and alcoholic beverages, and spicy foods tend to exacerbate symptoms, while calcium glycerophosphate and sodium bicarbonate tend to improve symptoms. At present we recommend employing a controlled method to determine dietary sensitivities, such as an elimination diet, in order to identify sensitivities while at the same time maintain optimal nutritional intake. We review current literature with regard to diet's effect upon IC/BPS and common comorbidities (irritable bowel syndrome, fibromyalgia, chronic fatigue syndrome, neuropathic pain, vulvodynia, and headache) with a focus upon questionnaire-based investigations. We discuss the pathologic mechanisms that may link diet and IC/BPS related-pain, concentrating upon specific comestibles such as acidic foods, foods high in potassium, caffeine, and alcohol. Up to 90% of patients with interstitial cystitis/bladder pain syndrome (IC/BPS) report sensitivities to a wide variety of comestibles. Pathological mechanisms suggested to be responsible for the relationship between dietary intake and symptom exacerbation include peripheral and/or central neural upregulation, bladder epithelial dysfunction, and organ 'cross-talk', amongst others. Current questionnaire-based data suggests that citrus fruits, tomatoes, vitamin C, artificial sweeteners, coffee, tea, carbonated and alcoholic beverages, and spicy foods tend to exacerbate symptoms, while calcium glycerophosphate and sodium bicarbonate tend to improve symptoms. Specific comestible sensitivities varied between patients and may have been influenced by comorbid conditions. This suggests that a controlled method to determine dietary sensitivities, such as an elimination diet, may play an important role in patient management.
已知问题是什么？这项研究有何新发现？将近 90%的间质性膀胱炎/膀胱疼痛综合征 (IC/BPS) 患者对各种饮食有敏感性。目前基于问卷的文献表明，柑橘类水果、西红柿、维生素 C、人造甜味剂、咖啡、茶、碳酸饮料和酒精饮料以及辛辣食物往往会加重症状，而甘油磷酸钙和碳酸氢钠往往会改善症状。目前，我们建议采用控制饮食的方法，如排除饮食，来确定饮食敏感性，同时保持最佳营养摄入。我们回顾了饮食对 IC/BPS 以及常见合并症（肠易激综合征、纤维肌痛、慢性疲劳综合征、神经病理性疼痛、外阴痛和头痛）影响的现有文献，重点是基于问卷的调查。我们讨论了可能将饮食与 IC/BPS 相关疼痛联系起来的病理机制，重点关注特定的食物，如酸性食物、高钾食物、咖啡因和酒精。将近 90%的间质性膀胱炎/膀胱疼痛综合征 (IC/BPS) 患者对各种食物有敏感性。 据推测，导致饮食摄入与症状加重之间关系的病理机制包括外周和/或中枢神经上调、膀胱上皮功能障碍和器官“串扰”等。 目前基于问卷的研究数据表明，柑橘类水果、西红柿、维生素 C、人造甜味剂、咖啡、茶、碳酸饮料和酒精饮料以及辛辣食物往往会加重症状，而甘油磷酸钙和碳酸氢钠往往会改善症状。患者之间存在特定食物敏感性差异，可能受到合并症的影响。这表明，一种确定饮食敏感性的控制方法，如排除饮食，可能在患者管理中发挥重要作用。
