First Phase: Lifestyle Changes

Lifestyle changes, known as "behavioral therapy," are often the first treatments used to manage IC/BPS.  In behavioral therapy, you make some changes in the way you live day-to-day.  This may include changing your diet, or practicing methods that may help control your symptoms.  Most patients don't get rid of all their symptoms with lifestyle changes.  But many do have fewer symptoms using these types of treatments.

Manipulative Physical Therapy

Patients with IC/BPS often have tenderness and/or pain in the pelvic floor area, and sometime manipulative physical therapy can reduce symptoms.  There is evidence that physical therapy exercises to strengthen the pelvic floor muscles do not improve symptoms, and often make them worse, so activities such as Kegel exercises are not recommended for patients with IC/BPS.   

Limiting Stress

Emotional and mental stress can worsen IC/BPS symptoms.  Patients are encouraged to come up with coping methods to deal with family, work and/or past painful experiences, and may need to seek additional help to develop the best coping strategies to help manage their pain.   

Limiting Certain Foods and Drinks

Most (but not all) people with IC/BPS find that certain foods make their symptoms worse.    There are 4 foods that patients most often find irritating to their bladder:

  • citrus fruits

  • tomatoes

  • chocolate

  • coffee

Other foods that bother the bladder in many patients are:

  • alcoholic drinks

  • caffeinated drinks

  • spicy foods

  • some carbonated drinks

Elimination Diet

The list of foods that have been said to affect IC/BPS is quite long, but not all foods affect all patients the same way. Each patient must find out how foods affect his or her own bladder. The simplest way to find out whether any foods bother your bladder is to try an "elimination diet" for 1 to 2 weeks. On an elimination diet, you stop eating all of the foods that could irritate your bladder. IC/BPS food lists are available from many sources ( or

If your bladder symptoms improve while you are on the elimination diet, this means that at least 1 of the foods was irritating your bladder. The next step is to find out exactly which foods cause bladder problems for you. After 1 to 2 weeks on the elimination diet, try eating 1 food from the IC/BPS food list. If this food does not bother your bladder within 24 hours, this food is likely safe and can be added back into your regular diet. The next day, try eating a second food from the list, and so on.  In this way, you will add the foods back into your diet one at a time, and your bladder symptoms will tell you if any food causes problems for you. Be sure to add only 1 new food to your diet each day. If you eat a banana, strawberries and tomatoes all in the same day, and the IC/BPS symptoms are worse that evening, you will not know which of the 3 foods caused the symptoms to flare up.