What lifestyle modifications can I recommend to patients with interstitial cystitis to help alleviate their symptoms?

While the provided guidelines do not specifically detail lifestyle modifications for interstitial cystitis, recommendations for related conditions such as overactive bladder (OAB), urinary incontinence (UI), and pelvic floor dysfunction can be considered to help alleviate symptoms:

• Caffeine Reduction: A trial of caffeine reduction can be recommended, as increased caffeine intake may exacerbate symptoms of overactive bladder, and reducing it may decrease frequency and urgency ²,³,⁴,⁵.
• Fluid Intake Modification: Advise patients to modify their fluid intake if it is either too high or too low, as both excessive and inadequate fluid intake can contribute to lower urinary tract symptoms ²,³,⁴,⁵.
• Weight Loss: For patients with a Body Mass Index (BMI) greater than 30 kg/m², advise weight loss, as obesity is associated with urinary incontinence and losing weight may improve symptoms ²,³,⁴,⁵.
• Balanced Diet: Explain how a balanced diet and appropriate fluid intake can improve stool consistency, which may help with symptoms associated with pelvic floor dysfunction ⁵.
• Physical Activity: For patients who are doing supervised pelvic floor muscle training and wish to be physically active, advise that supervised exercise, such as yoga, may help with their symptoms ⁵.
• Bladder Training: Offer bladder training as a first-line treatment for urgency or mixed urinary incontinence, with programmes lasting for a minimum of 6 weeks ².
• Bladder Diaries: Recommend the use of bladder diaries in the initial assessment to document urinary frequency, urgency, leakage episodes, and fluid intake, and to monitor treatment outcomes. These should be kept for a minimum of 3 days ³,⁴.