The state of the body’s acidity vs alkalinity both reflects and affects health.
The alkaline diet is a topic I summarised in my last post. But what about the specific scenarios of chronic pelvic pain, vulvodynia and interstitial cystitis?
Does acidity or alkalinity have anything to do with chronic pain?
The short answer here is yes. We all know that after heavy exertion with exercise, we wake up with sore muscles; one explanation for this has been lactic acid in the tissues. There is also an interesting 2001 study that tested an “alkalising supplement” on people with chronic lower back pain. There was an improvement in pain scores; in fact they dropped by 50%, showing that acidity may be associated with pain, especially muscle or joint pain. The conclusion of the researchers was that “a disturbed acid-base balance may contribute to the symptoms of low back pain”.
Does acidity or alkalinity have anything to do with specific types of pelvic pain, like vulvodynia or interstitial cystitis?
Vulvodynia
I often consider at the concept of tissue acidity in patients with chronic pain conditions such as vulvodynia. Acidity is often present in these patients. At times, tissue acidity can be assumed from a combination of symptoms and blood test measures that give information about pH. It is difficult to be certain whether the acidity is one of the causes of the symptoms of vulvodynia, caused by one of the underlying processes in vulvodynia, or completely unrelated. However, if there are enough clinical clues pointing towards acidity being a problem, I often guide treatment to influence it. This may encompass addressing a cause of the acidity (such as tissue inflammation or mineral deficiency) and experimenting with a change in diet.
Interstitial cystitis or painful bladder syndrome
Interstitial cystitis is a special case here. Tissue acidity may well be present, but a common trigger reported by people with IC is acidic foods – drinking coffee, carbonated beverages (fizzy drinks), oranges and tomatoes. A theory here is that the lining of the bladder, which can be “worn away” in parts in IC, may be directly vulnerable to the acid in these foods. Many of my patients with IC have been firmly committed to cutting these out – even foods like lemon, which are acidic in nature, but don’t affect overall tissue acidity. However, “IC diets” on the internet are often an over-simplistic solution. Individual food sensitivities can cause inflammation of the tissue, which may exacerbate symptoms of IC in some people. Identifying individual food sensitivities is, in my experience, a more reliable approach to the food question in IC.
So in summary, I do not use a “one-size-fits-all-alkaline-diet” for patients with chronic pelvic pain, vulvodynia or interstitial cystitis. While the acidity-alkalinity issue is relevant and worth addressing, this is best done via individualised assessment and evaluation of factors promoting acidity, such as presence of inflammation, mineral deficiency and digestive dysfunction. For more about these individual factors, see my last post.