Kim (00:01.351)
Hi Kelly, welcome. I'm really happy to have you here and I'm excited to talk about this topic. I have had another episode about icy bladder pain before and I think there are so many facets about any topic in pelvic health and I was really happy that you reached out to me and wanted to share your approach. You're a nutritionist and you focus in specifically in interstitial cystitis.
That's a really hard word to say anyway, but then when you have Invisalign in your mouth, it's even harder to say. So welcome, I would love for you to take a moment and just tell us a little bit about your background and what led you to become a nutritionist and then also how you became passionately focused on IC.
Callie (00:48.386)
Yes, so thank you for having me. I reached out because raising awareness for interstitial cystitis is one of my passions and I'm just so glad to be here, spread the word. So yeah, so my name is Callie Kreicher. I am a registered dietician specializing in interstitial cystitis. I'm actually one of the only IC dieticians in the world, which is pretty cool. Basically, how I got here was I grew up with
really, really bad bladder pain. So if you, anyone listening has had a UTI in the past, a urinary tract infection, and you think about the symptoms you had, like that bladder pain, that burning, the frequency, the urgency, sitting on the toilet and fighting to get one drop of urine out and it just feels like fire. That is what I dealt with growing up. So what I see is essentially a UTI, but there's no active infection on the urinalysis.
So I spent the entirety of my childhood just essentially dealing with the pain because I realized no one around me was suffering like I was, nobody was complaining about their bladder. So I was actually a really tough kid. I was in a lot of sports. So I was just like, all right, I'll just push through this. Hopefully it'll go away at some point, but it did not. And
when I was 18, I went to my first urologist who I actually self-diagnosed myself with IC before I even saw her and she ended up doing a scope. So it's called a cystoscopy where they look at your bladder wall and she's like, honestly, your bladder wall looks fine, but based on your symptoms, it does seem to be interstitial cystitis. So that's kind of what we're going to go with.
went on to try various treatments that were offered to me by my doctors. A lot of them were invasive. So there's a procedure called a hydro distension where they essentially stretch your bladder with fluid. It's done under anesthesia. It's kind of about half of the people get relief, half don't. And for me, it actually made me worse. It gave me a ton of frequency on top of the bladder pain I already experienced.
Callie (03:08.73)
I tried other procedures like installations, which is when they put a catheter in your bladder and they insert a liquid cocktail of medications and you hold it in for a certain period of time and kind of did that for a bit. Also didn't really help me. I tried lots of medications, so many different side effects that came out of those. Nothing really helped. Tried supplements, tried diets.
And I was in this cycle for about four years from age 18 to about 22. And eventually there, there was a doctor in my area that she was like the top doctor for IC and she was like, honestly, there's nothing more we can offer you. Like I can give you the names of other specialists, like outside of the state, but like right now we can't do anything for you. And that absolutely crushed me.
I was so hopeful that she was gonna be the one that could help and she really couldn't. So I took a couple years off, just kind of muscled through it like I was doing my whole life and eventually I just got to a place where I hit rock bottom and I was like, I need to change something. I need to try something new. And that's when I started to focus on revisiting the basics essentially. So
I started to look at my stress levels and I was a very, very stressed person. I was a college athlete. I had issues just like socializing in college and eating nutritious food and there's a lot of stress. So I started addressing that, going to therapy, working on coping mechanisms. I started going to pelvic floor physical therapy and learned that my pelvic floor was very, very dysfunctional, very tight.
So I started doing that using a pelvic wand every day. And I also did an elimination diet. So I wanted to learn, is my bladder diet sensitive? Is it sensitive to certain foods? And we can talk about that later. There's something called the IC diet with some more common bladder irritants. So I started to figure out, okay, I'm really not diet sensitive. So for me, I started getting relief once I addressed my pelvic floor and my nervous system. And
Callie (05:26.778)
The next year, maybe two years after that, my symptoms virtually disappeared. And that kind of brings me to where I am today. Personally, I am about 95% symptom-free from IC. I only flare up if I have a really, really stressful event, which stress is kind of hard to avoid, but I know how to, you know, treat my flare-ups. I know how to minimize the duration and the intensity of the flare. So that's my IC journey.
How I ended up being an IC dietician is I became a dietician after college, you know, after I passed my board exam. I started out in a hospital. Long story short, really didn't like anything that I was doing. And I knew the power of diet and lifestyle changes, like the stress management I was telling you about. And I knew that there was only one IC dietician in the entire world at the time.
And I was like, this is the perfect opportunity for me to use my personal and professional experience and expertise to help other people that are struggling with this condition. Because in the US, there's millions. I think the estimate is about 7 million people, men and women, living with this. And I was like, this is the perfect role for me to fill. And that was about three years ago. And yeah, I've helped over 100 people.
so far in my big program that I have. And it's really fulfilling to see the power of just lifestyle changes and some diet tweaks. So I know I just talked a really long time, so feel free to just ask me whatever you want from here.
Kim (07:02.524)
Mm-hmm.
Kim (07:07.179)
Yeah, that's good. I wrote down a few little notes here, but so I'm curious because you said that as you were going through investigating before you even got to the top doctor, you had been told about diet and tried some things, I'm assuming, and then you, several years later after that, you made your own diet changes, decided that or found that yours wasn't necessarily sensitive to
Kim (07:36.975)
you had such success with the diet and that's what made you go into nutrition and then that's what made you specialize in IC. But when did you decide that you wanted to become a nutritionist? Like what was the seed that planted you down that path?
Callie (07:51.366)
Honestly, it was the only class I took in college that I was good at. I was originally an occupational therapy major, and I was like, I don't actually want to touch people. I'm kind of good at nutrition, so I'm going to switch majors. And that's just what led me down that path. Yeah.
Kim (08:06.095)
That's funny. That's funny. Okay, cool. A few things that you said that I want to ask questions on and it'll kind of, you know, bring us along the path of all the things that I wanted to ask. But when you said you started to learn or you do know now how you can minimize the intensity of a flare or even the likelihood that it's going to happen.
Are we jumping the gun by talking about this now, do you think? Or I just think that you mentioned it. So I'd love to hear your thoughts on how you and your body have found that you can manage those symptoms best.
Callie (08:40.81)
Yeah, yeah, no, that's fine. So people with IC, their flare ups typically look extremely different. So a flare up is essentially just an increase in your symptoms. So day to day, I have zero symptoms at all. I barely think about my bladder. Obviously this is my work, so I do have to think about it. But when I have a stressful moment, so I'll give you the example. Last week I had a root canal.
is my first root canal ever and I have heard horror stories and I was getting myself all worked up. I knew I was going to be anxious about it and I knew that I was probably going to have some sort of bladder pain afterwards. I was ready for that and later that night of course I did have you know I would say around three or four out of ten on a pain scale when I urinated and immediately after.
Callie (09:37.812)
by stress. So I will utilize my pelvic wand, which I learned how to do that through my pelvic floor physical therapist. So I will use that for maybe five to 10 minutes. I will work on calming my nervous system. So I'll just maybe do a meditation, do some guided breathing. I'll make sure that I'm hydrated because dehydration is the bladder's worst enemy, especially with IC. So I will do that. If I ever get desperate, I'll take an Azo, but I haven't had to in over a year.
Kim (10:08.304)
What's an azo?
Callie (10:08.533)
but Azo is if anyone's ever had a UTI or if you've had a UTI you take this pill that turns your pee orange if that rings a bell it basically helps with pain it doesn't like treat
a bacterial infection or a UTI or anything like that. It really just helps with pain frequency and urgency. So that's kind of like my, my lifeline if I need it. But like I said, I usually don't need it or any sort of medications, but back in the day, I was taking that on a daily basis because that's like the only thing I, that worked for me. So those are what my flare ups look like. Everybody's flare ups are very different. So it might be a couple hours to a couple days.
versus food versus hormones can look completely different so it really just comes down to the person.
Kim (10:58.743)
Okay, and the ASOs, is that a short form for a term and is it a prescribed medication?
Callie (11:05.83)
You can get it at any pharmacy. So Azo is the brand. The drug name is called phenazopyridine. It's a really long word. Or I think if you get it prescription, it's called peridium. So you could get it either way, but if you're desperate, you can walk into a Rite Aid right now and buy it. A lot of people with IC do take that, but it's only meant to be taken short term. I think there is a risk of kidney issues if you do take it long term.
Kim (11:34.695)
Got it. Okay. So I have lots of other questions, but I wanna go back now to where we were going to start. What are, you've talked about your symptoms. What are the most, like what are the hallmark symptoms of IC? And to distinguish, maybe not even to distinguish, but to inform, it's also sometimes called painful bladder syndrome or bladder pain syndrome as well. Is that correct?
Callie (12:02.262)
Yes, yes. So about five to 10% of people with an interstitial cystitis diagnosis have what we call Hunter's lesions, which are these open wounds on the bladder wall. And then the rest of that.
population like 90 ish percent of people don't have those lesions and that's where it can get really confusing when your doctor is doing that cystoscopy and they're looking at your bladder saying this looks completely normal. Well that could mean that maybe your IC is rooted in your nervous system or maybe you have pelvic floor dysfunction or maybe there's a hormone issue you know like estrogen atrophy something like that that's causing it and you asked about the
Callie (12:46.78)
It's variable, but the most common symptoms are frequency, so having to pee a lot, urgency, having that urge to pee a lot.
pain. So it can be pain upon your bladder filling that gets relieved after you urinate. There are people like me whose pain gets worse once you urinate, but that also can cross over with pelvic floor dysfunction. So that gets a little murky there. Nocturia, which is just having to go to the bathroom at night, constant bladder awareness, pain with sex can be an issue for a lot of people. But again, that could be a pelvic floor issue as well.
Kim (13:24.131)
What causes the lesions in the small percentage of people that do have them?
Callie (13:28.874)
We don't have any known cause for the lesions or the non-lesions. Like I see currently has no known cause, but we do have theories. So it's another condition that just needs so much more research in order to help people. But it's difficult because we all present very differently with our symptoms, our responses to treatments. Some people will respond really well to that hydro-distention procedure or the installations I was telling you about,
I didn't, they made me worse. So it seems that there are certain subtypes in our community that researchers are definitely looking to solidify and like make it a more universal thing.
Kim (14:13.331)
And is it to see the lesions, is it something you would see on an ultrasound or is that something that a cystoscopy could find as well?
Callie (14:20.266)
Yeah, yeah, yeah. Generally, the cystoscopy is the gold standard. In the United States, the American Urologic Association does not require a cystoscopy to give an IC diagnosis, but they say if lesions are suspected, so if somebody is
Kim (14:27.705)
the gold standard.
Callie (14:44.91)
having blood in their urine, or they just have really severe symptoms, or they have high levels of diet sensitivity, that could be enough reason to do a cystoscopy. And I think their reasoning behind that was a cystoscopy is invasive, you're getting catheterized, there is a scope, it can be done in office or under anesthesia. So I mean, for me personally, it was a really painful and traumatic experience just having that procedure done in the office.
to avoid any additional like medical trauma that could come from that procedure.
Kim (15:23.024)
You kind of alluded to a few buckets with food and hormone and you've talked about the lesions. Are there, would symptoms present differently based on what the main contributor was for a person? Have you seen any, like if somebody is more diet driven, would the symptoms change at all or are they basically the same? It's just trying to find what's causing it.
Callie (15:45.186)
The symptoms are basically the same, I will say. Sometimes I can tell within my clients, like, okay, your nervous system is the issue, or if you're flaring at the same time every single month, let's look at your hormones. There might be something going on there. That's where it really comes down to, keeping really detailed.
like symptom logs and tracking what you're eating, what your stress levels are, things like that. Keeping track of as much as you can so that you can really identify those patterns in the data that you're collecting so you can present that to your doctor or just help you figure out what is causing my symptoms. And for me, that was nervous system dysregulation. I have been stuck in fight or flight my entire life. That's a work in progress.
other contributing or root cause I'll sometimes say is that pelvic floor dysfunction. And once I started stretching those muscles out and being consistent with my pelvic wand, that's when I started to notice like really significant relief. I mean, my symptoms went from 24-7, 10 out of 10 bladder pain. It felt like I was peeing out hot sauce. I know that's weird visual, but that's what it felt like. And I'm now, I don't have any of those symptoms at all. So it's like, once I figured
or at least what I suspected was causing my symptoms. That's how I got relief from my symptoms. And that's essentially what I help my clients do is just figure out what is that underlying cause? Is it hormones? Is it pelvic floor? Is it another condition like endometriosis or vulvodynia or something of that nature? Like there's a lot of overlap in different conditions that have really similar symptoms.
Kim (17:37.787)
With the hormone piece, I had written down a note earlier, a couple of notes, when you were talking initially in your introduction, so mentioning UTIs, UTIs are very common post-menopause especially in a low estrogen state. And then you're talking about potentially hormones being an influence. Is it high estrogen, low estrogen? What is the influence from a hormone change or shift that you feel is contributing to the symptoms?
Callie (18:06.566)
Yeah, so I just want to start out by saying there is very minimal research on the effect of hormones on the bladder and on ice, or actually icy specifically, let me say. People with icy do tend to flare either during ovulation or during their period. It's kind of split half and half with those people. So it just seems to be the change in estrogen. It could be high, it could be low. It's just
that's kind of where we're at. We're kind of just really looking for more research to look into this. And it's a struggle for people who do realize that is their issue. There's like a disconnect between, okay, I have low estrogen or high estrogen. Like, what do I do from here? Like, doctors aren't always the most helpful is kind of what I'm trying to say.
Kim (18:56.927)
Mm-hmm. Yeah, you know, I feel like doctors are taking a beating recently, like since especially since COVID when things shifted and there was a lot more online access, a lot more education. They're fantastic when we have an infection that can be treated with pharmaceuticals or when we require a surgical or some sort of intervention procedure like a cystoscopy. They are amazing.
from an actual prevention perspective or managing things that don't have a kind of a pill for an ill typical presentation, they're not. And I think I'm seeing anyway, that there are way more practitioners like yourself who are available to people online. And there is a lot more acceptance of virtual telehealth in many different ways, but you have to sort of know where to look.
And back to another point I wrote down, when you were, you know, you've been struggling with this for a long time, and you said when you went to a practice, you knew what you had before you even went. So what was your journey to find out about IC? Was it Google? Good old Google? Yeah.
Callie (20:04.422)
It was Google. Yep, I was a 17, 18 year old just Googling and I read, you know, I see is bladder pain that worsens when your bladder fills and then you get relief when it empties. And I was like, well, mine's kind of opposite of that. But that's the closest thing I've ever read to what I'm experiencing. So I'm going to bring that to my doctor and see what they think. And, you know, every doctor has since agreed with me.
So that's just kind of what my journey has looked like. For other people, it can take a long time to get a diagnosis. A lot of doctors aren't, you know, urologists or urogynecologists, they may not, even though that's their specialty and they should know about IC, they don't always know about IC, which is a shame, but that's the reality.
Kim (20:53.167)
Yeah, yeah. You've talked about the wand and pelvic floor physical therapy. Obviously, anybody who knows me, I say ad nauseum, everybody should see a pelvic floor physical therapist once a year, even if you have no symptoms, but especially if you do. And so how did you find out about that link? How did you find out about pelvic floor physical therapy? And like, I guess walk us through what your initial assessment and treatment and then.
the use of the wand because this is I love wands for so many things so how do you use your wand?
Callie (21:24.746)
Yes, I love talking about this because I have gone, like I've done a complete 180 with my thoughts about pelvic floor PT and a wand. So when I was diagnosed and I was referred to pelvic floor physical therapy, I remember they called me to book an appointment and I was just like, that's in my head. I was like, that's there's no way this weird PT is going to help my bladder symptoms. Like that didn't make sense. I wasn't comprehending how it worked. So I didn't make an appointment, but eventually.
I got desperate and I booked my first appointment when I was a sophomore in college and that's kind of got me started on.
You know, it's a weird experience because you go in and they're doing internal work and your first time is always weird, I think. But once you get through that, it gets to be more normal. I will say I have seen four different public for physical therapists over the past decade, and they have all been very different in their approach to me and my situation where some of them would be more into stretching and like external manipulations. And some.
are more just, you know, strictly internal. And I feel like I do better with that internal work. And then my current pelvic floor physical therapist who I love, she recommended using a pelvic wand and I bought one before the pandemic and I never really used it because I didn't quite understand how it worked. And it just sat there for years until about a year ago, I kind of hit another plateau.
where I was like, all right, I got to change something. And I said to myself, I'm going to make a commitment to use this every day, or at least do my very best to do it every day for two months. And I'm going to evaluate at the end of that two month period, like have I made any progress? And that's a lot for me two months because I'm terrible at committing to things. I'm terrible at consistency, but I did it. I built it into my routine. So I do it after I take a shower and I'll do it for.
Callie (23:33.138)
maybe three to five minutes, maybe longer if I feel I need it, but I'll essentially just use, so I use an Intimate Rose Wand. I also have a Desert Harvest Wand, but I kind of gravitate more towards the Intimate Rose Wand, and I use the Pinkish Purple one if anybody is familiar with their wands, and I'll use the Shorter End, and I'll just, you know, use it, and I'll try to find
Callie (24:03.152)
of the wand on that spot for 30 to 60 seconds and then I'll just kind of feel for other spots. Some days I have more spots than others, you know, it kind of fluctuates but that was at the end of that two months my symptoms had virtually disappeared and I was like, holy crap, why didn't I take this seriously before? Like it was such a game changer that I'm truly bought into
Callie (24:33.052)
people with interstitial cystitis and pelvic floor dysfunction because the I think the current statistic is about 90% of people with IC also have pelvic floor dysfunction. So it is something that is very common. And yeah, I'm a big believer for that. I'm with you on that.
Kim (24:46.056)
Mm-hmm.
Kim (24:51.383)
Yeah, and I had the founder of Intimate Rose, Dr. Amanda Olson, was on the podcast and we go through all the different products that she has, including the wand. And just to clarify for people that aren't familiar with what a Thera wand is, it is kind of like an odd S-shaped, it's not like completely S-shaped, but it's sort of a bit of a curved silicone device with usually two different
Kim (25:20.487)
bulbous, the other one was a little bit more pointy, is not quite the right word, but a little bit more directed. And you can choose to use both or you just use one at a time, but this is inserted into the vagina. And the tip is what you're using to explore, to find those, almost like finding a trigger point. And sometimes it's maybe gentle pressure, sometimes it's sustained pressure, sometimes it's mobilization around that point to essentially try to get blood flow.
flow, circulation, reduce, tension, all the above, and it was life-changing for you. That's really cool.
Callie (25:55.646)
Yeah, it's amazing. And same for my clients. I have so many clients who they weren't quite bought into it. And on our group coaching calls, me and a couple other people will be like, just try it. It's really helpful. And they do it. And they're like, wow. Same response I had. Wow, this is amazing. And I also want to say, if somebody listening is in PT,
and they're not getting the results they want, definitely communicate that to your physical therapist. Maybe there's other things you can explore. Maybe it's just not the right fit. And I mean, I've seen four different people, so you're allowed to shop around for somebody that you truly vibe with and trust, because it's such an intimate type of therapy. You need to have that open communication, that trust, and I think that's really important.
Kim (26:44.071)
Totally agree, totally agree. And the other thing that's coming to my mind too is the people who, you had a reluctance because you're kind of like, how is that gonna help? And it seemed weird, it seemed strange. There's also people that may come from the source of their stress and anxiety could also be trauma. And the thought of something insertion from a tool or a person is just absolutely a no-go.
and part of working especially with a trauma-informed practitioner, and this is the importance of finding the right fit for you as well, is maybe that internal doesn't happen right away and maybe it never does but maybe it's the person or the therapy that helps make that something that is accessible again, right? Yeah, yeah. Okay, hydration you've talked about,
Callie (27:31.606)
Yeah, no, that's so true.
Kim (27:40.195)
which I talk a lot about hydration, mostly from a bladder, just elimination perspective, keeping the urine so it's not getting concentrated, it's not gonna irritate the bladder, also from a constipation perspective. Is there anything specific to IC that makes hydration more important or is it the general rules?
Callie (28:02.194)
Yeah, it's the general rules. I mean, with IC, they theorize that there is a layer of the bladder wall called the gag layer, glycosaminoglycans, what we call the gag layer. They theorize that it's either damaged or missing. And if your urine is too concentrated, that can just
Simply put, it can irritate the nerves of the bladder wall and cause symptoms. So just a theory, but it is backed up by the fact that all of these millions of people with IC do tend to say that their symptoms are.
less or milder when they are more hydrated. For me, dehydration is my total enemy. Like that is when my symptoms are at their worst. So I aim for 64 ounces of water a day. You know, if I don't get there, it's okay. But you know, that's, that's really important. Another thing about hydration. So there are some bladder irritants that come in the form of fluids. So things like coffee, alcohol,
Callie (29:06.104)
in them, those can be common bladder irritants. I will say not for everybody, you know, some people can do things in moderation like me. I can have whatever I want as long as it's in moderation. If you want to figure out if you are sensitive to any of those things, you can do an elimination diet and figure out you know what your body is uniquely sensitive to.
Kim (29:28.019)
Okay, let's go there with the elimination diet. So this is something that I had heard about first when I was exploring autoimmunity with my own situation, my own body, not about the bladder. Mine was thyroid related, but learning about autoimmunity, all the how many different types of autoimmune disorders there are. But that's where I first heard the term elimination diet or even the AIP, the autoimmune protocol, which is sort of a form of.
But can you describe what an elimination diet is and how somebody would do that, how they would do that type of diet?
Callie (30:02.046)
Yeah, so an elimination diet is the gold standard for identifying food sensitivities. It can be in any of those conditions that you just mentioned. For IC specifically, I generally, so let me back up a step. So what the elimination diet does is you temporarily remove potentially bothersome foods and beverages and you eventually will test them back into your diet and in reintroduction phase one at a time,
science experiments so you can determine, okay, what are you sensitive to versus what are you not sensitive to? So with IC, the common bladder irritants, I just told you about the drinks, but also the foods that are commonly bothersome include citrus, tomato, tomato products, chocolate, soy, artificial sweeteners, MSG, and citric acid. I think those are the main ones.
everything fun, obviously, everything that tastes good in life. So we don't want somebody following, we don't want them restricting their diet from all those foods for too long. So I say like anything past six months, like we really don't want to get there because you can risk nutrient deficiencies, weight loss can occur, and you can develop food fear. That's a really common thing I'm seeing among the IC community is people are afraid of these items, and they may not even be sensitive to them. So
Kim (31:04.2)
Hehehe
Callie (31:32.178)
This diet for IC, we call it the IC diet, and researchers created it not to be followed forever, but to use it to guide an elimination diet. So that's your starting point.
So with an IC elimination diet, how I have my clients do it is we break it into three phases. We have a baseline elimination and testing period. So baseline is just a week or two where you're not changing your diet yet, you're just tracking your symptoms as specifically as possible. So we can just have that baseline data to compare to as you progress throughout, you know, when you're making these changes.
After that, you go into a elimination phase, which lasts around three to four weeks, where you would remove all of those items that I just mentioned for that period of time to give your bladder and your body time to rest and recover and just get it out of your system.
If during that, those three to four weeks, you have improvements in your symptoms, even if it's just a tiny bit of improvement, amazing. Then you start going into the testing phase. If you don't have improvement in your symptoms, we can take two different paths from there. We can either one, assume that you aren't diet sensitive and move into the testing period, or we can investigate food even more and look into maybe a low histamine.
or a low oxalate type of diet. So that's not necessary for everyone. It's a very individualized thing and I kind of collaborate with my clients on what feels right. So once everyone goes into the testing period that's where we're doing this.
Callie (33:07.946)
kind of science experiment. So each food will have a three day testing period. So on day one, you'll have let's say we'll use a banana, for example. So on day one, you would have a bite of the banana. If you don't have any symptoms, everything's good, you move to day two, you'll have let's say half that banana. If all is well, you can move on to day three and have a full banana. If after day three, you're good, no symptoms, you take two to three days off, it's a bit of a washout period.
because your body can take up to three days to present or for symptoms to present in the bladder. So we want to give it time to get out of the system and then you move on to the next item. But if you do have symptoms during that testing period, you know, you would stop eating that item, get that flare managed, and then you would move on to the next thing and kind of keep track of, you know, what you're successful with versus what you're not. And then after five successful
I have my clients add those five things back into their diet and then they move on to the next five things. So that's kind of the pattern that I have my clients following. It can be a little bit different in terms of the elimination diet structure, but that's generally how it's recommended to be done for IC.
Kim (34:26.259)
Mm-hmm. When I was again exploring this, the autoimmune protocol, elimination diet, all that type of stuff, there was also many people talking about food sensitivity testing. And there's, I would say there's two very different views. One, absolutely you need that there's so much value. The other, they don't, it'll show you false positives. And so where do you sit on that spectrum? And do you like for the people that look at an elimination diet and think,
there's no way I'm gonna do that, it's too much work. And some people may be driven from their symptoms to just still do whatever it takes, but other people think of it as like, oh my gosh, that's too much work, I'll just do the testing.
Callie (35:06.974)
My opinion is I don't support using them. If somebody uses it, okay, we can kind of use that data to do an elimination diet, but they're really not super evidence-based. I know so many dieticians that agree with me on that.
you know, our academy of dieticians that we kind of are falling under, you know, they don't support food sensitivity testing. So that's how my opinion has kind of shaped with that. Uh, I've seen a lot of people take these types of tests and get results. That's just like so many different foods and drinks that they're.
allegedly sensitive to and then a lot of the times they're not it's just that they ate it right before they took the test. A lot of the times people start severely restricting their intake because they view those foods as bad they're going to hurt them and it can just feed into that nervous system up regulation that fight-or-flight response and it can make symptoms worse. So I really believe that the elimination diet is the gold standard obviously if someone's actively
It's not appropriate, but for most people, you know, it is the best way to really figure that out and you cannot get out in Like three months. I know it sounds long, but once you're in it You're kind of just moving through it and if you can work with a registered dietitian that that's optimal I know not everybody has the means to do that. But that's you know, if you can you should
Kim (36:33.415)
Mm-hmm. My mind is going also to gut health, and obviously, gut health has been a buzzword for the last number of years and all about, you know, intestinal, intestinal and intestinal permeability. I can never say that word either. Where essentially there's stuff going through the gut barrier that shouldn't be. And is there, like indirectly with the elimination diet and that protocol.
it would potentially contribute to healing a leaky gut. What are your thoughts on that? And are there gut health protocols that you would do in conjunction with the elimination diet?
Callie (37:15.202)
So as of right now, I'm currently not bought into the whole leaky gut thing. I know intestinal permeability, yes, there is some research behind it. I'm not just, I feel like I could talk about this for a really long time. But.
I will say that there is a big overlap between IC and IBS and constipation and diarrhea. And there does seem to be organ crosstalk, you know, between the bladder and the bowel. So if somebody, for me, I mean, I have IBS. So if my IBS is flaring, it usually does also flare my IC. If I have high levels of stress, you know, both of these conditions are triggered by stress. So when I'm working with somebody who has gut issues, we are working on regulating the
calming things down, you know, we're focusing on nourishing the body, adding more foods back in rather than taking them away. So those are a couple of the things that we do. You know, we could look into supplements, but that's a really individualized process and it just depends on the person.
Kim (38:16.519)
Got it. What types of foods are helpful for ICs? So we've talked about the more main triggers. What would you say are ones that could potentially play a helping role?
Callie (38:29.183)
I mean...
Like I said earlier, very minimal research on diet for IC. So we're kind of just going off of what a couple hundred people said bothers their bladder. So it's really kind of not the greatest thing, but I generally say, you know, try to eat a more anti-inflammatory diet, try to have fresh fruits, fresh vegetables, whole grains, try to limit your processed foods, added sugars. You know, generally that's a really helpful and healthy eating
I do want to say that our community has really been pushing the IC diet and making these foods into like the enemy and What I'm noticing in having worked with over like 130 people with IC and helping them through the elimination diet Like there's really not that many people who are super diet sensitive and a lot of the time it is one of those other Contributing factors like the nervous system or pelvic floor dysfunction
or hormones. There's a lot of fear. I mentioned earlier surrounding food, but once people can get through that food fear and do the elimination diet, they really do start to notice like I'm either not diet sensitive or it's like two, three, maybe four things that I'm sensitive to.
Kim (39:47.619)
Okay, I'm coming back to the nervous system now. This is, you've mentioned it so many times and you've given, you know, you've talked a little bit about what you do, you're seeking out therapy. I guess tell the listeners what is the nervous system and what would nervous system dysregulation, what's happening and then how do we get it back into being regulated, if that's the right terminology to use.
Callie (40:10.594)
Yeah.
Yeah, so essentially our nervous systems are supposed to kind of cycle through different states. So I'm sure everyone's heard like rest and digest and fight or flight or the freeze response before and your body or your nervous system is meant to kind of cycle through those as we go through life, you know, we have these threats that come along. And it's different from back in the day when there was actual like predators and things like that, that are actually trying to harm you.
Like today, our threats might look like a big homework assignment in school, a big work project, some family drama. Like these can come across as threats to our nervous system. And a lot of us, you know, we get into that fight or flight where we're either, you know, in that
in that scenario where like many, many hundreds of years ago, like you're trying to fight off a lion, for example. So you're either going to actually fight this thing or you're going to run away. And our nervous systems are still essentially doing that, but with different types of threats. And so we can get stuck in this fight or flight or even this freeze response. And I've been learning more about this. I'm by no means an expert in this. So, you know, this is
Callie (41:31.872)
But step one for me was just learning these basics. And I think a really great resource to learn about these basics is Cureable, the app C-U-R-A-B-L-E. They have a free version. I think they have phenomenal resources in there just to teach you more. Another really great resource for me in the beginning was a book called The Way Out by Alan Gordon. That was really great.
It's gonna look different for everyone in terms of how to regulate your nervous system So for me I'm someone who isn't really into like the meditation stuff or You know things that really make me like my mind stray or anything like that like for me it's more so
exercising and aromatherapy and listening to music and watching comedy and laughing. Like those are the things that help me regulate my nervous system. But, you know, for example, I have a client who she's super into meditation, like that's her thing and that works for her. So it really comes down to finding something that works for you. But I would say those two resources are like, I recommend them to everyone because they're really, really helpful.
Kim (42:48.035)
Okay, cool. I've written them down and I will add them into the show notes.
Callie (42:52.202)
And there's also a lot of really great accounts on Instagram to learn more about the nervous system, and I can send you a couple of those after too, if you want. Sure.
Kim (43:01.135)
Yeah, that would be great. Thank you. One final question before we wrap up. I've heard you talk about I see belly. What is I see belly?
Callie (43:14.346)
Yeah, so there are some people with IC who noticed some abdominal bloating, and we really don't know what this is, but we have kind of just called it IC belly.
For me, I've always wondered, okay, is it just general inflammation in the abdominal area, in the bladder area? Could it be something like endometriosis that they have endo belly? Could it be related to your gut? Could it be an IBS issue or something else? Could it be SIBO? I think there's a lot of medical conditions to rule out, but we really don't know what is causing
Bloating and I will say not everybody with I see experiences it experiences it. Yeah, I Personally have not but I have some clients who have and it is tough I mean, you know people aren't always kind when you're bloated, you know, they might make comments Your pants may not fit so it definitely can affect you not only physically but mentally and emotionally as well. So that's really tough
it's unclear what's causing it, but I would definitely rule out those other medical conditions if somebody is struggling with that type of bloating.
Kim (44:36.335)
Yeah. Is there anything that we didn't touch on that you want to share about IC?
Callie (44:43.622)
Um, I mean, there's so much I could talk about, but if somebody is thinking they have IC, you know, reach out to a urologist or a urogynecologist, they're going to do some testing probably. It's a diagnosis of exclusion. So they're going to want to run some tests first. Um, you know, push for answers, advocate for yourself, learn as much as you can so that you can make informed decisions. You know, I, I just went along with whatever my
Callie (45:13.877)
more informed back then and more confident and you know.
more confident in my ability to speak up. I would just do whatever they told me to do. So, you know, I would just say learn as much as you can, connect with other IC warriors. I mean, we have lots of support groups. If you're in a dark place, I wouldn't necessarily like dive into those. Try to find more positive support. I have lots of resources too for that.
Kim (45:43.579)
Yeah, where can people find you?
Callie (45:45.298)
Yeah, yeah, yeah. If you're looking to learn more and you like podcasts, I have my own podcast called ICU. So it's IC space y OU, where I do lots of expert interviews. It's a really great resource. I'm also on Instagram and tech talk at Kelly K nutrition. And I put a lot of really helpful information out there. And I also share my journey. So yeah, if anybody has questions, you know, you're welcome to reach out. I'm also currently taking clients. So
And yeah, that's pretty much where you can find me.
Kim (46:17.355)
Awesome. Amazing. We'll share all of that in the notes as well. Thank you so much for the work that you do. Thank you for coming and joining us today and sharing all of your wisdom and your personal story. And I'm really, I think it's very cool how much of a change you notice specific from the pelvic floor side of things as well too. Of course I'm pious to that, but that's, I really appreciate you sharing. And I think...
there, as you sort of alluded to, there's a path and you have to kind of find out what your, maybe what your triggers are. And maybe it's all of them, maybe it's just one of them, but I think you're a testament to, even if something seems weird, you never know. Give it a try because it could be the thing that really helps, right?
Callie (47:01.546)
Yeah, it's going to take a lot of trial and error, but it will be worth it.
Kim (47:05.519)
Yeah, yeah, amazing. Thank you so much. I really appreciate you joining us.
Callie (47:09.887)
Thanks for having me. It's been fun.
