Salicylates and Bladder Irritability

Salicylates have been long suspected of triggering the urinary tract. An extract from a paper published in 1904 (122 years ago) reflecting the widespread of salicylic acid at the time....

The salicylates have been so widely employed and have proved of such distinct utility in the treatment of a large number of disorders, that the fact should not be ignored that they may give rise to irritation of the urinary tract, particularly the kidneys. In order to convince themselves of the accuracy or otherwise of statements of this character, Dr. Carl Klieneberger and Dr. Richard Oxenius made a careful study of the urine from a large number of practically normal persons and from individuals suffering from rheumatic disorders, particularly polyarthritis, to whom later salicylates were administered. As a result of their observations they found that the administration of even small doses of salicylates gave rise to the urinary (issues)

REFERENCE: THE ACTION OF SALICYLATES ON THE URINARY TRACT. JAMA. 1904;XLIII(8):552. doi:10.1001/jama.1904.02500080030007

Fruits, high in salicylates, may cause bladder irritability in persons with salicylate sensitivity.

Since this early study, there is little in the literature to provide any evidence linking salicylates and bladder and/or urethra irritability.

Anecdotally, people with salicylate sensitivity often present with bladder irritability and/or frequent urination. Bladder iritability is usually not the reason why people seek Specialist Dietitian help when food intolerances are suspected. People with potential food intolerances usually seek help for symptoms such gut or skin issues BUT when salicylate looks to be an underlying issue, it is not uncommon for chronic urinary tract infections and/or frequent urination to also be present.

A Common Narrative when Salicylates are Suspected

Clients with suspected salicylate sensitivity and also bladder issues and/or frequent urination may provide the following information:

• Chronic (ongoing) bladder or frequent urination that cannot be explained medically

• Worsensing of these issues when foods very high in salicylates consumed (for example fruits).

This personal account gives a sense of what this may look like.

I have had painful bladder symptoms for over 2 months now:

• Kidney pain (only with onset of symptoms)

• Burning urethra, constantly (not just when urinating)

• Bladder/urethra spasms and small sharp pains, randomly

• Painful pressure in urethra, like it is being expanded from the inside

• Waking several times during night with painful bladder, relieved after urinating. I get this during the day too.

• Urine urgency and frequency

• Nausea

After two lots of antibiotics both my doctor and I realise it is not a UTI. Symptoms did decrease for a few days after starting each course but just came back again.

I have been given a referral to a Urologist.

I’ve been on such a rollercoaster ride. Every time I thought my symptoms were clearing, they just came back with a vengeance. I’m exhausted and an emotional wreck.

This person's account, similar to many clients I have seen with a salicylate sensitivity, responded well to lowering salicylates in the diet.

NOTE: it is always really important to check with your Doctor/General Practioner and/or Medical Specialists if having these issues to make sure there are not any underlying medical underlying issues that need to be medically addressed.

What Are Salicylates?

Salicylates are chemicals found in plants that serve as natural pesticides and preservatives. They are present in many fruits, vegetables, spices, and nuts. Additionally, salicylates are the active ingredient in common pain relievers like aspirin. While most people tolerate salicylates without issue, there is a subset of individuals have a salicylate sensitivity.

How Salicylates Potentially Affect the Bladder (if you are salicylate sensitive)

A potential mechanism underlying salicylate sensitivity and bladder issues relates to an oversensitivity of the Transient Receptor Potential (TRP) channels in the bladder. These receptors are found though out the body, including the bladder wall and are involved in sensing pain, temperature, and irritants.

An over sensitivity of these receptors in the bladder to salicylates means that when a high load of salicylates builds up in the body (from the diet), crossing a threshold will trigger these receptors and the bladder will mistakenly react to the salicylates as if they are an irritant.

This can be thought of as a hypersensitivity of pelvic nerves to salicylates.

Bladder irritation can cause inflammation, leading to symptoms such as:

• Frequent urination

• Urgency to urinate

• Burning sensation during urination

• Pelvic discomfort or pain

  
  

Common Sources of Salicylates to Watch For

People experiencing bladder irritation should be aware of common dietary and medicinal sources of salicylates, including:

• Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs)

• Fruits, especially citrus fruits and berries such as strawberries

• Fruit juices, especially orange and apple juice

• Tomatoes and tomato-based products

• Herbs and Spices such as curry spices

Salicylates are found in a wide variety of foods, but as this is not an allergy and consequently not all salicylate foods need to be avoided, just reduced enough in the body to remain under your personal reaction threshold (which differs from person to person).

It is always best to see a Food Intolerance Specialist who is used to dealing with salicylate sensitivity, given the difficulty of this sensivity and potential for over restriction that impact nutritional quality of the diet. Always, always seek medical advice to make sure there are no underlying medical issues that need to be managed.