Editor's Commentary - Influence of smoking, coffee, and tea consumption on bladder pain syndrome in female twins

BERKELEY, CA (UroToday.com) -

Tea May Be Environmental Risk Factor For IC/BPS

Exacerbation of bladder pain is often reported after consuming particular foods or beverages, such as coffee and tea. Tobacco use, and in particular smoking, has been implicated as a possible causative agent for IC/BPS. BPS occurs more frequently in family members of patients affected by BPS, suggesting that familial factors, such as genes and shared environmental factors may play a role in the etiology of the disease. Tettamanti and colleagues from Stockholm, Milan, and Gothenberg studied the influence of smoking, coffee, and tea consumption on the risk for BPS and evaluated whether these associations are confounded by genetic and environmental factors in a cohort of young female twins.

Using the Swedish Twin Registry, all twins born between 1959 and 1985 (n=42,852) were invited to participate in a web-based survey. The study was limited to female twins who responded (n=9349). After adjustment for age, basal metabolic index (BMI), parity, educational level, smoking, and coffee and tea consumption, women with a co-twin affected by BPS-like symptoms had more than 4 times higher odds of BPS compared with women with a healthy co-twin. There was a significantly higher prevalence of current and former smokers, as well as tea consumers among women with BPS symptoms compared with those without. Coffee intake was similar in prevalence between those with and without BPS.

BMI was twice as high among those with BPS compared to those without. Educational level was lower among the BPS group. Women who consumed more than 2 cups of tea per day had a 74% greater odds of have BPS compared with non-tea drinkers. Low tea consumption was also associated with BPS. The association between tea intake and BPS was not confounded by familial factors. Current and former smokers had similar increased odds of BPS compared to nonsmokers. Coffee consumption was not associated with BPS symptoms.

This is a fascinating paper and worth a close read. The authors conclude that the positive association between tea consumption and BPS is real, but note that the positive association between smoking and BPS was confounded by genetic factors. They bring up the question as to whether coffee drinkers in the BPS group had switched to tea consumption, and if so whether that might have influenced the findings.

This writer wonders why, if tea consumption stands out as a risk factor for IC/BPS, countries at the top of the tea consumption ladder (England, Turkey, Iran) do not report far higher prevalence of the disease than the majority of nations where per capita tea consumption may be one-tenth of that in tea-loving countries. Certainly, further study of this provocative finding from this excellent group is warranted.

Tettamanti G, Nyman-Iliadou A, Pedersen NL, Bellocco R, Milsom I, Altman D

 

Urology. 2011 Jun;77(6):1313-7
10.1016/j.urology.2010.12.072

PubMed Abstract
PMID: 21439616

UroToday.com IC/PBS/BPS/HBS Section