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UTI Won’t Go Away? How to Tell the Difference Between Chronic UTIs and Interstitial Cystitis


Have you ever felt constant pain while urinating and frantically wondered why your UTI won’t go away? If that’s happening to you right now, you’re not alone.

Urinary tract infections (UTIs) are extremely common for women of all ages — even after menopause. One in five women will have at least one UTI in her lifetime, according to the National Kidney Foundation. However, that’s probably little comfort to you if you’re struggling with the worst UTI symptoms out there, such as discomfort while urinating and abdominal pain.

You’ve already tried drinking extra water and Googled the heck out of UTI home remedies. Maybe you’ve even visited your doctor and asked for your usual medications. But no matter what you do, you’re still feeling pain whenever you have to use the bathroom, which is often. So how come your UTI treatment didn’t work? For that matter, why can’t you manage to kick this condition to the curb for good?

Long story short: If you find yourself asking, “Why is my UTI not going away?” you might have a completely different issue on your hands.

Is it a UTI or interstitial cystitis?

Since UTIs are such a common health problem, many of us immediately associate them with the frequent need to urinate and pain while urinating. But if it turns out that you don’t have a UTI, you may actually have interstitial cystitis, which is a bladder condition with multiple symptoms that are often mistaken for a UTI, according to the Interstitial Cystitis Association

The precise cause of interstitial cystitis is still a mystery, but experts believe a trigger damages the bladder or bladder lining, which leads to the development of interstitial cystitis. Some potential triggers may include bladder trauma, pelvic floor muscle dysfunction, or a bacterial infection. Since this damage to the bladder wall is thought to allow particles in the urine to leak into the bladder lining, this often leads to pain and urinary urgency — awfully similar to UTI symptoms.

If it does turn out that you have interstitial cystitis, it makes sense why UTI treatments have done nothing for your symptoms: they’re usually designed to simply attack bad bacteria in the urine, not to repair potentially significant bladder damage.

What is a UTI, anyway?

A UTI is an infection in any part of your urinary system, but usually the bladder and urethra, according to the Mayo Clinic. UTIs are typically caused by bad bacteria entering the urinary tract through the urethra and multiplying in the bladder, leading to infection. Even the most mild UTI can be intensely aggravating, but chronic UTIs — repeated or prolonged bacterial infection of the bladder or urethra — can be even worse.

What are chronic UTI symptoms?

Women with chronic UTIs may have repeated or recurring infections (such as two or more infections in a six-month period), UTI symptoms that don’t disappear within 48 hours after treatment, or a UTI that lasts longer than two weeks, according to the Baylor College of Medicine. Although symptoms can vary from woman to woman, they often include:

  • Urgent need to urinate
  • Frequent need to urinate
  • Pain or burning when urinating
  • Soreness in the lower abdomen, back, or sides
  • Urine that has a strong or foul odor, is cloudy, or is tinged with blood

Some UTIs are more likely to return than others, according to recent research. An October 2018 study published in Infection Control & Hospital Epidemiology found that patients with a drug-resistant UTI were more likely to have a relapse of their infection within a week than people with non-resistant infections. Unfortunately, the folks with drug-resistant UTIs were also more likely to be prescribed an incorrect antibiotic.

“This study adds to the evidence that drug-resistant bacteria are an increasing issue, even in the community and even in patients who have something seemingly uncomplicated, like a urinary tract infection,” said lead author Judith Anesi, MD, in a press release. “These drug-resistant infections are difficult to treat, and our study shows that relapses are common. This is an alarming finding, and interventions to curb antibiotic resistance are urgently needed.”

But if you go to the doctor and every type of UTI is ruled out — including a chronic one — then you might need to get checked for symptoms of interstitial cystitis instead.

What are interstitial cystitis symptoms?

As you may remember, the symptoms of interstitial cystitis are quite similar to those of a UTI. The important ones to recall include the following:

  • Urinary frequency
  • Urinary urgency
  • Pelvic pain and pressure
  • Discomfort in the bladder and pelvic region
  • Pain in the lower abdominal, urethral, or vaginal area

How can you identify and treat interstitial cystitis?

As you can probably guess, it’d be extremely difficult to diagnose interstitial cystitis from home. If you’re experiencing chronic bladder pain or urinary urgency and frequency, make an appointment with your doctor as soon as you can. A medical professional can diagnose you with interstitial cystitis through a pelvic exam or biopsy.

Experts estimate that anywhere from three to eight million women in the United States alone have interstitial cystitis. Although there is no cure for interstitial cystitis, medication and other therapies can offer much-needed relief, according to the Mayo Clinic.

No singular treatment for interstitial cystitis is right for every patient. Some folks respond well to physical therapy for their pelvic pain, while others benefit from oral medications such as antihistamines and tricyclic antidepressants. In other cases, nerve stimulation or even surgery may be the best option. That’s why if you have interstitial cystitis, it’s imperative to talk with your doctor about the best treatment fit for you.

You deserve to feel as healthy and happy as possible — everywhere on your body.

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