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Women's Health

Severe UTIs Might Actually Be Interstitial Cystitis — Here’s the Difference (and the Cure)

You don't have to live with interstitial cystitis.

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For many women, Urinary Tract Infections (UTIs) are a fact of life. Introduced as early as our teens (and sometimes before), they occur when bacteria enter the urinary tract through the urethra and spread to the bladder. They’re more frequent in women than men because of our anatomy — we have a shorter urethra than men do, which means bacteria don’t have to travel as far to reach the bladder. Sexual activity, certain forms of birth control, and menopause can all trigger a UTI.

For decades, prevailing wisdom advised drinking a whole lot of cranberry juice when UTI symptoms appeared. Research now shows that while cranberry juice can help to prevent UTIs before they occur, it does nothing to remedy them once they’ve begun. Rather, a low dose antibiotic is the preferred cure.

One condition, however, that can present like a UTI but have much more severe symptoms —and implications — is interstitial cystitis (CI). A FIRST for Women reader plagued by UTIs, but noticing that they’d recently gotten much more extreme, wrote in to ask for advice on this topic. Barbara DePree, MD, our consulting gynecologist, responded. Below are her recommendations.

Q: I’ve had UTIs for years, but now things feel different. I need to urinate all the time — up to 60 times a day. But when I ‘go,’ there’s almost no urine, and I feel terrible pain and pressure in my lower abdomen. Is this just a severe UTI or could it be something else?

A: Even though these symptoms sound like a chronic urinary tract infection (UTI), I suggest seeing your doctor. She can order a urinalysis and urine culture to confirm or rule out a UTI. If there isn’t one, it’s possible you have interstitial cystitis. This condition affects up to 12 million people — mostly women — in the US and can feel like a severe bladder or urinary tract infection. But unlike a UTI, IC is not caused by bacteria.

Though the exact cause is not known, IC may be due to a defect in the lining of the bladder, an autoimmune reaction, heredity, or even an allergy. IC symptoms can come and go, and understanding what makes them worse can often help women manage the condition. Things like sex, stress, sitting too long, certain foods or drinks, and high-impact exercise can all trigger flares.

Fortunately, studies have shown that adapting certain lifestyle measures — specifically, effect of maintaining a plant-based, low saturated fat diet designed for anti-inflammationmay help reduce symptoms and improve overall quality of life for those living with IC.

Some women find relief by lowering their consumption of coffee, tea, alcohol, chocolate, spicy foods, and anything containing artificial sweeteners. Others get relief by drinking a daily glass of water mixed with one teaspoon of baking soda, which may help neutralize acid in the urine to ease burning sensations and calm the bladder. (Avoid, however, over-relying or overusing this home remedy, as it can have ill effects if incorrectly applied.) Finally, you may want to consult with a urologist, who can make a definitive diagnosis and help outline the most effective treatment strategies for you.

Meet the Expert

Barbara DePree, MD, is a gynecologist in private practice and director of Women’s Midlife Services at Michigan’s Holland Hospital. A Certified Menopause Practitioner, she is the founder of MiddlesexMD.com, an educational resource for women’s sexual health in perimenopause and beyond. To ask her a question, send an email to health@firstforwomen.com.

This content is not a substitute for professional medical advice or diagnosis. Always consult your physician before pursuing any treatment plan.

A version of this article originally appeared in our print magazine, First For Women.

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