Key takeaways:
Interstitial cystitis and urinary tract infection (UTI) cause similar urinary symptoms.
The main difference is that a UTI is an infection, whereas interstitial cystitis isn’t.
People often confuse interstitial cystitis with UTI, so it’s important to get medical attention if symptoms persist.
There’s no cure for interstitial cystitis, but avoiding triggers and other treatments can help with symptoms.
Interstitial cystitis and urinary tract infection (UTI) are two conditions that cause bladder pain and urinary symptoms. Because they can cause similar symptoms, it’s easy to confuse the two. But they’re very different conditions.
Let’s take a closer look at interstitial cystitis versus UTI and some of the major differences between the two.
What is a urinary tract infection (UTI)?
A UTI is an infection. It happens when bacteria infect parts of the urinary tract, usually the bladder. It’s more common in women, although it can occur in anyone.
What is interstitial cystitis?
Interstitial cystitis (also called bladder pain syndrome) is a chronic bladder problem that isn’t due to an infection. It causes pain and pressure around the bladder. Cystitis is also more common in women.
Symptoms of a UTI vs. cystitis
UTI and cystitis are painful conditions that affect the bladder. There’s some overlap in the symptoms — but there are some differences too.
Cystitis symptoms
Interstitial cystitis symptoms can be long lasting, or they can come and go over time. Common symptoms include:
Pain with urination
Lower abdominal pain and pressure
Lower back pain
Vaginal pain
Pain in the penis or testicles
Pain with or after sex
Need to urinate urgently
Need to urinate more frequently than normal
Quiz: Do I have interstitial cystitis?
UTI symptoms
UTI symptoms can feel like:
Burning or pain with urination
Need to urinate urgently
More frequent urination
Blood in the urine
Pain in the pelvic region
But untreated UTIs can worsen and spread to the kidneys over time. Kidney infections can be serious and may require a hospital stay. Symptoms of kidney infection or a complicated UTI include:
Fever
Nausea and vomiting
Back or flank pain
What causes interstitial cystitis and UTI?
Although cystitis and UTI can have similar symptoms, the causes of each condition are different. Here are the most common reasons you may have bladder pain from interstitial cystitis or UTI.
Interstitial cystitis causes
The cause of interstitial cystitis is still not clear. But theories propose that it’s inflammation due to:
Injury to the bladder
Nerve changes in the bladder
Allergic reaction in the bladder
Damage to the lining of the bladder
Hormone changes
There are also things that can trigger flares of interstitial cystitis in some people, like:
Stress
Sexual activity
Dehydration
Tight clothing
Menstruation
UTI
Certain foods and drinks
UTI causes
UTI happens when bacteria enter the urethra and travel to other parts of the urinary tract. Sometimes, it’s unclear why this happens. Other times, it can be caused by:
Sexual activity
Urinary catheters
Holding your urine too long
Risk factors that can make it more likely to develop a UTI include:
Dehydration
Low estrogen levels (like menopause)
Spermicide and diaphragm use
How do you diagnose UTIs and interstitial cystitis?
To make the diagnosis of UTI or interstitial cystitis, you’ll need to visit a healthcare professional. They’ll ask about your symptoms, including how long and how often you have symptoms. Then they might order some testing, which can include:
A urinalysis tests your urine for signs of infection or inflammation. With a UTI, there’ll be signs of infection or bacteria in the urine. There won’t be signs of infection in the urine if it’s interstitial cystitis.
Urodynamic testing may be the next step if there are no signs of a UTI on urinalysis. This test is to see how well your bladder fills, holds, and empties urine.
A cystoscopy is a procedure to look inside the bladder. This also allows your team to take a biopsy of the bladder wall, which may help with diagnosis.
There are no specific tests for interstitial cystitis. But it can be diagnosed when other causes for your symptoms have been ruled out.
Treatment for a UTI vs. cystitis
Treatment for UTI versus cystitis is very different. That’s because the causes are different. Let’s take a closer look at the typical treatment for UTI and cystitis.
Interstitial cystitis treatment
Because there’s no clear cause for interstitial cystitis, there’s no single treatment that works to treat it. Treatment may vary from person to person, and it may require some trial and error to see what works. Some treatment options include:
Bladder training
Avoiding possible triggers, like chocolate, caffeine, and citrus
Stress management, since stress can worsen pain
Over-the-counter (OTC) pain medication, like acetaminophen (Tylenol) and ibuprofen (Advil)
OTC antihistamines, like cimetidine and hydroxyzine
Prescription medication pentosan polysulfate, which is the first FDA-approved medication for interstitial cystitis
Bladder instillation (medication inserted into the bladder)
UTI treatment
Treating a UTI often involves an antibiotic to rid the body of the bacteria that’s causing the symptoms. Common antibiotics used to treat a UTI include:
Sulfamethoxazole / trimethoprim (Bactrim)
Nitrofurantoin (Macrobid)
Fosfomycin (Monurol)
Cephalexin (Keflex)
Amoxicillin / clavulanate (Augmentin)
Cefdinir (Omnicef)
Ciprofloxacin (Cipro)
Levofloxacin (Levaquin)
Doxycycline
Other ways to treat a UTI include:
OTC pain and fever reducers (like acetaminophen or ibuprofen)
Phenazopyridine (Azo)
Increased water intake
To treat UTIs, people often try home remedies like cranberry juice. But there isn’t much evidence to support that it works.
Sometimes, a UTI can go away on its own in a couple of days without any treatment. But if your UTI symptoms last longer than a few days, it’s best to see your healthcare team for antibiotics.
When to see a healthcare professional for symptoms of a UTI or interstitial cystitis
It’s a good idea to get medical attention if you’re having urinary symptoms, especially if they’re getting worse. It’s hard to tell on your own if your symptoms are due to UTI or interstitial cystitis, so getting your urine tested can help.
That said, it’s common for interstitial cystitis to be misdiagnosed (and even treated) as a UTI. Living with these symptoms can be frustrating, especially if you’re not getting the answers you need. Seeing a urologist — someone who specializes in conditions of the urinary tract — may help. Here’s when to get help from a urologist:
You continue to have symptoms without signs of infection in your urine.
Your symptoms last for 6 weeks or more.
You’re having pain with sex and also have urinary symptoms.
Your symptoms are frequently treated with antibiotics without definitive signs of infection in your urine.
Frequently asked questions
This can be a tricky situation. First, it’s common for people to experience recurrent UTIs, when a UTI comes back after treatment. So, if you’ve recently treated a UTI and the symptoms have returned, that’s a possibility.
But if you have symptoms and your urine doesn’t have signs of infection, it could be something else. It’s a good idea to see your primary care provider, or even a specialist, to help you get to the bottom of things.
It’s unclear. A survey of people with interstitial cystitis showed that they report a higher rate of miscarriage. Interstitial cystitis has been linked with pregnancy complications and early delivery. It’s not clear if this is due to the actual condition or associated stress. Research is ongoing.
Neither interstitial cystitis or a UTI can delay your period. That said, the associated stress could affect your symptoms and your monthly cycle.
There’s no clear evidence that a UTI can cause interstitial cystitis. And the cause of interstitial cystitis remains largely unknown. But having a UTI can cause a flare-up of cystitis symptoms. Research is ongoing regarding the effects of bacteria in the bladder on interstitial cystitis.
This can be a tricky situation. First, it’s common for people to experience recurrent UTIs, when a UTI comes back after treatment. So, if you’ve recently treated a UTI and the symptoms have returned, that’s a possibility.
But if you have symptoms and your urine doesn’t have signs of infection, it could be something else. It’s a good idea to see your primary care provider, or even a specialist, to help you get to the bottom of things.
It’s unclear. A survey of people with interstitial cystitis showed that they report a higher rate of miscarriage. Interstitial cystitis has been linked with pregnancy complications and early delivery. It’s not clear if this is due to the actual condition or associated stress. Research is ongoing.
Neither interstitial cystitis or a UTI can delay your period. That said, the associated stress could affect your symptoms and your monthly cycle.
There’s no clear evidence that a UTI can cause interstitial cystitis. And the cause of interstitial cystitis remains largely unknown. But having a UTI can cause a flare-up of cystitis symptoms. Research is ongoing regarding the effects of bacteria in the bladder on interstitial cystitis.
The bottom line
UTI and interstitial cystitis have similar symptoms. But they’re different conditions, and their treatments are different too. Antibiotics won’t help treat interstitial cystitis, so it’s important to get the correct diagnosis if you have urinary symptoms.
Living with interstitial cystitis can be painful and frustrating. If you’re struggling with symptoms, it’s important to see a healthcare professional who specializes in bladder conditions, like a urologist. They can help identify triggers, tailor treatments, and find strategies that make symptoms more manageable.
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References
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