What’s the Difference Between Interstitial Cystitis and a Urinary Tract Infection (UTI)?

Interstitial cystitis and urinary tract infection (UTI) are two conditions that can make it painful to pee. Because they can cause similar symptoms, it’s easy to confuse the two. But they’re very different conditions. 

Interstitial cystitis happens when the bladder gets inflamed, but it’s not entirely clear why this happens. UTIs happen when bacteria infect parts of the urinary tract, usually the bladder. Let’s take a closer look at interstitial cystitis versus UTI and some of the major differences between the two.

Symptoms of a UTI vs. cystitis

UTI and cystitis are painful conditions that affect the bladder. They’re both more common in people with female anatomy, although they can occur in anyone. Let’s go over the most common symptoms of interstitial cystitis versus UTI. 

Cystitis symptoms

Interstitial cystitis symptoms can be chronic and long lasting, or they can come and go over time. Common symptoms include:

• Pain with urination

• Need to urinate urgently 

• Need to urinate more frequently than normal

• Lower abdominal pain and pressure

• Lower back pain

• Vaginal pain

• Pain in the penis or testicles

• Pain with sex

Quiz: Do I have interstitial cystitis?

UTI symptoms

UTI symptoms can start off mild when in the bladder. This may cause symptoms like: 

• Burning or pain with urination

• Need to urinate urgently

• More frequent urination

• Blood in the urine

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. 

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Interstitial cystitis causes

The cause of interstitial cystitis is still not clear, but some theories include:

• Injury to the bladder

• Nerve changes in the bladder

• Allergic reaction in the bladder

• Damage to the lining of the bladder

• Autoimmune condition 

There are also things that can trigger flares of interstitial cystitis in some people, like:

• Stress

• Sexual activity

• Dehydration

• Tight clothing

• Menstruation

• UTI

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

• Wiping back to front

• Urinary catheters

Risk factors that can make it more likely to develop a UTI include:

• Older age

• Pregnancy

• Dehydration

• Diabetes

• Low estrogen levels (like menopause)

• Spermicide use

• Kidney stones

• Enlarged prostate

How do you diagnose UTIs and interstitial cystitis?

To make the diagnosis of UTI or interstitial cystitis, you’ll need to visit your healthcare provider and discuss your symptoms. You’ll get a urinalysis to test your urine for signs of infection or inflammation. With a UTI, there will be signs of infection or bacteria in the urine. Interstitial cystitis, on the other hand, is not an infection. 

If there are no signs of a UTI, your provider may order more testing to see if your symptoms are related to cystitis. This testing may include a test to see how well your bladder fills and empties or a cystoscopy to look inside the bladder. There are no specific tests for interstitial cystitis, but it is often diagnosed when other causes for your symptoms have been ruled out. 

Treatment for a UTI vs. cystitis

Treatment for UTI versus cystitis symptoms 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 for interstitial cystitis often targets the symptoms and will vary from person to person. Some treatment options include:

• Bladder training (to reduce the frequency of urination)

• Pelvic floor training

• Lifestyle changes (like avoiding food triggers, quitting smoking, and increasing activity)

• Over-the-counter (OTC) pain medication, like acetaminophen (Tylenol) and ibuprofen (Advil)

• Bladder instillation (numbing medication inserted into the bladder)

• Surgery (to enlarge or remove 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 provider for antibiotics. 

When to see a doctor 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 specialist:

• 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. 

Can a UTI lead to interstitial cystitis?

There’s no clear evidence that a UTI can cause interstitial cystitis. And the cause of interstitial cystitis remains largely unknown. But there’s a theory that having a UTI may be a risk factor for a flare-up of cystitis symptoms. Research is ongoing regarding the effects of bacteria in the bladder on interstitial cystitis. 

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Written by:

Mandy Armitage, MD

Mandy Armitage, MD, has combined her interests in clinical medicine with her passion for education and content development for many years. She served as medical director for the health technology companies HealthLoop (now Get Well) and Doximity.

Edited by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

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