Interstitial Cystitis vs. UTI: How to Tell the Difference

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Interstitial cystitis and urinary tract infections are frequently confused with one another. This article will illuminate the differences between IC and UTI.

Cystitis is the medical term for inflammation of the bladder.

Most cases of cystitis are caused by a bacterial infection, called a urinary tract infection (UTI). By definition, UTI occurs in the urinary tract, which includes the bladder, kidneys, urethra, etc. 

UTI-caused cystitis may be called bacterial cystitis or bladder infection.

Interstitial cystitis (IC; or, painful bladder syndrome) is non-infectious cystitis caused by chronic inflammation in the bladder.

Both interstitial cystitis and UTI are more common in women than men. They both share similar symptoms. But treatment is very different for these interconnected conditions.

Interstitial cystitis affects up to 4 million men and up to 8 million women in the United States, according to the Urology Care Foundation. Many IC patients claim their IC symptoms began as kids, making it important to look for these symptoms in young children.

We’ll give you the basics on how to tell them apart, but you’ll need to see a doctor to be 100% sure whether or not you have interstitial cystitis or a UTI. This is because the high-quality diagnostics are mostly unavailable outside of a hospital lab.

Do you have cystitis or a UTI?

You may have UTI in your bladder, which leads to bacterial cystitis. However, UTI doesn’t have to occur in your bladder — in which case you would not have bacterial cystitis.

You may have interstitial cystitis if you’re experiencing cystitis symptoms without any bacteria in your urine. Interstitial cystitis is sometimes called non-infectious cystitis because it is bladder inflammation (cystitis) that is not caused by a bacterial infection.

What is the difference between cystitis and UTI? There are 3 main differences between cystitis and UTI:

  1. Lower urinary tract infections can cause bacterial cystitis, but don’t always. Cystitis can’t lead to UTI.
  2. Cystitis is bladder inflammation — only referring to the bladder. UTI may occur in the bladder, but also may occur in the kidneys or ureters.
  3. UTI is bacterial (usually Escherichia coli). Cystitis is bladder inflammation, which may be caused by a bacterial infection, but may also be caused by immune dysfunction or other root causes.

Can a UTI cause cystitis? UTI can directly cause bacterial cystitis, or indirectly cause interstitial cystitis. If UTI is left untreated, it can lead to chronic bladder inflammation, which is the underlying cause of interstitial cystitis.

UTI and interstitial cystitis are interconnected, yet they are different. Below, we list what differentiates the two.

Interstitial Cystitis (IC)

Interstitial cystitis is an inflammatory disease of the bladder. Also called bladder pain syndrome or painful bladder syndrome (PBS), interstitial cystitis is a condition in which chronic inflammation in the bladder leads to painful and potentially embarrassing symptoms.

Conventional doctors and mainstream medicine claim that the cause of IC is unknown. However, there are several risk factors that can be identified, which may inform a unique and effective treatment plan.

How many people have IC? Up to 12% of women have early signs of IC, according to 2006 research cited by the CDC.

Symptoms of IC:

  • Pelvic pain
  • Bladder pain
  • Bladder pressure
  • Bladder stiffening, scarring
  • Frequent urination
  • Urinary urgency
  • Decreased bladder capacity
  • Urinary incontinence
  • Low-grade fever
  • Discomfort in penis or scrotum
  • Painful sexual intercourse

In women, symptoms of IC usually worsen around the time of their periods. Women are also more likely to get IC than men.

Stress can worsen symptoms of IC but does not cause them.

As IC progresses over a course of years, cycles of pain (called “flare-ups” or “flares”) and relief occur. Symptoms may vary from day to day.

More and more healthcare professionals believe that IC may be an autoimmune condition. If you are worried about IC or other autoimmune conditions, click here to find out how PrimeHealth approaches treatment for autoimmune issues.

Urinary Tract Infection (UTI)

Urinary tract infection occurs when a pathogen (usually bacteria like E. coli) gets in your urinary tract, which includes your bladder, kidneys, urethra, etc.

By definition, UTI occurs in your urinary system, which includes your bladder, as well as other organs. If you have UTI in your bladder (bladder infection), this usually triggers bladder inflammation (AKA cystitis). This may be called bacterial cystitis or infectious cystitis.

Symptomless UTI or bladder infection is called “asymptomatic bacteriuria” (literally, “bacteria in the urine, with no symptoms”). Asymptomatic bacteriuria is not cystitis.

Side note: UTI in your kidneys (called “kidney infection” or “pyelonephritis”) is the worst type of UTI. Bladder infections are rarely life-threatening, whereas kidney infections can lead to kidney damage, bloodstream infection, or death. Kidney infection is not cystitis.

How many people get UTIs? More than 8 million people go to the doctor for UTIs each year. About 60% of all females and 12% of males get a UTI at one point in their life.

Symptoms of UTI:

  • Bladder infection (then potentially bacterial cystitis)
  • Kidney infection
  • Pain or burning sensation while urinating (called “dysuria”)
  • Urinary leakage
  • Lower abdominal pain
  • Cloudy urine
  • An unusual odor to your urine
  • Low-grade fever
  • Nausea
  • Vomiting
  • Accidental daytime wetting, in children (not bedwetting by itself)

In very rare cases, UTI spreads bacteria to the bloodstream, which can lead to sepsis and death.

Not only is UTI sometimes confused with cystitis, but UTI is also sometimes confused with STDs, such as gonorrhea or chlamydia.

Risk Factors for Cystitis

Whether you have interstitial cystitis or UTI, the risk factors and common causes are similar. Let’s break them down between risk factors for UTI only, IC only, and both.

Risk factors for both interstitial cystitis and UTI:

  • Female gender
  • Pregnancy
  • Post-menopause (lack of estrogen often changes urinary tract)
  • Kidney stones
  • Diabetes mellitus
  • HIV infection
  • Spinal cord injuries
  • Prolonged use of indwelling urinary catheters
  • Chemotherapy or radiation

Risk factors for UTI only:

  • Sexual activity
  • Use of diaphragm birth control pills
  • Bladder stones
  • Enlarged prostate
  • Antibiotic overuse

Risk factors for interstitial cystitis only:

  • Abnormalities in bladder structure
  • Chronic inflammation
  • Autoimmunity
  • Immune system dysfunction
  • Increased nervous system activation in nerves to the bladder
  • Gynecological surgery
  • Untreated infection (such as UTI)
  • Certain chemotherapy drugs
  • Allergies to certain chemicals
  • Food sensitivities
  • Toxicity to mold, heavy metals, or other chemicals
  • Chronic hidden infections (ie: parasites or tick-borne illnesses)

How to Diagnose Interstitial Cystitis vs. UTI

A urologist may diagnose UTI by detecting bacteria in a urine sample. However, a urological doctor may diagnose IC by ruling out other similar conditions.

Diagnosing interstitial cystitis vs. UTI may include:

  1. Symptoms checklist
  2. Medical history
  3. Physical examination (such as pelvic exam)
  4. Urinalysis
  5. Ruling out other conditions
  6. Urine culture (in case of suspected kidney infection or persistent symptoms)
  7. Potassium sensitivity test (potassium injected into the bladder causes increased bladder urgency with IC)

Urinary frequency combined with painful urination (and without vaginal discharge) is 90% likely to be a UTI diagnosis.

A bladder diary may be helpful in diagnosing both IC and UTI.

A doctor may use cystoscopy to see into the urethra and bladder, looking for inflammation, infection, ulcers, cancer, etc.

There’s no official diagnostic test for IC besides a symptom checklist and ruling out other conditions, such as bladder cancer.

What can mimic a urinary tract infection? IC can mimic similar symptoms as a UTI since their causes are so closely linked.

Prevention & Treatment of UTI and Interstitial Cystitis

Treatment of interstitial cystitis and UTI depend on the severity of your symptoms.

Treatment for UTI

Doctors often give a brief course of antibiotics for UTI. (Be careful with recurrent UTI. Repeated use of antibiotics can build up a dangerous antibiotic resistance in your body.)

For severe UTI, you may be prescribed intravenous (IV) antibiotics.

Topical estrogen may help older women restore healthy vaginal flora and reduce harmful bacteria in their urinary tract, decreasing risk of UTI.

Treatment for IC

For interstitial cystitis, doctors may prescribe the following treatments:

  • Physical therapy to strengthen your pelvic floor muscles
  • Nerve stimulation to reduce urinary frequency
  • Bladder distention to “stretch” the bladder with water
  • Over-the-counter meds
  • Nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen
  • Tricyclic antidepressants
  • Antihistamines
  • Surgery, rarely

These treatment methods manage painful symptoms — but they don’t address the root cause of your IC.

Bladder training is another treatment option, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Bladder training helps patients train their bladders to go when they want to go.

What is the best thing for cystitis? The best thing for interstitial cystitis is visiting a functional doctor. 

Like many autoimmune conditions, interstitial cystitis can only be effectively treated — or even reversed — by identifying what’s causing it and correcting that root cause. That’s exactly what a functional doctor does!

Here are 7 ways to prevent cystitis and UTI at home:

  1. Drink plenty of fluids, particularly water or cranberry juice. (Avoid cranberry juice if you’re on blood thinners like warfarin.)
  2. Don’t use deodorant sprays or other potential irritants on your genital area.
  3. Take showers, not tub baths.
  4. After intercourse, urinate as soon as possible.
  5. Wash around your vagina/scrotum and anus — daily, gently, and not with harsh soaps.
  6. Urinate frequently. If you feel an urge to urinate, go right away.
  7. Wipe front-to-back after bowel movements. This prevents harmful bacteria from your rectum from spreading to the urethra.

Talk to Your Doctor

You need to talk to your doctor if you think you have a urinary tract infection or interstitial cystitis. At the end of the day, a doctor is the only person who can definitively diagnose IC vs. UTI.

Seek immediate medical attention if you exhibit dangerous symptoms that don’t go away, such as:

  • Back pain
  • Side pain
  • Fever
  • Chills
  • Nausea
  • Vomiting
  • Painful urination
  • Blood in urine
  • Increased urgency or frequency in urination habits

Visit PrimeHealth in Denver, Colorado for an evidence-based approach to diagnosing and treating IC or UTI. Click here to schedule a FREE phone consultation with us today!

Sources

  1. Charrua, A., Pinto, R., Birder, L. A., & Cruz, F. (2015). Sympathetic nervous system and chronic bladder pain: a new tune for an old song. Translational andrology and urology, 4(5), 534. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4708549/
  2. Colgan, R., & Williams, M. (2011). Diagnosis and treatment of acute uncomplicated cystitis. American family physician, 84(7), 771-776. Full text: https://www.aafp.org/afp/2011/1001/p771.html
  3. Bent, S., Nallamothu, B. K., Simel, D. L., Fihn, S. D., & Saint, S. (2002). Does this woman have an acute uncomplicated urinary tract infection?. Jama, 287(20), 2701-2710. Full text: https://www.ncbi.nlm.nih.gov/books/NBK69537/
  4. Rozenberg, S., Pastijn, A., Gevers, R., & Murillo, D. (2004). Estrogen therapy in older patients with recurrent urinary tract infections: a review. International journal of fertility and women’s medicine, 49(2), 71-74. Abstract: https://pubmed.ncbi.nlm.nih.gov/15188831/

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