Interstitial cystitis and urinary tract infections are frequently confused with one another.
Cystitis is the medical term for inflammation of the bladder. The cause of cystitis may be bacterial infection or chronic inflammation. Most cases of cystitis are caused by a UTI, but there are other underlying causes that may lead to cystitis.
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.
UTIs (urinary tract infections) are infections of the urinary system. They may occur in the bladder, kidneys, urethra, or any other part of the urinary tract.
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 health care provider to be 100% sure whether or not you have interstitial cystitis or a UTI. This is because high-quality diagnostics are mostly unavailable outside of a hospital lab.
Do You Have Cystitis or a UTI?
Acute cystitis and UTIs both present with very similar symptoms, although these health conditions have different root causes. The only way to know for sure if you have acute cystitis vs. UTI is for your provider to do a urinalysis to determine the root cause.
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 of the bladder.
What is the difference between cystitis and UTI? There are 3 main differences between cystitis and UTI:
- Lower urinary tract infections can cause bacterial cystitis, but don’t always. Cystitis can’t lead to UTI.
- Cystitis is bladder inflammation — only referring to the bladder. UTI may occur in the bladder, but also may occur in the kidneys or ureters.
- 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 Cystitis
- 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, learn more about how PrimeHealth treats 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, and urethra.
Inflammation of the urethra is called urethritis.
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.
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.
Symptomless UTI or bladder infection is called “asymptomatic bacteriuria” (literally, “bacteria in the urine, with no symptoms”). Asymptomatic bacteriuria 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 a 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
- 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
- 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
- Age (older adults are at higher risk for infection overall)
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
- 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 can diagnose your condition by checking for red and white blood cells, bacteria, and other particles in your urine. A UTI can be diagnosed by detecting bacteria. However, a urological doctor may diagnose IC by ruling out other similar conditions.
Diagnosing IC vs. UTI may include:
- Symptoms checklist
- Medical history
- Physical examination (such as pelvic exam)
- Ruling out other conditions
- Urine culture (in case of suspected kidney infection or persistent symptoms)
- 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.
Keeping 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, such as Nitrofurantoin, for UTI treatment. For severe UTI, you may be prescribed intravenous (IV) antibiotics.
Be careful with recurrent UTI. Repeated use of antibiotics can build up a dangerous antibiotic resistance in your body.
What are the side effects of taking antibiotics for cystitis? The side effects of taking antibiotics for cystitis include dizziness, nausea, diarrhea, rashes, and yeast infections. Repeated antibiotic treatment can build up a dangerous antibiotic resistance in your body.
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
- 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 way to cure cystitis? The best way to cure cystitis is to receive proper medical advice by 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:
- Drink plenty of water and cranberry juice. Avoid cranberry juice if you’re on blood thinners like warfarin.
- Take D-mannose, a dietary supplement that may help prevent bacteria from sticking to the lining of your urinary tract.
- Don’t use deodorant sprays, lubrication, spermicide, or other potential irritants on your genital area.
- Take showers, not tub baths.
- After intercourse, urinate as soon as possible.
- Wash around your vagina/scrotum and anus — daily, gently, and not with harsh soaps.
- Urinate frequently. If you feel an urge to urinate, go right away.
- 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
- Painful urination
- Blood in urine
- Increased urgency or frequency in urination habits
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- 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.
- Ala-Jaakkola, R., Laitila, A., Ouwehand, A. C., & Lehtoranta, L. (2022). Role of D-mannose in urinary tract infections–a narrative review. Nutrition journal, 21(1), 18.