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Bladder Pressure: Interstitial Cystitis vs Urinary Tract Infection

It wouldn’t be an exaggeration to say that the human urinary system is fascinating. While most of us don’t pay much attention to it unless there is a problem, the urinary system plays a vital role in our bodies. It cleans the blood, removes toxins, and regulates blood volume and the elements our blood contains. However, it’s not uncommon to experience urinary system issues. Many of them start with bladder pressure and increased urination. In this article, we’ll discuss the most common culprits for bladder pressure and compare them to help you recognize the distinct signs.

Conditions: Bladder Pressure, Interstitial Cystitis, Urinary Tract Infection

We’ve all been there—no bathroom in sight and you need to go NOW! The discomfort we typically feel at such moments is pressure on the bladder from being full of urine. Women can store ~500 ml of urine, and men can store ~700 ml of urine.

But our bodies are pretty smart. Rather than waiting until the last minute, you typically get the urge to pee when your bladder fills up to 200–350 ml. Then the nerves in your bladder walls signal your brain that it’s time to go. The longer you wait, the more difficult it is to ignore these signals. Once you relieve yourself, the pressure dissipates, and you can relax. Normally, we pee between 4 and 10 times a day depending on how much liquid we consume, how much we sweat, and other factors.


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However, for people suffering from a bladder pressure condition, that ache doesn’t go away with urination and might even increase. In most cases, this type of bladder pressure is associated with a chronic condition called interstitial cystitis (IC). However, urinary tract infections (UTIs) are also a common cause of intense bladder discomfort that usually require some medical attention to cure. Let’s compare the two so we can recognize the differences and know what to watch out for.

Interstitial cystitis vs. urinary tract infection

The table below compares the two most common causes for bladder pressure. If you can recognize the warning signs, you will know when it’s time to seek medical attention. While there are a variety of causes for bladder pressure, these two have very distinct symptoms and both can cause life-long complications, especially if left untreated too long.

Comparison: Interstitial Cystitis vs. Urinary Tract Infection


Interstitial Cystitis

IC, also called bladder pain syndrome, is a condition when the bladder becomes overly sensitive and active. IC causes you to urinate more than normal—up to 60 times a day—even if your bladder is empty. The condition is painful and can make urination and sexual intercourse very uncomfortable.

What causes interstitial cystitis?

Interstitial cystitis isn’t an infection, and the medical community still doesn’t fully understand what causes it. Factors that might trigger or worsen IC include:

  • allergies
  • vascular problems
  • autoimmune response
  • problems with the lining of the bladder wall
  • certain infections that make the bladder over-sensitive
  • genetics

While men sometimes suffer from interstitial cystitis, women are much more prone to developing the condition.

Interstitial cystitis symptoms

The main symptoms of IC are bladder pressure and bladder ache. Other signs to pay attention to:

  • a constant need to urinate (around 60 times a day)
  • urinating in small amounts
  • pelvic pain
  • pain during sex

These symptoms may disappear for a while and then reappear again.

Progression

Most people who develop interstitial cystitis are in their 30s. You might start noticing the symptoms even if you were healthy and had no bladder issues before. While there’s no cure for IC, it’s important to seek medical help. If you don’t make lifestyle changes and start medical treatment immediately, the condition can progress and lead to:

  • decreased bladder capacity and difficulty holding urine
  • pelvic pain and frequent urination, which can cause sleep issues, leading to exhaustion
  • pelvic pain during sex can affect your relationships.

Type of pain

The type and severity of the pain can vary from person to person. In most cases, it starts with pressure in the pelvic area and abdomen. It can progress from mild to severe and last for extended periods.

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Interstitial cystitis treatment

To receive treatment, your doctor needs to diagnose you with IC. This can be challenging because the symptoms of IC resemble many other bladder diseases and conditions. Your doctor will likely  perform a pelvic exam and run various tests such as urine analysis, cystoscopy (inserting a tiny tube into the urethra), biopsy, or urine cytology to rule out other conditions.

Once an IC diagnosis is confirmed, your doctor will recommend treatment options, for example:

  • physical therapy to strengthen the pelvic muscles
  • prescription medications such as pentosan polysulfate sodium  (Elmiron), an approved medicine for IC treatment, or tricyclic antidepressants to alleviate bladder pressure and reduce the need for frequent urination
  • antihistamines may also be recommended if your IC is related to allergies

If initial treatments don’t alleviate the pain and discomfort, more advanced treatment options include:

  • stretching the bladder by filling it with water
  • nerve stimulation targeting the nerves within the bladder
  • bladder instillations, or the direct insertion of one or more medications such as  dimethyl sulfoxide (DMSO), steroids, heparin, sodium bicarbonate, or hyaluronic acid into the bladder.

Lifestyle changes can help. Eliminating foods and beverages such as alcohol, citrus fruits, artificial sweeteners, spicy foods, caffeine, pickled foods, tomatoes, and other acidic foods that irritate the bladder can provide relief.

Quitting smoking is also highly recommended because the toxins found in cigarettes are known to worsen IC.

Can you prevent it?

While IC cannot be prevented or cured since we don’t know what causes it, following a treatment plan can minimize the discomfort and help you feel better.

Urinary Tract Infection

UTIs are commonly occurring infections that can affect every part of the urinary tract. The infection usually starts in the urethra and can travel all the way up to the kidneys.

What causes UTIs?

E. coli bacteria account for approximately 90% of UTIs. These bacteria are always present in the lower intestine and anus and can migrate to the urethra through improper wiping after peeing or pooping, during sex or masturbation, as a result of poor hygiene, or from using a catheter to empty the bladder.

Women are more prone to getting UTIs. In fact, at least 20% of women will get a UTI at some point in their lives. This is due to anatomical differences between males and females. The male urethra is approximately 20 cm long, while the female urethra is only 5 cm long, which makes it much easier for bacteria to travel up the urinary tract before being flushed out by urine.

Some people believe cold temperatures can cause urinary tract infections. While low temperatures don’t cause infection, cold or fluctuating weather can increase your likelihood of getting a UTI. When you feel cold, your kidneys need to filter more blood to protect the internal organs. This increases your need for hydration. If there’s not enough liquid to go around, urine can remain in the urinary tract longer, facilitating prime conditions for bacteria to proliferate.

UTI symptoms

UTIs cause many uncomfortable symptoms, such as:

  • a strong urge to urinate that doesn't go away after peeing
  • a burning sensation while urinating
  • urinating often, and passing small amounts of urine
  • cloudy looking urine
  • blood in the urine—you might notice blood spots after wiping, or urine that looks brown and dark
  • strong-smelling urine
  • pelvic pain
  • back pain—if the infection progresses into the upper urinary tract
  • fever
  • chills
  • feeling generally unwell and tired

However, sometimes UTIs don’t produce any symptoms, which makes them even more dangerous because the bacteria can colonize the upper urinary tract without being noticed and cause more serious complications.

Progression

While UTIs normally start in the lower urinary tract, an infection can affect any part of the urinary system and progress if left untreated.

Complications from an untreated UTI can be dire. One of the worst being permanent kidney damage.

Other complications to be aware of:

  • sepsis and blood poisoning if the bacteria enter your bloodstream
  • recurring UTIs
  • urethral narrowing, especially in men
  • the risk of a low-weight baby if the infection occurs during pregnancy.

Type of pain

Pain from a UTI usually starts at the opening of the urethra, often causing a burning sensation while peeing. As the infection advances, it causes achiness in the pelvic area and abdomen, progressing into lower- and mid-back pain where the kidneys are located.

Treatment

Sometimes, a UTI can resolve on its own. However, in most cases, a cure will require antibiotics, especially if you experience severe pain,  develop fever or nausea, or if the symptoms persist for more than 5–7 days.

Your doctor will perform a urinalysis and examine the urine cultures to determine the cause of your symptoms and the type of infection. Antibiotics commonly used for UTIs include:

  • nitrofurantoin
  • sulfonamides
  • amoxicillin
  • cephalosporins
  • doxycycline
  • fosfomycin
  • quinolones

Can you prevent UTIs?

UTIs are often preventable, and there are many hygiene tips you can follow to lower your risk of contracting a UTI. However, don’t feel bad if you get one, as it happens even to the most vigilant people.

To limit your risks of contracting a UTI:

  • Drink lots of fluids, especially water. The more you drink, the more you urinate,—and urine flushes out unwanted bacteria.
  • Always pee right after sex and masturbation. Lots of skin-to-skin contact and friction make it easier for bacteria to migrate to the urethra.
  • Wipe from front to back: This way, you will avoid bringing bacteria from the anus to the urethra. 
  • Always practice safe sex: Use condoms, and if you engage in both anal and vaginal sex, always use a fresh condom when switching.
  • Use birth control methods other than diaphragms and condoms with spermicide as these can increase the risk of UTIs.
  • Wear loose-fitting, natural-fibre underwear to let your skin breathe and allow sweat to evaporate more easily.

Final words

Living with a chronic condition such as interstitial cystitis or having to endure the painful symptoms of a UTI can seriously detract from your wellbeing. We hope that this information has empowered you to better understand these conditions and recognize their symptoms, so you know when to seek medical assistance and treatment.

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Share this article:
https://www.ncbi.nlm.nih.gov/books/NBK279384/
https://www.kidney.org/atoz/content/interstitial
https://www.mayoclinic.org/diseases-conditions/urinary-tract-infection/symptoms-causes/syc-20353447
https://my.clevelandclinic.org/health/diseases/9135-urinary-tract-infections
https://www.nia.nih.gov/health/15-tips-keep-your-bladder-healthy
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