UTI Symptoms Not Caused by Bacteria: What Worked for Me
I Have to Pee all the Time, But I Don't Have an Infection
You go to the doctor with what you're sure is a bladder infection, only to find out it's not. A urinalysis shows that there is no bacteria present. So what now?
When I was in this situation, I found out that antibiotics don't help; in fact, they may make things worse. Often a doctor will prescribe antibiotics for UTI symptoms without performing a urinalysis, but that can be a mistake if you're actually dealing with a condition such as bladder spasm or, worse yet, interstitial cystitis. After what I have been through, I would recommend that you insist on a urinalysis before taking antibiotics for urinary symptoms.
Through research and trial and error, I found the things that worked for me. I now have been pain-free for over a year and a half, and I am not taking any medications.
Many women find themselves in a situation like the one I have described at some point in their lives. Their GP or gynecologist may not be very knowledgeable about it. Trying to get information about urinary symptoms that are not caused by bacteria and getting the appropriate treatment can be very frustrating.
The urologist I went to called my problem "bladder spasm," and he took great pains to explain to me how difficult it is to find the cause and right treatment for symptoms like urinary frequency and urgency. He also said that many women have episodes of bladder spasm at some time in their lives, but recover from it completely.
I am not a medical professional. I am sharing my experience in the hope that it helps someone else who is going through this. Every person and every bladder is different. As my urologist pointed out, there are many things that can cause the same symptoms, and the cause of bladder pain can be hard to diagnose.
The Symptoms of Bladder Spasm
The most common symptoms of bladder spasm are:
- Urinary frequency and urgency
- Urethral burning
- Pelvic pain
In my experience, most doctors, especially male doctors, do not perceive these symptoms in a female as a serious medical matter, certainly not an emergency. After all, your vital signs are all fine, an examination doesn't find anything amiss, nothing is showing up in your blood or urine. Therefore, you're fine.
It's easy to get overwhelmed and very emotional when this happens. You're extremely uncomfortable, it's very hard to get any sleep, and you're physically and emotionally frazzled. But try to get a grip on yourself.
If you show up at a doctors office in that condition, it will be even harder to be taken seriously. (In fact, when I showed up at the ER in tears, I was prescribed Xanax by a doctor who obviously thought I was just hysterical.) Also, the pain cycle can feed on itself, and the more emotionally worked up you get, the worse you may feel. Believe me, it will get better.
Bladder First Aid
I'll get into more details later, but if you are suffering right now, this is what I would do:
- Drink Baking Soda Mixed With Water - The first line of defense for me is to drink 1/4 tsp of baking soda (do not exceed two teaspoons of baking soda a day) dissolved in a small amount of water. This neutralizes the acid in your urine. I started feeling better within 10 minutes. I read about it in a book, and it helped me much more than anything any of the doctors I had been going to for months had.
- Take a Hot Bath - I found a soaking in a hot tub to be very palliative.
- Relax your Pelvic Floor Muscles - The muscle you want to relax is the same muscle you work when doing Kegel exercises. Locate the muscle you use to stop your urine flow by tightening it once, then consciously relax it. It seems like it's too simple, but I was really surprised how much better this made me feel.
Don't Strain When You Urinate
This is really important. You've probably been straining to empty every drop when you urinate; try not to do that, it's making things worse. The muscles in that area are all tense, and the nerves are overstimulated. You need to calm them down
Stop Drinking Cranberry Juice!
Do not drink cranberry juice or other fruit juice! it is very acidic and will irritate your bladder. Many people who develop these symptoms have been drinking large quantities of cranberry juice; if you are doing so, stop immediately.
Avoid Acidic Food and Drink
- Immediately stop consuming all carbonated drinks, alcohol and coffee.
- Do not eat any chocolate.
- Drink plenty of plain water, but do not force yourself to drink gallons. Simply drink a glass whenever you think about it.
I give a more comprehensive list of "trigger foods" toward the end of this article.
What To Avoid: Don't Sabotage Yourself
Don't give in and reach for the foods that are hurting you. I really sabotaged myself for a while because I would not give up that one cup of coffee in the morning. Once I got past that, I started to get better. Don't undermine your recovery with that one glass of wine or cup of coffee, the way I did. Just stop. If all goes well, this will be a temporary situation. You can go back to enjoying those things later, but for now, you have to get this situation under control.
Instead of your regular acidic indulgences, milk or vanilla ice cream can be pleasant and very soothing. Make sure you get a brand of ice cream that does not contain a lot of chemicals.
Some Hot Drinks You Can Have
Have hot Vanilla Milk in the morning instead of coffee. Just put a drop of pure vanilla extract, and a little sugar or honey in a mug of hot milk. Some other options are Marshmallow Root, Chamomile or Catnip tea. They are usually well tolerated, and can be beneficial. Make your teas weak until you are sure they don't bother you. Sometimes, just sipping a cup of hot water is comforting, and it helps keep you hydrated.
What's Wrong with Me? Could It Be Interstitial Cystitis?
The answer to that question is maybe, but maybe not.
If you are researching these symptoms on the Internet, or talking to your doctor, you may have heard of interstitial cystitis (IC). It is a chronic inflammation of the lining of the bladder.
If you have urinary frequency and urgency, urethral burning, and pelvic pain, you probably have cystitis, which is bladder inflammation. If it doesn't go away and no other cause can be found for it, then it may be interstitial cystitis.
Interstitial cystitis is often mistaken for a urinary tract infection. Patients may go as long as four years between the time they first experience symptoms and the time they receive their diagnosis. It most commonly affects women, although men can get it too.
IC is diagnosed by ruling out other conditions, such as bladder infections or bladder cancer. Also, when it is advanced, it can be diagnosed by cystoscopy, as there will be visible ulcers on the lining of the bladder. For a cystoscopy, you will have to see a urologist.
IC is a chronic condition. Just because you have urinary symptoms without bacteria does not mean that you have IC. It is a possibility, but many people, especially women, have these symptoms yet they recover completely.
Seeing a Urologist
Once your GP recognizes that you don't have a garden-variety bladder infection, you will probably be referred to a urologist. All of this takes time, and it will likely be a couple of months before you actually see the urologist. Usually the first thing he will want to do is a cystoscopy, for which a tube with a camera on the end is inserted through the urethra into the bladder to examine it. My urologist made an appointment for me to have that test, but it was six weeks away. He said that if I got better before then, I should call and cancel.
The idea of that test really freaked me out, given the way I was feeling. And reading the interstitial cystitis forums I found online, I wasn't optimistic about the outcome. I didn't see a lot of positive comments about how great things were after the diagnosis. Everyone seemed to be on a lot of drugs that were marginally effective at controlling their symptoms, and it sounded like a life sentence to me, one of those conditions you just have to live with.
Don't Lose Hope
Now, looking back, I think most people who get over their problems never go back to the forum to share their story, so just because you don't see many success stories doesn't mean they don't exist. I did get some good advice for dietary changes and supplements from the IC forum, but I had to do a lot of digging. Here, I've tried to condense the information that helped me to make it more accessible for someone having a first experience with bladder irritation.
I never did have the cystoscopy. I was able to get my symptoms under control and opted not to have it. The cause of interstitial cystitis is mysterious, and I was never diagnosed with it, but I feel as though if I had continued to irritate my bladder, I could have developed this chronic condition.
From my reading and research, it sounds like it's important to get your symptoms under control early. Dietary changes when you first experience symptoms can prevent your condition from progressing. Patients who have had an irritated bladder for a longer period of time experience less relief from dietary changes.
If, despite your best effort, you don't get better, by all means have the test. If it turns out you do have interstitial cystitis, there are medications and treatments that may be beneficial to you.
You Don't Have to Live with Cystitis
I found great advice in this book; it was recommended to me by my urologist. I found it to be very helpful and informative. It goes into depth about the causes of cystitis, how to reduce bladder pain and how your diet can impact the condition.
Healing an Irritated Bladder: What Worked for Me
The healthy bladder is coated with a mucosal tissue called the glycosaminoglycan layer, generally referred to as the GAG layer. This layer protects the bladder from direct contact with urine. The GAG layer can become damaged by bacteria or other trauma, such as pelvic surgery, repeated infections, or a complicated pregnancy. I went on a regimen designed to heal the GAG layer.
First of all, go on a low-acid diet. If you look up Interstitial Cystitis diet or IC diet, you will get a lot of varying advice on this. Different people seem to have different triggers. The ones I mention below in the "Common Food Triggers" section should be avoided. Most of them definitely affected me.
One book I read said, "If you wouldn't put it on an open wound, don't eat it," and this resonated with me. So things like hot spices, lemon and vinegar would be off limits. If I ate acidic food, I could feel it within 10 minutes, burning my bladder.
This list is a good starting point. Pay attention to you body. If you feel worse, ask yourself, "What did I eat?"
Common Food Triggers
Foods to Avoid for Bladder Spasm or IC
- Fruits other than pears
- Alcoholic beverages
- Tomatoes and tomato sauce
- Spicy foods
- Carbonated beverages
- Aged cheese
- Sour cream
- Corned beef
- Cured meats like salami, bacon, or ham
- Salad dressing
- Tree nuts
- Artificial flavors
- Vitamin Supplements - Especially Vitamin C
What to Eat
It can be hard, with just a list of things you can't have, to figure out what to eat. There are plenty of foods you can still eat.
- Any meat, poultry, fish, or shellfish is OK, except cured meats like bacon or salami.
- Most vegetables other than tomatoes, onions, or hot peppers are fine.
- You can still eat bread, other than rye and sourdough.
- Dairy foods including milk, butter, cottage cheese, American cheese, and vanilla ice cream work. You can start adding some of the milder aged cheeses in small amounts once you start feeling better.
- Pasta, rice, and most cereals are OK.
- Salads can be a problem because of the dressing, but you can try them with herb infused olive oil and coarse salt.
When you feel better, start slowly adding foods one at a time. It can be tempting to just go back to your regular eating pattern, but you don't want to have to start over. I started with a little mayonnaise on my sandwich because I really missed it.
Add one food at a time, and take it very slowly.
What Supplements I Used
Based on what I read in books and researched on the Internet, I used the supplements and products listed below:
- Glucosamine and Chondroitin (400 mg 3x per day): It coats the GAG layer, giving it a chance to heal.
- Calcium Citrate + Vitamin D (200 mg 2x per day): It helps your body excrete oxalates more efficiently this helps prevent vulvodynia, an associated condition which is also very unpleasant.
- Bromelain (100 GDU 3x per day): Bromelain is an anti-inflammatory enzyme.
- Quercetin (100 mg 3x per day): Quercetin is another anti-inflammatory agent.
- Prelief: Prelief is an antacid that you can take before eating acidic foods. I would not recommend eating acidic foods, even with it, until you get your symptoms somewhat under control. But I did use it occasionally as a precautionary measure if I needed to eat out, and I used it more often as my bladder improved and I was able to return to a more normal diet.
You might want to start off with the glucosamine and chondroitin and work your way down the list. add one supplement at a time and wait a few days before adding the next one, just to make sure it's not a trigger for you. I used 21st Century, Glucosamine 250 mg, Chondroitin 200 mg, just because it doesn't have a lot of extra ingredients in it. I don't think the brand matters so much, but look out for added vitamin C in some of them.
One prescription medication I took for a short time that did help me was Ditropan (oxybutynin chloride). It is supposed to relax your bladder muscles to prevent urgent, frequent urination. At first, I was taking 5 mg a day, and it wasn't helping. But when my doctor raised it to 10 mg a day, it gave me some relief.
This Is Based on My Personal Experience
I am not a medical professional. I only want to share my experience in the hope that it helps someone else who is going through this. Every person and every bladder is different. As my urologist pointed out to me, there are many things that can cause the same symptoms, and the cause of bladder pain can be hard to diagnose. What worked for me may not work for you. If it doesn't, don't give up; keep trying until you find something that does.
If you're really suffering right now, you're probably having a flare. It won't last forever; it will pass. It will take time for your bladder to heal, so don't expect a miracle cure overnight. I have experienced two flares that lasted several months each. I am able to eat a normal diet now, even coffee and chocolate. But if I had to give them up forever to prevent that kind of pain, it would be well worth it. Now I know what I have to do when that feeling comes back.
Some Seasonal Advice
It is December 21 when I am writing this, and I am seeing a spike in visits to this page. That is making me recall the time when I had my very worst flair. It was Christmas time, and the office I work at was full of tasty treats. I love chocolate, and I was not able to resist the lure. If you are suffering right now, and you are eating a lot of chocolate, please stop!
I know it's hard, but nothing is worth that kind of suffering. Give yourself a gift for Christmas. The gift of healing!
There is Great Advice in These Comments
I have had many people visit this page and leave comments. If you need more advice, I would recommend looking through them.
The list is long, but there is some great wisdom to be gained from others who have experienced unexplained bladder pain.
© 2012 Sherry Hewins