UTI Symptoms but no Bacteria: What Worked for Me
My Experience With Unexplained Bladder Pain
When I wrote this article in 2012, I had just recovered after suffering from very distressing urinary symptoms for months. While I was suffering, I was desperately searching the Internet for some kind of advice. I had to really dig deep to get anything at all.
I am happy to see that now there is actually some advice available from medical websites such as Web MD. I hope this means that doctors are better informed about this problem and that it is leading to better medical care and less suffering. Still, I think it is helpful to hear about the experience from a patient's perspective. The doctor's don't know what you are going through, but I do.
Some of the subjects I will cover are:
- Symptom relief
- When to see a urologist
- What to eat and which foods to avoid
- Supplements I used
Many people have read this article, and many have left their stories in the comments section. I hope you find something here that will lighten your burden.
I Had to Pee all the Time, But I Didn'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.
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.
Bladder Spasm or Overactive Bladder
The urologist I went to called my problem "bladder spasm." This condition is also known as overactive bladder syndrome or OAB. 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.
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 to urinate: This is really important. You've probably been straining to empty every drop when you urinate; try not to do that because it's making things worse. The muscles in that area are all tense, and the nerves are overstimulated. So instead, you need to calm them down.
- Do not drink cranberry juice or other fruit juice! Cranberry juice 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 certain drinks and foods:
- Immediately stop consuming all carbonated drinks, alcohol, and coffee.
- Do not eat any chocolate. In addition, avoid spicy food and citrus.
- Drink plenty of plain water, but do not force yourself to drink gallons. Simply drink a glass whenever you think about it.
I will give a more comprehensive list of foods to avoid near the end of this article.
Why Don't Doctors Believe Women With Urinary Symptoms?
For many years doctors were taught that urinary symptoms with no discernible cause were psychosomatic. As late as 1984, they questioned whether interstitial cystitis was even a real medical disorder. Tests showed that women with such symptoms were anxious and depressed. Gee, I wonder why that would be? I think the medical community is far too ready to dismiss symptoms they can't explain as being "all in your head."
What are Common Food Triggers for Bladder Spasm or Interstitial Cystitis?
- 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
Healing an Irritated Bladder
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 an Interstitial Cystitis diet or IC diet, you will get varying advice on this. Different people seem to have different triggers. The ones I mention above, 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 my bladder burning within 10 minutes.
This list is a good starting point. Pay attention to you body. If you feel worse, ask yourself, "What did I eat?"
What to Eat When You Have Bladder Pain
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 back 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.
Don't Sabotage Your Recovery
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 Try
- 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 good tea options are marshmallow root, chamomile, catnip, licorice, ginger, or peppermint. 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 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, which helps prevent vulvodynia, an associated condition that 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 and Chondroitin 200 mg, just because it didn'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.
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.
When to See 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. That can seem like a lifetime when you are suffering. Usually, the first thing they will want to do is a cystoscopy, during 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 out. 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. Reading about other people's experiences on the interstitial cystitis forum, 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.
I did get a lot of great information from the IC forum, but I had to do a lot of searching around. I have tried to condense the information here for people having their first experience with bladder inflammation.
Could It Be Interstitial Cystitis (IC) or Bladder Pain Syndrome?
If you are researching these symptoms on the Internet or talking to your doctor, you may have heard of interstitial cystitis (IC) also known as bladder pain syndrome. It is a chronic inflammation of the lining of the bladder. According to the National Institute of Diabetes and Digestive and Kidney Diseases, IC may affect between 3 million and 8 million women and between 1 million and 4 million men in the United States.
What Are the Symptoms of IC?
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—lasts more than six weeks—and no other cause can be found for it, then it may be interstitial cystitis. Some people experience UTI-like symptoms constantly while others experience it intermittently. IC can cause pain during intercourse and can be accompanied by other health issues such as irritable bowel syndrome, fibromyalgia, and other pain-related diseases.
What Is the Cause of IC?
The cause of IC is unknown, and although it can be treated, there is no cure. But take heart, just because you have urinary symptoms without bacteria does not necessarily mean that you have IC.
How Is IC Diagnosed?
Interstitial cystitis is often mistaken for a urinary tract infection. Patients often 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. Not all doctors believe a cystoscopy is necessary or an effective way to diagnose the condition since the exam can be normal but you still may have IC.
What Are Treatment Options for IC?
IC is a chronic condition for which there is no cure. There is not a single treatment that works for everyone. There are two FDA-approved treatments for IC: an oral medication called pentosan polysulfate sodium and a once-weekly treatment where dimethyl sulfoxide (DMSO) is placed directly into the bladder through a catheter. However, some doctors may try other treatments if their patients don't respond to these medications.
People with urethral syndrome experience similar symptoms to those with the other conditions I've described. Like with bladder spasm and IC, people with urethral syndrome have very tight pelvic floor muscles. However, their symptoms originate in the urethra instead of the bladder. The problem can be caused by bacteria, but it is often caused or aggravated by chemical or physical irritation, such as scented feminine products or rough sex.
People with IC or OAB often have urethral syndrome as well. I believe this is largely because of the constant peeing and wiping. Be careful to use a soft, unscented toilet paper that doesn't irritate you. If you are traveling, bring your own along with you. Gas station toilet paper is notoriously cheap and scratchy.
- lower abdominal pain
- urinary urgency
- frequent urination
- blood in urine (often microscopic)
- pain during urination
- pain during sex
- Stop using products that irritate the urethra. Some example are: tampons, scented feminine hygiene products, tight or irritating clothing or scratchy toilet paper.
- Avoid activities that cause irritation such as bicycle riding.
- Vaginal sex may need to be avoided until you've had a chance to heal.
- Doctors sometimes order anesthetics, antispasmodics, antidepressants, or alpha-blockers. If tests show that the patient has an infection, they should be treated with appropriate antibiotics.
Urethral syndrome is another malady that is not well understood by medical science, and it was also considered psychosomatic until recently.
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. I've tried to condense the information that helped me here to make it more accessible.
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 might have developed that 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 it turns out you do have interstitial cystitis, there are medications and treatments that may be beneficial to you.
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.
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 persistent bladder pain.
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
Questions & Answers
I have had pain for 2 months in my bladder. It constantly feels swollen and urethra feels tingly. I have no trouble urinating. After I do urinate though my bladder feels sore and urethra twinges. I have also found I don't feel any different when I eat different types of food. When you did eat though foods did it cause symptoms right away? How long did you live with the symptoms? Should I still cut out that food from my diet?
If you are extremely symptomatic, you won't feel better right away when you change your diet, although very acidic food could make you feel worse.
It sounds like your urethra is irritated. Be careful what kind of toilet paper and feminine products you use (soft and nothing scented). I also found tampons to be very irritating. Also pay attention to relaxing those pelvic floor muscles.Helpful 11
I have an occasional problem with urge incontinence. My doctor said it was probably something that I was eating, most likely caffeine. Checking the internet, I see that many other foods can cause the problem. How long after eating one of these foods is can one expect a bladder spasm? I cut way back on the caffeine. Yesterday I ate a medium size pickle and within a half hour had a mild spasm.
The effects of eating acidic foods can be felt soon after you've eaten it, 15 to 30 minutes. On the other hand, it takes longer to get relief when you stop eating acidic foods. It takes time for the bladder to heal.Helpful 3
I had a UTI for months because my doctor didn't diagnose it in time. I then went to another doctor who treated it after I'd had it for three months. Now, my bladder isn't working regularly, and I am only 14, so it really messes me up. Do you think that my bladder tissue is still healing from the UTI?
There is a good chance that your bladder is still healing. You can help it by following a low acid diet. If you do that, your bladder will probably be feeling better in a few weeks.Helpful 7
Were you able to drink green tea when you quit coffee? I need some tea type of substitute for my coffee.
When I first quit coffee, I took a little caffeine in tablet form, and weaned myself off of it; I just could not function without it. It probably wasn't the best thing, but it didn't seem to have the negative effect on my bladder of drinking coffee.
As a hot drink in the morning to replace coffee, I would have vanilla milk, a very weak catnip tea, or just hot water. If you want to try tea, make it very weak, just dip the bag enough to add a little color to the water.Helpful 5
A microscopic amount of blood in my urine was found, and now, I have a persistent urge to urinate. It's frustrating because my ultrasound came out normal; there are no bacteria in my urine. I’m really nervous that this is going to be an on-going thing. I will try some of the things that worked for you, and I hope I get some relief. I will see a urologist in two weeks. Can these spasms come and go randomly? How long did it last for you?
I'm so sorry you're not feeling well. Symptoms can come and go. Usually, it doesn't go away suddenly once you have severe symptoms, but they can get better gradually. Symptoms can come on suddenly though. That's the time to examine your diet and any other behavior or things in your environment that could give clues to what caused it to flare up.
For me it took three or four months once I got on the program I have described, but for many, it takes longer. We can't even be sure we are all dealing with the same problem since many things can cause the same symptoms.Helpful 5
© 2012 Sherry Hewins