UTIs and now IC

[confused234]

Hello Doctor,
I had UTI in Jan, April, June and another one on July 21 usually I have burning and frequent urination and bladder irritation but this time I only had frequent urination, bladder and urethra irritation Doc said that I had a high count leukocytes & put me on antibiotics (Cipro). I took the meds for thee days but did not feel better I called the doc and he
ordered another round of antibiotics. I Still did not feel better so I went in, they did a culture on my urine even tested for herpes and both
came back negative however the Doc said I had small traces of blood
in my urine but didn't explain why. Symptoms returned in August but
still no bacteria in my urine went to my gyno and she said it might be
IC she lets wait to see if symptoms return. Well Sep they did and put me on Elmiron. My question is does IC develop after recurent UTIs? If
it is IC will I have it for the rest of my life?  

[David A Burks, MD]

Hi, you need to go to the ICA website:  ishelp.org.  There is a listing of physicians across the country that have expertise in IC.  You would need to see the nearest one and at least do a consultation visit, bring your old records and let him/her give you an opinion regarding the next steps.  Unfortunately, like many other IC patients you have a second pain disorder: IBS.  You will need to so a gastroenterologist for a workup and treatment.  Bladder spasms and the constant urge to void with little or no urine in your bladder is common in IC.  Elavil is an antidepressant but is a first line drug to treat IC, especially when getting up frequently at night is a real problem.  It helps patients sleep, and reduces pain in most IC.  The dose is 10mg for 7 days then 25mg, with gradual increase to 75mg as tolerated.  Drowsiness is the #1 side effect so the dose is  slowly increased.  This may be more effective than Vesicare.  Goo Luck.

[David A Burks, MD]

Hi,  Unfortunately your story is very common.  Patients frequently have symptoms of a uti, the culture is positive for infection, and the patient is successfully treated with antibiotics.  For some reason, patients then develope symptoms but the cultures are negative for infection, and treatment with antibiotics no longer helps.  These patients often have IC as the cause of their current symptoms.  The theory is that the repeated infections somehow damaged the bladder wall allowing bad things in the urine like potassium to get into the bladder wall causing the cascade of inflammation that ends up in pain, frequency and urgency  seen with IC.  Urine cultures show no infection.  To confuse the picture more, these patients with IC can still get recurrent bacterial infections in the urine like 20% of all adult women get.  This is part of the diagnostic challenge in IC when so many patients also have utis with the same symptoms.  Most research studies require you to have  at least 3 months of symptoms and no uti to be diagnosed with IC because  of this confusion. Unfortunately we have no cure for IC but the symptoms often get better or worse spontaneously.  You need to see a Urologist or Urogynecologist who is wxperienced in IC.  Good Luck  

[David A Burks, MD]

Go to theICA website: ichelp.org.  Look under the diet recommendations and eliminate those foods and beverages that can make symptoms worse.  That's the first step.  continue the elmiron until you see your Urologist. Yes, another uti can make symptoms worse. Good Luck.

[kissgrly65]

I've had IC for at least 4 years, they only diagnosed me with it about 2 years ago. I'm on Elmiron and Vesicare. Is it normal to get BAD bladder spasms.?? Sometimes they are so bad it feels like my whole stomach is moving on the inside. And some days I go to the restroom at least 30 + times. And sometimes only be a few drips of urine. And the pain on some days is terrible, all I can do is lay down with a heating pad on me. Is this all normal with IC.???  And I have IBS as well, (mostly I have bad contipation), can that make my IC worse.?? There are days 2-3 days I dont have a BM. Now last week or so, I've got up in the middle of the night to use the restroom and I cant go pee I sit there for about 5 minutes and I have to go but it will not come out, so I go back to bed and go back to sleep and will wake up maybe 1/2 an hour later to go to the restroom and I'll be lucky most of the time I can pee. Is this normal.??  I'm sorry to ask so many questions but I go to a MD doctor and I dont think she knows much about IC. And where I live  I cant seem to find a Doctor that knows about IC that will take my insurance. Thank-you.

[confused234]

Thank you Doctor for the information. Luckily my symtoms are pretty mild, I don't have any bladder pain or urgency. I now urinate about 6 to 10 times a day when i wiuld usually only go around 5 times and some minor bladder irritation and inflammation. I have made an appointment with a urologist  in two weeks can you please tell me if I can do anything to prevent my symtoms from getting worse? Will the Elmiron help keep my symptoms in check? If I do get another Uti will that damage my bladder further?