Painful Bladder – More than a UTI?

Lisa HawesLisa Hawes, M.D., shares the story of a 35-year old female patient who, for more than nine years, lived with the pain and discomfort of recurrent urinary tract infections. At least she thought she had UTIs, but as it turns out, this woman was living with the chronic pelvic condition known as interstitial cystitis (IC).


Interstitial cystitis, also known as painful bladder syndrome, is a chronic inflammatory condition of the bladder lining that causes pain and pressure in the pelvic area around the bladder. IC can be confused with recurrent urinary tract infections but, unlike a UTI, antibiotics won’t help diminish the symptoms of interstitial cystitis.

Lisa Hawes, MD, a urologist with Chesapeake Urology who specializes in female pelvic health conditions, discovered this woman wasn’t living with UTIs and diagnosed her with IC, setting her on a new course of treatment and restoring her quality of life in the process.


“The patient had been complaining of recurrent UTIs for almost nine years. Most of the time, she was treated with antibiotics by her primary care physician and was sent on her way. But over the years, the infections became more frequent and the symptoms more bothersome. She couldn’t figure out what triggered the infections; they weren’t related to sexual intercourse or stress like many UTIs. By the time the patient found her way to my office she had developed chronic symptoms of a UTI that just didn’t go away including constant pressure in her pelvic area accompanied by urinary frequency and urgency, as well as painful urination.  She had this feeling all the time, and it was greatly diminishing her quality of life.

I performed a thorough examination and found that her urine cultures were negative for a UTI. I then diagnosed her with interstitial cystitis through cystoscopy and began treatment.  We combined dietary changes with medication that reduced the inflammation present in her bladder.  

Many women do not realize that diet has a huge effect on symptoms of IC. Certain foods are very acidic which, in turn, makes the urine more acidic and irritating to the bladder. In patients with IC, the bladder is already raw and inflamed. Add acidic urine, and it’s like pouring alcohol over a cut - it really burns. Ironically, people stop drinking fluids to avoid the pain during urination. But the more fluid you drink, the better off you’ll be as the fluids dilute the acid in the urine.

We started by cutting just about every trigger food out of this patient’s diet including caffeine, tomatoes, acidic fruits and juices, bananas, alcohol, carbonated drinks and even chocolate. Eventually, the patient was able to discern which foods triggered her IC, and she was able to slowly put certain foods back into her diet. Now she has her condition managed just through diet and is able to eat almost anything. She knows her trigger foods and has been able to stop taking the medication.

The good news is: patients get significant improvement and relief from painful symptoms of IC once they are properly diagnosed and treated by an experienced urologist.

Many women have to go through years of frustration, however, before they ever receive a proper diagnosis of interstitial cystitis. And many patients with IC who seek constant treatment are often made to feel as if they are crazy or that the symptoms are all in their head. In turn, doctors become frustrated with these patients because they don’t know what’s wrong with them and cannot fix the problem. At some point, women get so exasperated that many just stop seeking treatment!

Women need to know that there is help. Interstitial cystitis is a real problem for many women. I often advise women who have had three or more bladder infections in one year to see a urologist experienced in female pelvic health issues like IC.  Recurrent infections are not only painful but are life limiting. Many women stop having sex and limit their travel or daily activities for fear of getting yet another infection.

Seek the help of a urologist. Patients find significant relief from IC with treatment as well as a renewed sense of health."