Many women know the misery of a urinary tract infection and how easily symptoms can return despite antibiotic therapy. But sometimes symptoms are present and tests show no infective organisms. Less than 1 per cent of people affected by urinary tract pain without bacteria are men. When burning sensation continues and tests show no bacteria are present in the urine, there are many possible causes and treatments that can end the suffering.
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Doctors first take a careful history of when symptoms began and what lifestyle changes occurred at that time. Some women report that symptoms worsen during times related to their menstrual cycle. Changing from oral contraceptives that contain oestrogen to ones that contain only progesterone can eliminate urethral burning for some women.
Interstitial Cystitis (IC) is a painful bladder condition that has a specific set of symptoms and possibly diverse causes, but physicians now lump other painful urinary disorders in a broad category called Painful Bladder Syndrome (PBS). The National Institute of Diabetes and Digestive and Kidney Diseases published this definition: "IC/PBS includes all cases of urinary pain that can't be attributed to other causes such as infection or stones." Although no infective organisms are found in the urine of IC/PBS patients, the presence of antiproliferative factor (APF), which appears to prevent normal repair of the urinary tract lining, is a common finding, often concurrent with other inflammatory conditions such as fibromyalgia or irritable bowel syndrome.
Some dietary chemicals and food intolerance conditions have long been known to irritate urinary tract tissue in some individuals. The Interstitial Cystitis Association (ICA) offers guidelines for bladder-safe foods and suggests keeping a diary of symptoms and foods eaten. Foods to avoid include concentrated tomato products such as sauce or ketchup, alcohol, coffee, tea, sodas and flavoured drinks, processed foods, cured or flavoured meats, cheeses, frozen desserts, pickles, spicy foods, raw onions, sauerkraut, soybeans, tofu, acid fruits (including cranberries), chips, nuts (except cashews), junk foods, fast foods and artificial sweeteners.
According to the Celiac Disease Foundation, many inflammatory diseases are also linked to gluten intolerance, or Celiac disease. If avoiding foods on the ICA list does not completely clear up urethral burning, a gluten-free diet (avoiding all products containing wheat, barley and rye) offers hope. For some individuals, the elimination of milk protein, or casein, is also necessary for a time. Gluten intolerance is lifelong, however dairy products may be tolerated after gluten-induced inflammation subsides.
Hot baths and hot water bottles placed over the bladder can relieve pain. For temporary and quick relief of urethral burning apply tea tree oil to the external meatus.
Occasionally diagnostic tests show irritation at the juncture where the urethra joins the bladder. Rimso is a prescription medication form of Dimethyl Sulfoxide that treats such inflammation and pain with only mild side effects. A doctor can determine if Rimso is appropriate for this type of Interstitial Cystitis.
Avoid feminine hygiene sprays, commercial douches, bubble baths, sanitary pads or toilet paper containing fragrance. Wash only with warm water. If soap is used, it should be a mild natural soap.
Blood in the urine may be a sign of more serious disease. Consult a physician.
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