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What is the treatment for bladder pain and painful urination inspite of taking macrobid?

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I am 33 year old female. Have been having bladder pain and frequency for over a month now. Painful urination. UTI negative but treated with 7 day course of macrobid. Now the pain has turned into severe urethral pain with pressure prior to and end of urination. Last night started right flank pain. Eased up during day but right now is 8/10 pain.
Posted Wed, 8 Jan 2014 in Urinary and Bladder Problems
Answered by Dr. Rakesh Karanwal 44 minutes later
Brief Answer: Evaluate for causes of UTI with sterile urine Detailed Answer: Hi there, Thanks for your query. Usually, empirical (presumptive) diagnosis is made of UTI due to bacterial infection, and a course of antibiotics is given, with no response. The infection can also be due to yeast or a parasite (Trichomonal), which are normally not looked for in the urine. These infections respond to anti-fungal and anti-amebic drugs respectively. Other conditions which mimic UTI are:- * hypertrophic bladder wall (called Interstitial Cystitis), in which the urine shows no organism; * infection in Pouch of XXXXXXX * Vaginal infection due to yeast or herpes, chlamydia, trichomoniasis. * Kidney stones * Pelvic Inflammatory disease (PID)Interstitial cystitis (painful bladder syndrome). Hence, in your case, persistence of UTI symptoms with a no organisms isolated in urine, should prompt your doctor to investigate for the above mentioned causes. Consult your doctor and apprise him of my opinion. I am certain that he will agree with my opinion; order required tests, and- based on the reports- will arrive at a certain diagnosis and prescribe suitable treatment as advised. Hope I have addressed to your concerns to your complete satisfaction and you find my response helpful and informative. I will be happy to answer further queries, if any. Fond regards and have a nice day, Dr. Rakesh Karanwal
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