Using urine dipsticks when you have Interstitial Cystitis
If you asked most folks about the greatest mysteries in the world, they would answer with things like religion, outer space, chickens and eggs, Houdini, the Bermudua triangle and so forth.
But when you have IC, the greatest mystery in the world is whether this is an IC flare or a UTI.
As you know, the pain can be oh-so-similar. We fret and ruminate and worry: Do we bother our doctor and call the clinic to be seen? Will our UA and culture come back negative again? Will we be forced once more to hear the lady at the check-out desk announce her chipper voice “Looks like no follow-up needed! Just call us if you need anything.”
And adding to the frustration and discomfort is the never-ending loop playing in your head: Do I need antibiotics before my kidneys are ravaged by an untreated bladder infection?? Or will my 60-oz-of-water-low-fiber-low-acid-diet-plus-a-massage-and-kinsio-tape-flare-repair get me some relief?
I’ve made the mistake of thinking my sudden onset of intense bladder pain and sensation of peeing razors was just a return of an unwelcome but well known enemy. By the time I actually went to urgent care (because you know, intense lower back pain hadn’t been one of my normal IC symptoms), I had a kidney infection.
My favorite part of that memory is the urgent care NP chastising me with “Why did you wait so long to come in?”
Ha! Mrs. Nurse Practitioner, you have no idea!! If you don’t have, IC you just don’t get it.
Things certainly started to improve once I started the Cipro. Duh. When you have a UTI you need TREATMENT. Like ASAP.
But what I learned from that experience is “trust but verify.” Do not assume that bladder pain is ALWAYS IC.
From then on I always made sure I had a container of Urine Dipsticks at home to check my own urine when a flare shows up. Now, remember, I’ve been in what I would call “in remission” for about 11 yrs.
At this point in my IC journey, I am mostly symptom-free, but every couple of months, my old friend decides to drop by for a cup of tea. And these dipsticks help me to know what I need to do to get back to baseline as quickly as possible.
What are Urine Dipsticks?
So what do I mean by urine dipsticks? These are the little plastic strips with paper squares on them that have chemicals added so that when you pee on them, they can show you what is going on in your Urine.
Some really important info on these though. So please keep reading, I want you to feel better and most importantly I want you to be SAFE.
Urine dipsticks are a tool in your IC toolbox and you have to consider the whole picture. I don’t know anything about you or your own unique health circumstances. So be sure to team up with your provider.
This is a site about self-empowerment in dealing with your IC; we are NOT anti-health care.
- These things go bad quickly. And if you don’t store them properly, it will be VERY quickly, like before the next time you need to use them. It is SUPER important to minimize the time you have the container open. Open the lid, grab the strip and get the lid back on ASAP.
- Never use them beyond the expiration date. I know we’ve all used/drank/eaten things beyond their expiration date. Please don’t do that with these. They are delicate. When they are expired they aren’t accurate. What is the point of bothering with an inaccurate urine dipstick?!?
- Timing matters. On the canister label, it tells you how many seconds before you should read/interpret the result. It is important that you actually read the strip in the timeframes described. You can’t go back and look at it 10 mins later. It will no longer correlate. Again, inaccurate dipstick = worthless test.
- Don’t go crazy and pee all over them until they are drenched. They are fragile and the paper squares on the strip will be damaged. Trust me on this. Just a quick soft drenching. Then gently tap the side of the strip on a paper towel or a couple pieces of toilet paper. All of these instructions come with the strip so take the time to read the insert and follow the directions.
- You do not need a prescription for these. You can easily buy these over-the-counter. Amazon is where I get mine but CVS and Walmart have them too. I don’t tend to get the ones from AZO but that is perfectly fine if you want to try those. They are simple to use but keep reading to find out why I don’t use the AZO ones with the 3 boxes.
- Ladies…don’t forget…if you are on your period, you will be positive for blood on the strips (if the ones you use include that test). Also, for a day or two before and after, you may show as positive for a trace amount of blood. So keep that in mind when you are reading the results.
- The Spouse-Trick: Okay this doesn’t need to be a spouse…a friend, a relative, a boyfriend or girlfriend…doesn’t matter. They just need to be willing to pee on a stick for you. And you need to think well enough of them to not be grossed out by reading the urine dipstick of another person. Those are the 2 qualifying metrics. I’ve had times where I am questioning the results I am seeing and I’m not sure if my strips are still good. Just have another person do a strip and see. If their strip is wonky too, your strips are probably bad. Order more. And close the canister lid next time!!!!
Why I don’t use the AZO UTI Test Kit strips
Simply because I am a Nerd.
I like to track and correlate how I am feeling (bladder wise) with what my Urine is showing. Specifically, Urine PH and Specific Gravity. I am also interested in Ketones (keto diet!) and blood…and of course, and most importantly, the infamous nitrites and leukocytes.
If I want to see how my lifestyle is impacting my bladder, PH and Specific Gravity are things that are fun (and informative) to look at. And the UTI test kits like the ones the CVS and AZO makes don’t include that information.
My strips of choice are the same brand that clinics use when they do a urine dipstick on you. Some clinics put these strips into a Urine Analyzer machine (Clinitek is an example of an automated Urine Analyzer) that automates the reading of the results.
But a lot of clinics just do the old-fashioned dip-the-strip technique and then use a timer to do the readings. And that’s what you’ll be able to do yourself.
Forgive my photography skills, but these are the ones I always get: Mission brand Urinalysis Reagent Strips.
These strips have the following tests on them:
- Specific Gravity
So let’s talk about the ones I look at.
Leukocytes (actually it is measuring Leukocyte Esterase): Leukocyte Esterase is an enzyme produced by neutrophils (a type of white blood cell that is released by the body to deal with some sort of infection). This test isn’t super specific, but it can signal the pyuria (a.k.a. pus) that comes along with a UTI.
BUT, white blood cells coming from ANYWHERE in the genitourinary tract, including your other girl parts, can end up in your urine and will produce this enzyme. Result? You can be positive for this but not actually have a UTI. With this test, you need to look for other correlating factors suggesting a UTI. Also, the timing on this one is imperative: the dipstick should be allowed to sit for at least 30 to 60 seconds before reading this test. Read the lable on your canister for the exact time.
Nitrates: Nitrites are not normally found in pee. But if you have bacteria in your urine going to town and converting urinary nitrates to nitrites, the dipstick will be positive. You need to have bacteria present in your urine for the dipstick to register a positive nitrite.
A positive nitrite test usually means you have a bladder infection. But a negative nitrite test doesn’t necessarily mean you DON’T have an infection. Why? Because not all types of bacteria that can cause a UTI do the nitrate-to-nitrite dance.
Also…the nitrites test is the one most impacted by improper storage or expired dipsticks. Improperly stored dipsticks are the most common cause of a false-positive test for nitrites*.
*This is when I utilize the Spouse-Trick I mentioned earlier. If Mr-never-had-a-uti-in-his-life comes up positive for nitrites, I know I’ve got a bad batch of strips on my hands.
pH: In general, the urine pH reflects the serum pH, but don’t forget that the function of the kidney is to acidify the urine. Normal serum pH is 7.4, but the normal urinary pH can range from 4.5 to 8. A widely accepted normal pH of urine is about 5.5 to 6.5. And don’t forget the higher the number, the more “basic” or “alkaline,” the lower the number the more acidic.
The urine pH is influenced by diet as we all know. After all, that is the whole point of following the IC diet. Urine with a low pH can be the result of the ingestion of certain foods that acidify the urine. Some foods can cause alkaline urine. Meat eaters tend to have more acidic urine, and vegetarians tend to have alkaline urine. If you have a diagnosed UTI, alkaline urine may suggest that the infection is due to a urea-splitting organism (such as proteus).
Specific Gravity: This test gives insight into your hydration status and how concentrated your urine is. And I am VERY interested in my hydration status. I want to know if I am drinking enough fluids. We all know how that can help with a flare.
The normal Spec Grav ranges from 1.003 to 1.030. Spec Grav less than 1.010 suggests you are well hydrated and values greater than 1.020 indicate relative dehydration.
So, the higher the number, the more concentrated your urine is.
Blood: Just what it says. Detects blood in your urine. Interesting enough, urine dipsticks actually test for the peroxidase activity of red blood cells, not for the actual presence of the red blood cells. But you don’t need to worry about that stuff. And don’t forget to consider where you are in your menstrual cycle.
So to sum things up, I love having a bottle of these things around. For two major reasons:
- Helps me gather data on what is happening with my urine during a flare. I can get a better idea of if this is a UTI or not. It’s not perfect but it is better than nothing.
- Helps me gather data when I am at baseline and I can see what PH & Spec Grav seems to keep me the most comfortable.
I feel these strips have been a powerful tool in my quest to understand the “Great Bladder Mystery” that came into my life so many years ago.
I hope you’ll find this info useful too. Good luck and stay well!
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