{"id":1787,"date":"2020-10-23T10:38:18","date_gmt":"2020-10-23T03:38:18","guid":{"rendered":"https:\/\/drsoaraweeurology.com\/?p=1787"},"modified":"2026-08-30T04:33:28","modified_gmt":"2026-08-29T21:33:28","slug":"%d9%85%d8%aa%d9%84%d8%a7%d8%b2%d9%85%d8%a9-%d8%a2%d9%84%d8%a7%d9%85-%d8%a7%d9%84%d9%85%d8%ab%d8%a7%d9%86%d8%a9","status":"publish","type":"post","link":"https:\/\/drsoaraweeurology.com\/ar\/2020\/10\/23\/bladder-pain-syndrome\/","title":{"rendered":"\u0645\u062a\u0644\u0627\u0632\u0645\u0629 \u0623\u0644\u0645 \u0627\u0644\u0645\u062b\u0627\u0646\u0629 (\u0627\u0644\u062a\u0647\u0627\u0628 \u0627\u0644\u0645\u062b\u0627\u0646\u0629 \u0627\u0644\u062e\u0644\u0627\u0644\u064a): \u0639\u0646\u062f\u0645\u0627 \u0644\u0627 \u062a\u064f\u062c\u062f\u064a \u0627\u0644\u0645\u0636\u0627\u062f\u0627\u062a \u0627\u0644\u062d\u064a\u0648\u064a\u0629 \u0646\u0641\u0639\u0627\u064b"},"content":{"rendered":"\n<div class=\"wp-block-columns coblocks-author-columns has-background is-layout-flex wp-container-core-columns-is-layout-52275889 wp-block-columns-is-layout-flex\" style=\"background-color:#8C8C971A;padding-top:2.5rem;padding-right:2.5rem;padding-bottom:2.5rem;padding-left:2.5rem\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:25%\">\n<figure class=\"wp-block-image size-full is-style-rounded\"><img data-recalc-dims=\"1\" fetchpriority=\"high\" decoding=\"async\" width=\"800\" height=\"800\" data-attachment-id=\"7037\" data-permalink=\"https:\/\/drsoaraweeurology.com\/ar\/new-photo-2024\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?fit=800%2C800&amp;ssl=1\" data-orig-size=\"800,800\" data-comments-opened=\"1\" data-image-title=\"Dr. Soarawee Weerasopone \u2014 Board-Certified Urologist in Bangkok, Thailand\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Dr. Soarawee Weerasopone \u2014 Board-Certified Urologist in Bangkok, Thailand&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?fit=800%2C800&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=800%2C800&#038;ssl=1\" alt=\"Best Urologist working in Chonburi and Cambodia\" class=\"wp-image-7037\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?w=800&amp;ssl=1 800w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=300%2C300&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=150%2C150&amp;ssl=1 150w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=768%2C768&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=12%2C12&amp;ssl=1 12w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=600%2C600&amp;ssl=1 600w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=400%2C400&amp;ssl=1 400w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=200%2C200&amp;ssl=1 200w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><\/figure>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:75%\">\n<p class=\"wp-block-paragraph\"><strong><a href=\"https:\/\/drsoaraweeurology.com\/\" target=\"_blank\" rel=\"noreferrer noopener\">Soarawee Weerasopone, Urologist<\/a><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.bangkokhospital.com\/en\/bangkok\/doctor\/dr-soarawee-weerasopone-2\" target=\"_blank\" rel=\"noreferrer noopener\">Bangkok hospital Headquarter, Bangkok<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"tel:+66880221445\" target=\"_blank\" rel=\"noreferrer noopener\">Samitivej Sriracha Hospital \u2014 Urology department: <strong>088-022-1445<\/strong><\/a><\/p>\n\n\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button is-style-outline is-style-outline--1\"><a class=\"wp-block-button__link has-background-background-color has-text-color has-background has-link-color has-small-font-size has-custom-font-size wp-element-button\" href=\"https:\/\/www.bangkokhospital.com\/en\/bangkok\/doctor\/dr-soarawee-weerasopone-2\" style=\"color:#1b4965\" target=\"_blank\" rel=\"noreferrer noopener\">Book a Consultation<\/a><\/div>\n<\/div>\n<\/div>\n<\/div>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<ul class=\"wp-block-social-links aligncenter has-normal-icon-size is-style-default coblocks-animate is-content-justification-center is-layout-flex wp-container-core-social-links-is-layout-3e41869c 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8.83 8.83 0 0 1-.022-.547C0 13.221 0 12.985 0 12.704c0-.281 0-.515.001-.704a8.81 8.81 0 0 1 .022-.547 3.802 3.802 0 0 1 .044-.366c.02-.094.048-.203.082-.328.134-.471.385-.864.752-1.176.368-.313.847-.469 1.434-.469.477 0 .892.087 1.246.262.353.175.622.443.806.804.044.083.083.157.117.222.034.066.069.144.105.235.022.054.011.099-.034.135l-.66.292c-.045.027-.082.013-.112-.045a4.043 4.043 0 0 0-.155-.27 1.247 1.247 0 0 0-.49-.495c-.225-.131-.522-.196-.892-.196-.402 0-.726.064-.972.193-.247.13-.422.302-.527.518-.027.045-.054.099-.082.16a1.39 1.39 0 0 0-.067.197 2.46 2.46 0 0 0-.05.282 5.51 5.51 0 0 0-.033.43c-.008.17-.013.376-.013.617 0 .242.005.448.013.618.008.17.02.314.034.43.013.117.03.21.05.282.02.072.042.137.066.197.105.216.28.39.527.518.246.13.57.193.972.193.4 0 .714-.07.94-.21.227-.14.394-.346.503-.617a2.43 2.43 0 0 0 .104-.395c.018-.123.027-.282.027-.477V13.2H2.34c-.04 0-.06-.02-.06-.062v-.5c0-.04.02-.062.06-.062h1.812c.04 0 .062.02.062.06v.5c0 .156-.005.296-.014.422a4.71 4.71 0 0 1-.04.342 1.732 1.732 0 0 1-.064.262c-.13.523-.402.913-.815 1.17-.413.255-.95.382-1.61.382z\"\/>\n    <\/svg>\n  <\/a>\n  \n  <a href=\"https:\/\/orcid.org\/0009-0004-8387-3559\" \n     target=\"_blank\" \n     rel=\"noopener\"\n     title=\"ORCID iD\"\n     aria-label=\"View ORCID Profile\"\n     style=\"text-decoration: none; color: #A6CE39; transition: transform 0.2s; display: inline-block;\"\n     onmouseover=\"this.style.transform='scale(1.15)'\"\n     onmouseout=\"this.style.transform='scale(1)'\">\n    <svg width=\"28\" height=\"28\" viewBox=\"0 0 24 24\" fill=\"currentColor\">\n      <path d=\"M12 0C5.372 0 0 5.372 0 12s5.372 12 12 12 12-5.372 12-12S18.628 0 12 0zM7.369 4.378c.525 0 .947.431.947.947 0 .525-.422.947-.947.947-.525 0-.946-.422-.946-.947 0-.525.421-.947.946-.947zm-.722 3.038h1.444v10.041H6.647V7.416zm3.562 0h3.9c3.712 0 5.344 2.653 5.344 5.025 0 2.578-2.016 5.025-5.325 5.025h-3.919V7.416zm1.444 1.303v7.444h2.297c3.272 0 4.022-2.484 4.022-3.722 0-2.016-1.284-3.722-4.097-3.722h-2.222z\"\/>\n    <\/svg>\n  <\/a>\n  \n  <a href=\"https:\/\/scholar.google.com\/citations?user=lTgsRMUAAAAJ&#038;hl=en\" \n     target=\"_blank\" \n     rel=\"noopener\"\n     title=\"Google Scholar\"\n     aria-label=\"View Google Scholar Profile\"\n     style=\"text-decoration: none; color: #4285F4; transition: transform 0.2s; display: inline-block;\"\n     onmouseover=\"this.style.transform='scale(1.15)'\"\n     onmouseout=\"this.style.transform='scale(1)'\">\n    <svg width=\"28\" height=\"28\" viewBox=\"0 0 24 24\" fill=\"currentColor\">\n      <path d=\"M5.242 13.769L0.5 9.5 12 1l11.5 8.5-4.742 4.269C17.548 11.249 14.978 9.5 12 9.5c-2.977 0-5.548 1.748-6.758 4.269zM12 10a7 7 0 1 0 0 14 7 7 0 0 0 0-14z\"\/>\n    <\/svg>\n  <\/a>\n  \n<\/div>\n\n\n\n<p class=\"has-drop-cap wp-block-paragraph\">A large number of the women who come to my clinic with bladder pain arrive after months of going from clinic to clinic. The pattern is almost always the same: a bladder infection is suspected, antibiotics are prescribed, the course finishes, and nothing improves. Then it happens again. When that cycle keeps repeating, one condition deserves serious consideration \u2014 <strong><em><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/30566978\/\">bladder pain syndrome<\/a><\/em><\/strong>, also known as <strong><em>interstitial cystitis<\/em><\/strong>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">If that describes your experience, the most useful thing to know straight away is this: <strong>the antibiotics were not failing because the dose was wrong or the bacteria were resistant. They were failing because there is no infection to treat.<\/strong><\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" decoding=\"async\" width=\"800\" height=\"533\" data-attachment-id=\"1801\" data-permalink=\"https:\/\/drsoaraweeurology.com\/ar\/young-woman-feels-bad-and-experiences-abdominal-pain-during-the-period-of-pms-and-menstruation-painful-menstruation-inflammation-and-bladder-infection\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/10\/Unnecessary-Oral-ATB.jpg?fit=1200%2C800&amp;ssl=1\" data-orig-size=\"1200,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;1.4&quot;,&quot;camera&quot;:&quot;Canon EOS 7D&quot;,&quot;caption&quot;:&quot;Young woman feels bad and experiences abdominal pain during the period of PMS and menstruation. Painful menstruation. Inflammation and Bladder Infection&quot;,&quot;created_timestamp&quot;:&quot;1543595036&quot;,&quot;focal_length&quot;:&quot;30&quot;,&quot;iso&quot;:&quot;400&quot;,&quot;shutter_speed&quot;:&quot;0.033333333333333&quot;,&quot;title&quot;:&quot;Young woman feels bad and experiences abdominal pain during the period of PMS and menstruation. Painful menstruation. Inflammation and Bladder Infection&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Imprecise diagnosis may lead into unnecessary antibiotic usage\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Imprecise diagnosis may lead into unnecessary antibiotic usage&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/10\/Unnecessary-Oral-ATB.jpg?fit=800%2C534&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/10\/Unnecessary-Oral-ATB.jpg?resize=800%2C533&#038;ssl=1\" alt=\"Antibiotic capsules, often prescribed repeatedly and without benefit in bladder pain syndrome\" class=\"wp-image-1801\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/10\/Unnecessary-Oral-ATB.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/10\/Unnecessary-Oral-ATB.jpg?resize=300%2C200&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/10\/Unnecessary-Oral-ATB.jpg?resize=1024%2C683&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/10\/Unnecessary-Oral-ATB.jpg?resize=768%2C512&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/10\/Unnecessary-Oral-ATB.jpg?resize=16%2C12&amp;ssl=1 16w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">An imprecise diagnosis leads to repeated, unnecessary courses of antibiotics.<\/figcaption><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">Bladder pain syndrome (BPS) is a chronic painful bladder condition reported to affect at least 2.7% of women in the US. It has a long-lasting effect on quality of life and, because of the repeated consultations and treatments, a considerable financial cost too. It occurs in men as well, where it is frequently mistaken for chronic prostatitis, so the description below is not exclusively a women&#8217;s condition.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">One thing to say before the medicine, because a great many patients arrive having been told it. <strong>This is not a condition you are imagining, and it is not a psychological illness.<\/strong> It is a real disorder of a real organ, and the reason it took so long to name is that the tests that would show it do not exist rather than that there is nothing there. If you have been made to feel otherwise along the way, that was a failure of the explanation, not of you.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">How the diagnosis is made<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">BPS is suspected when the following criteria are met (American Urological Association):<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li>An unpleasant sensation \u2014 pain, pressure or discomfort \u2014 perceived as coming from the bladder<\/li>\n\n\n\n<li>Frequent urination, or an urgent need to pass urine<\/li>\n\n\n\n<li>Symptoms persisting for more than 6 weeks<\/li>\n\n\n\n<li>No infection or other identifiable cause<\/li>\n<\/ol>\n\n\n\n<p class=\"wp-block-paragraph\">There is no single definitive test, so the diagnosis rests on the clinical picture and on excluding other conditions. That exclusion matters: anyone suspected of BPS should be investigated to make sure nothing else is hiding behind the symptoms, infection and bladder cancer in particular. <strong>Blood in the urine is not a feature of bladder pain syndrome<\/strong> \u2014 if it appears, it needs investigating in its own right rather than being attributed to the syndrome. Cystoscopy is optional rather than mandatory; it adds confidence if it reveals the characteristic <em>Hunner&#8217;s lesions<\/em>, but their absence does not rule BPS out, and a trial of treatment is reasonable either way.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A related point that matters once you have the label. <strong>A diagnosis of BPS is not a reason to stop taking new symptoms seriously.<\/strong> Anything genuinely new \u2014 blood in the urine, fever, weight loss, pain that wakes you from sleep, or a change in the character of the pain rather than its intensity \u2014 needs assessing on its own merits. The risk with any chronic diagnosis is that everything afterwards gets attributed to it, and that is worth guarding against deliberately.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">And two situations need the same day rather than an appointment: <strong>fever or shaking chills with back or flank pain, or being unable to pass urine at all. Go to an emergency department \u2014 in Thailand you can call 1669.<\/strong> Neither is caused by bladder pain syndrome, which is exactly why they matter.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Why it happens<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">Several theories exist, and the honest answer is that the cause is not fully understood. Two explanations carry most of the weight:<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" decoding=\"async\" width=\"800\" height=\"1045\" data-attachment-id=\"1797\" data-permalink=\"https:\/\/drsoaraweeurology.com\/ar\/3d-medical-image-showing-bladder\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/10\/bladder.jpg?fit=1200%2C1568&amp;ssl=1\" data-orig-size=\"1200,1568\" data-comments-opened=\"1\" data-image-meta=\"{&quot;caption&quot;:&quot;3D render of a medical image of a male figure with bladder highlighted&quot;,&quot;created_timestamp&quot;:&quot;1476873135&quot;,&quot;title&quot;:&quot;3D medical image showing bladder&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Lots of theories try to explain what is the possibly cause of BPS\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Lots of theories try to explain what is the possibly cause of BPS&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/10\/bladder.jpg?fit=784%2C1024&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/10\/bladder.jpg?resize=800%2C1045&#038;ssl=1\" alt=\"Diagram of the bladder wall and its protective mucosal lining\" class=\"wp-image-1797\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/10\/bladder.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/10\/bladder.jpg?resize=230%2C300&amp;ssl=1 230w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/10\/bladder.jpg?resize=784%2C1024&amp;ssl=1 784w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/10\/bladder.jpg?resize=768%2C1004&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/10\/bladder.jpg?resize=1176%2C1536&amp;ssl=1 1176w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/10\/bladder.jpg?resize=9%2C12&amp;ssl=1 9w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">Both leading theories centre on the bladder&#8217;s protective lining and its nerve endings.<\/figcaption><\/figure>\n\n\n\n<ol class=\"wp-block-list\">\n<li>The protective outer layer of the bladder lining is disrupted, letting chemicals in the urine reach the deeper layer, which is dense with nerve endings \u2014 producing pain from something the bladder would normally tolerate without complaint.<\/li>\n\n\n\n<li>Repeated urinary tract infections set off inflammatory pathways in the bladder lining that persist as abnormal chronic sensation long after the infection itself has cleared.<\/li>\n<\/ol>\n\n\n\n<p class=\"wp-block-paragraph\">It is also common for BPS to sit alongside other conditions in which the body&#8217;s pain signalling behaves similarly \u2014 irritable bowel syndrome, fibromyalgia, chronic fatigue, and chronic pelvic pain among them. If you recognise more than one of those in yourself, that is a useful thing to mention rather than a coincidence, because it sometimes changes which treatments are tried first.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Treatment: start gently, step up if needed<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">Management begins conservatively and becomes more interventional only if the response is not good enough.<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Behavioural change and dietary adjustment \u2014 keeping track of which foods and drinks reliably worsen your symptoms is genuinely useful, because the triggers differ between individuals.<\/li>\n\n\n\n<li>Pelvic floor physiotherapy<\/li>\n\n\n\n<li>Stress reduction \u2014 stress does not cause BPS, but it reliably amplifies the symptoms<\/li>\n\n\n\n<li>Oral medication \u2014 reported success rates of up to 77%<\/li>\n\n\n\n<li>Intravesical therapy, where medication is instilled directly into the bladder \u2014 reported success rates of up to 93%<\/li>\n\n\n\n<li>Sacral neuromodulation \u2014 reserved for cases that do not respond to the above, given its cost and invasiveness<\/li>\n<\/ol>\n\n\n\n<p class=\"wp-block-paragraph\">Those success figures come from published series of selected patients rather than from a guarantee, and the higher ones sit at the far end of the reported range. They are a reason for optimism about the stepwise approach, not a promise about any individual.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Making the first step actually work<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">Dietary adjustment is the step patients most often abandon, usually because it is given as an instruction to avoid a long list of things at once. That is both miserable and unnecessary, since most people react to only a few of them. A more workable method is to cut out the usual suspects for a couple of weeks, then reintroduce them one at a time and watch what happens.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The items that most commonly provoke symptoms are coffee and tea, alcohol, carbonated drinks, citrus fruits and juices, tomatoes, spicy food, and artificial sweeteners. Your own list will be shorter than that one. Keeping a simple record for a week or two \u2014 what you drank and ate, and how the bladder was \u2014 is what turns a guess into something you can act on, and it is also the single most useful thing to bring to your appointment.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">One correction worth making, because it is the commonest self-management mistake in this condition: <strong>do not cut down on fluids to reduce how often you go.<\/strong> It is an understandable instinct, and it makes things worse \u2014 less fluid means more concentrated urine, and more concentrated urine is more irritating to a bladder lining that is already sensitive. Drink normally, and reduce the specific things that trigger you instead.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" width=\"800\" height=\"533\" data-attachment-id=\"1798\" data-permalink=\"https:\/\/drsoaraweeurology.com\/ar\/diet-alteration\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/10\/Diet-alteration.jpg?fit=1200%2C800&amp;ssl=1\" data-orig-size=\"1200,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;2.8&quot;,&quot;camera&quot;:&quot;Canon EOS 5D Mark III&quot;,&quot;created_timestamp&quot;:&quot;1559055296&quot;,&quot;focal_length&quot;:&quot;50&quot;,&quot;iso&quot;:&quot;500&quot;,&quot;shutter_speed&quot;:&quot;0.003125&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Observant habit on any diet that worsen BPS is recommended\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Observant habit on any diet that worsen BPS is recommended&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/10\/Diet-alteration.jpg?fit=800%2C534&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/10\/Diet-alteration.jpg?resize=800%2C533&#038;ssl=1\" alt=\"Foods and drinks, some of which trigger bladder pain syndrome symptoms\" class=\"wp-image-1798\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/10\/Diet-alteration.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/10\/Diet-alteration.jpg?resize=300%2C200&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/10\/Diet-alteration.jpg?resize=1024%2C683&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/10\/Diet-alteration.jpg?resize=768%2C512&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/10\/Diet-alteration.jpg?resize=16%2C12&amp;ssl=1 16w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">Tracking which foods worsen your symptoms is worth the effort \u2014 triggers vary between people.<\/figcaption><\/figure>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" width=\"800\" height=\"533\" data-attachment-id=\"1800\" data-permalink=\"https:\/\/drsoaraweeurology.com\/ar\/portrait-beautiful-young-asian-women-happy-smile-relax-around-sea-beach-ocean\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/10\/Stress-reduction.jpg?fit=1200%2C800&amp;ssl=1\" data-orig-size=\"1200,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;1.4&quot;,&quot;credit&quot;:&quot;siraphol s.&quot;,&quot;camera&quot;:&quot;ILCE-7M3&quot;,&quot;caption&quot;:&quot;Portrait beautiful young asian women happy smile relax around sea beach ocean at sunrise or sunset time&quot;,&quot;created_timestamp&quot;:&quot;1574846483&quot;,&quot;copyright&quot;:&quot;siraphol s.&quot;,&quot;focal_length&quot;:&quot;24&quot;,&quot;iso&quot;:&quot;100&quot;,&quot;shutter_speed&quot;:&quot;0.00125&quot;,&quot;title&quot;:&quot;Portrait beautiful young asian women happy smile relax around sea beach ocean&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Any kind of Stress reduction method may give benefit on BPS\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Any kind of Stress reduction method may give benefit on BPS&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/10\/Stress-reduction.jpg?fit=800%2C534&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/10\/Stress-reduction.jpg?resize=800%2C533&#038;ssl=1\" alt=\"A woman practising relaxation, part of conservative management for bladder pain syndrome\" class=\"wp-image-1800\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/10\/Stress-reduction.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/10\/Stress-reduction.jpg?resize=300%2C200&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/10\/Stress-reduction.jpg?resize=1024%2C683&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/10\/Stress-reduction.jpg?resize=768%2C512&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/10\/Stress-reduction.jpg?resize=16%2C12&amp;ssl=1 16w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">Stress does not cause the condition, but it does amplify the symptoms.<\/figcaption><\/figure>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" width=\"800\" height=\"533\" data-attachment-id=\"1799\" data-permalink=\"https:\/\/drsoaraweeurology.com\/ar\/cropped-view-of-woman-pouring-pills-from-bottle\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/10\/Oral-medication.jpg?fit=1200%2C800&amp;ssl=1\" data-orig-size=\"1200,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;3.2&quot;,&quot;camera&quot;:&quot;Canon EOS 6D&quot;,&quot;caption&quot;:&quot;Cropped view of woman pouring pills from bottle onto palm. Front view.&quot;,&quot;created_timestamp&quot;:&quot;1498320897&quot;,&quot;focal_length&quot;:&quot;70&quot;,&quot;iso&quot;:&quot;200&quot;,&quot;shutter_speed&quot;:&quot;0.01&quot;,&quot;title&quot;:&quot;Cropped View of Woman Pouring Pills From Bottle&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Oral medication is a good trial in BPS management\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Oral medication is a good trial in BPS management&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/10\/Oral-medication.jpg?fit=800%2C534&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/10\/Oral-medication.jpg?resize=800%2C533&#038;ssl=1\" alt=\"Oral medication used in the stepwise treatment of bladder pain syndrome\" class=\"wp-image-1799\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/10\/Oral-medication.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/10\/Oral-medication.jpg?resize=300%2C200&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/10\/Oral-medication.jpg?resize=1024%2C683&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/10\/Oral-medication.jpg?resize=768%2C512&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/10\/Oral-medication.jpg?resize=16%2C12&amp;ssl=1 16w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">Oral medication is a reasonable early trial in bladder pain syndrome.<\/figcaption><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">At Bangkok Hospital Headquarters I manage bladder pain syndrome through the conservative and medical steps above, and <strong>I perform intravesical instillation therapy myself<\/strong> \u2014 so the full pathway from assessment through to bladder instillation is available in one place. Sacral neuromodulation is not performed at BHQ; if your case reaches that point, a referral to a centre that provides it can be arranged.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Most patients improve with treatment. What has to be said honestly is that symptoms commonly relapse, so this is a condition to be managed over time rather than cured once. Knowing that in advance changes the experience completely: a flare after months of doing well is a normal feature of the condition, not evidence that the treatment has failed or that something was missed.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Living with persistent pain takes a toll, and in a condition that took months to name and that relapses, that toll is entirely understandable rather than a sign of weakness. If the pain is affecting your sleep, your work or your mood, please say so at your appointment \u2014 it is relevant clinical information, it changes what is offered, and support for the burden of chronic pain is part of treating the condition rather than an admission that the problem is psychological.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">If you have been suffering from chronic bladder pain, frequent urination, or recurrent UTI-like symptoms that don&#8217;t respond to antibiotics, Dr. Soarawee Weerasopone offers specialist consultations at Bangkok Hospital Headquarters. <a href=\"https:\/\/www.bangkokhospital.com\/en\/bangkok\/doctor\/dr-soarawee-weerasopone-2\" target=\"_blank\" rel=\"noreferrer noopener\">Book a Consultation<\/a>. Appointments at Samitivej Sriracha Hospital can be arranged by calling the Urology department on <a href=\"tel:0880221445\">088-022-1445<\/a>. Questions about the cost of consultation or treatment should go to the hospital directly \u2014 for Bangkok Hospital, by email to <a href=\"mailto:bhquro@bdms.co.th\">bhquro@bdms.co.th<\/a>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Bangkok Hospital also runs a Telemedicine service, arranged in advance by email to the Urology department at <a href=\"mailto:bhquro@bdms.co.th\">bhquro@bdms.co.th<\/a>. It suits this condition well for reviewing previous results, going through what has already been tried, and planning the next step \u2014 particularly for patients who have accumulated years of records at several clinics. Bring or send those records, especially any urine culture results, since a run of negative cultures alongside persistent symptoms is one of the most useful things in the file. Examination, cystoscopy and instillation therapy are done in person. Samitivej Sriracha is in-person only.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Frequently Asked Questions about Bladder Pain Syndrome<\/h2>\n\n\n\n<div class=\"schema-faq wp-block-yoast-faq-block\"><div class=\"schema-faq-section\" id=\"faq-question-1\"><strong class=\"schema-faq-question\">What is bladder pain syndrome (interstitial cystitis)?<\/strong> <p class=\"schema-faq-answer\">Bladder pain syndrome (BPS), also known as interstitial cystitis, is a chronic condition characterized by persistent bladder pain, pressure, or discomfort lasting more than 6 weeks, accompanied by urinary frequency and urgency, in the absence of any identifiable infection or other cause. It affects approximately 2.7% of women and can significantly impair quality of life. It occurs in men too, where it is often mistaken for chronic prostatitis.<\/p><\/div> <div class=\"schema-faq-section\" id=\"faq-question-2\"><strong class=\"schema-faq-question\">How is bladder pain syndrome different from a bladder infection?<\/strong> <p class=\"schema-faq-answer\">Bladder pain syndrome and urinary tract infection (UTI) share similar symptoms such as bladder discomfort and frequent urination, but BPS has no bacterial cause. Unlike a UTI, BPS does not respond to antibiotics and is a chronic, recurring condition. Many BPS patients are misdiagnosed with recurrent UTIs and given repeated courses of antibiotics without improvement before the correct diagnosis is made.<\/p><\/div> <div class=\"schema-faq-section\" id=\"faq-question-3\"><strong class=\"schema-faq-question\">Is bladder pain syndrome psychological?<\/strong> <p class=\"schema-faq-answer\">No. It is a genuine disorder of the bladder, and the reason it is often diagnosed late is that no single test demonstrates it, not that there is nothing to find. Stress does not cause the condition, although it reliably amplifies the symptoms, as it does with most chronic pain. Many patients arrive having been told or made to feel that the problem is in their head; that reflects a failure of explanation rather than anything about the patient. Living with persistent pain does take a real toll, and mentioning its effect on sleep, work or mood is useful clinical information rather than an admission that the condition is psychological.<\/p><\/div> <div class=\"schema-faq-section\" id=\"faq-question-4\"><strong class=\"schema-faq-question\">What causes bladder pain syndrome?<\/strong> <p class=\"schema-faq-answer\">The exact cause of BPS is not fully understood. The two leading theories involve either a disruption in the bladder mucosal lining that allows urine to irritate underlying nerve endings, or repeated urinary tract infections that trigger chronic inflammation pathways even after the infection has cleared. Both mechanisms result in hypersensitivity and persistent bladder pain. BPS also commonly occurs alongside other conditions in which pain signalling behaves similarly, including irritable bowel syndrome, fibromyalgia, chronic fatigue and chronic pelvic pain.<\/p><\/div> <div class=\"schema-faq-section\" id=\"faq-question-5\"><strong class=\"schema-faq-question\">Which foods and drinks should I avoid?<\/strong> <p class=\"schema-faq-answer\">The items that most commonly provoke symptoms are coffee and tea, alcohol, carbonated drinks, citrus fruits and juices, tomatoes, spicy food, and artificial sweeteners. Most people react to only a few of these, so avoiding the whole list permanently is unnecessary. A workable approach is to cut out the usual suspects for a couple of weeks, then reintroduce them one at a time while keeping a simple record of what you consumed and how the bladder behaved. Importantly, do not reduce your fluid intake to cut down on how often you go: less fluid means more concentrated urine, which is more irritating to an already sensitive bladder lining.<\/p><\/div> <div class=\"schema-faq-section\" id=\"faq-question-6\"><strong class=\"schema-faq-question\">How is bladder pain syndrome treated?<\/strong> <p class=\"schema-faq-answer\">Treatment follows a stepwise approach. First-line options include dietary changes, behavioral modification, pelvic floor physiotherapy, and stress reduction. Oral medications offer up to 77% success rates, while intravesical therapy (bladder instillation) achieves up to 93% improvement. For refractory cases, sacral nerve modulation may be considered. These figures come from published series of selected patients and represent the upper end of the reported range rather than a guarantee.<\/p><\/div> <div class=\"schema-faq-section\" id=\"faq-question-7\"><strong class=\"schema-faq-question\">I have BPS. Which new symptoms should I still take seriously?<\/strong> <p class=\"schema-faq-answer\">A diagnosis of BPS is not a reason to attribute everything that follows to it. Blood in the urine is not a feature of bladder pain syndrome and must be investigated in its own right. Fever, weight loss, pain that wakes you from sleep, or a change in the character of the pain rather than its intensity all need assessing on their own merits. Fever or shaking chills with back or flank pain, and being unable to pass urine at all, need same-day emergency assessment; in Thailand the emergency number is 1669. Neither is caused by bladder pain syndrome, which is precisely why they matter.<\/p><\/div> <div class=\"schema-faq-section\" id=\"faq-question-8\"><strong class=\"schema-faq-question\">Can bladder pain syndrome be cured?<\/strong> <p class=\"schema-faq-answer\">While many patients improve significantly with treatment, BPS is often a relapsing condition. Complete cure is not always achievable, but symptoms can be well-controlled with appropriate management. Long-term follow-up with a urologist, patient education about the disease&#8217;s natural history, and individualized treatment planning are key to maintaining a good quality of life. A flare after a good period is a normal feature of the condition rather than evidence of treatment failure.<\/p><\/div> <div class=\"schema-faq-section\" id=\"faq-question-9\"><strong class=\"schema-faq-question\">Can I discuss this by video consultation?<\/strong> <p class=\"schema-faq-answer\">Yes, and it suits this condition well for reviewing previous results, going through what has already been tried and planning the next step, particularly for patients who have accumulated records at several clinics over years. Bangkok Hospital Headquarters offers a Telemedicine service, arranged in advance by email to the Urology department at bhquro@bdms.co.th. Send previous records with the request, especially urine culture results, since a run of negative cultures alongside persistent symptoms is one of the most useful things in the file. Examination, cystoscopy and instillation therapy are done in person. Samitivej Sriracha is in-person only, booked through the Urology department line 088-022-1445.<\/p><\/div><\/div>\n\n\n\n<script type=\"application\/ld+json\">\n{\n  \"@context\": \"https:\/\/schema.org\",\n  \"@graph\": [\n    {\n      \"@type\": \"MedicalWebPage\",\n      \"@id\": \"https:\/\/drsoaraweeurology.com\/2020\/10\/23\/bladder-pain-syndrome\/#webpage\",\n      \"url\": \"https:\/\/drsoaraweeurology.com\/2020\/10\/23\/bladder-pain-syndrome\/\",\n      \"name\": \"Bladder Pain Syndrome (Interstitial Cystitis): When Antibiotics Never Help\",\n      \"description\": \"Why repeated antibiotic courses fail in bladder pain syndrome, the diagnostic criteria and what must be excluded first, the two leading theories of cause, how to make dietary adjustment actually workable, which new symptoms must not be attributed to the syndrome, and the stepwise treatment from dietary change through to intravesical instillation.\",\n      \"inLanguage\": \"en\",\n      \"datePublished\": \"2020-10-23\",\n      \"dateModified\": \"2026-08-30\",\n      \"lastReviewed\": \"2026-08-30\",\n      \"specialty\": \"https:\/\/schema.org\/Urologic\",\n      \"medicalAudience\": { \"@type\": \"MedicalAudience\", \"audienceType\": \"Patient\" },\n      \"isPartOf\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#website\" },\n      \"author\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#physician\" },\n      \"reviewedBy\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#physician\" },\n      \"publisher\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#physician\" },\n      \"about\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/2020\/10\/23\/bladder-pain-syndrome\/#bps\" }\n    },\n    {\n      \"@type\": \"MedicalCondition\",\n      \"@id\": \"https:\/\/drsoaraweeurology.com\/2020\/10\/23\/bladder-pain-syndrome\/#bps\",\n      \"name\": \"Bladder pain syndrome\",\n      \"alternateName\": \"Interstitial cystitis\",\n      \"description\": \"A chronic painful bladder condition reported to affect at least 2.7% of women in the US, and occurring in men where it is often mistaken for chronic prostatitis. Diagnosis rests on an unpleasant sensation perceived as coming from the bladder, urinary frequency or urgency, symptoms lasting more than six weeks, and no infection or other identifiable cause. There is no bacterial cause, which is why repeated antibiotic courses fail \u2014 not because of dose or resistance, but because there is no infection to treat. It is a genuine disorder of the bladder and not a psychological illness; late diagnosis reflects the absence of a definitive test rather than the absence of pathology. The cause is not fully understood; the two leading theories are disruption of the protective bladder lining allowing urinary chemicals to reach nerve endings, and inflammatory pathways persisting after repeated infections have cleared.\",\n      \"signOrSymptom\": [\n        {\"@type\": \"MedicalSignOrSymptom\", \"name\": \"Bladder pain, pressure or discomfort\"},\n        {\"@type\": \"MedicalSignOrSymptom\", \"name\": \"Urinary frequency\"},\n        {\"@type\": \"MedicalSignOrSymptom\", \"name\": \"Urinary urgency\"}\n      ],\n      \"differentialDiagnosis\": [\n        {\n          \"@type\": \"DDxElement\",\n          \"diagnosis\": {\"@type\": \"MedicalCondition\", \"name\": \"Urinary tract infection\"},\n          \"distinguishingSign\": {\"@type\": \"MedicalSignOrSymptom\", \"name\": \"Positive urine culture and response to antibiotics, both absent in bladder pain syndrome. Fever or rigors with flank pain indicates infection and requires same-day emergency assessment\"}\n        },\n        {\n          \"@type\": \"DDxElement\",\n          \"diagnosis\": {\"@type\": \"MedicalCondition\", \"name\": \"Bladder cancer\"},\n          \"distinguishingSign\": {\"@type\": \"MedicalSignOrSymptom\", \"name\": \"Blood in the urine, which is not a feature of bladder pain syndrome and must be investigated in its own right. Weight loss, night pain waking the patient, or a change in the character rather than the intensity of pain likewise require independent assessment and must not be attributed to an existing BPS diagnosis\"}\n        }\n      ],\n      \"associatedAnatomy\": {\n        \"@type\": \"AnatomicalStructure\",\n        \"name\": \"Urinary bladder\"\n      },\n      \"typicalTest\": {\n        \"@type\": \"MedicalTest\",\n        \"name\": \"Cystoscopy\",\n        \"description\": \"Optional rather than mandatory. It adds confidence if it reveals the characteristic Hunner's lesions, but their absence does not exclude the diagnosis, and a trial of treatment is reasonable either way.\"\n      },\n      \"possibleTreatment\": [\n        {\"@type\": \"LifestyleModification\", \"name\": \"Behavioural and dietary adjustment\", \"description\": \"Triggers differ between individuals, so blanket avoidance of the whole list is unnecessary. The workable method is elimination of the common provocateurs for two weeks followed by staged reintroduction with a symptom record. Commonly implicated: coffee and tea, alcohol, carbonated drinks, citrus fruits and juices, tomatoes, spicy food and artificial sweeteners. Fluid restriction must be avoided: reducing intake concentrates the urine and worsens irritation of an already sensitive bladder lining.\"},\n        {\"@type\": \"MedicalTherapy\", \"name\": \"Pelvic floor physiotherapy\"},\n        {\"@type\": \"LifestyleModification\", \"name\": \"Stress reduction\", \"description\": \"Stress does not cause the condition but reliably amplifies the symptoms. Support for the burden of chronic pain forms part of treatment rather than implying a psychological cause.\"},\n        {\"@type\": \"MedicalTherapy\", \"name\": \"Oral medication\", \"description\": \"Reported success rates of up to 77% in published series of selected patients.\"},\n        {\"@type\": \"MedicalTherapy\", \"name\": \"Intravesical instillation therapy\", \"description\": \"Medication instilled directly into the bladder, with reported success rates of up to 93% in published series. Performed by Dr. Soarawee at Bangkok Hospital Headquarters.\"},\n        {\"@type\": \"MedicalProcedure\", \"name\": \"Sacral neuromodulation\", \"description\": \"Reserved for cases not responding to the steps above, given its cost and invasiveness. Not performed at Bangkok Hospital Headquarters; referral can be arranged.\"}\n      ],\n      \"expectedPrognosis\": \"Most patients improve with treatment, but symptoms commonly relapse, so this is a condition managed over time rather than cured once. A flare after months of doing well is a normal feature of the condition rather than evidence that treatment has failed or that something has been missed.\"\n    }\n  ]\n}\n<\/script>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Disclaimer:<\/strong> This content is written and reviewed by Dr. Soarawee Weerasopone, a board-certified urologist at Bangkok Hospital Headquarters. It is intended for educational purposes only and does not constitute medical advice. A diagnosis of bladder pain syndrome is made after other causes have been excluded, and new or changing symptoms should always be assessed rather than attributed to it. No medical advice, diagnosis or prescription is provided through personal messaging channels or social media. Always consult a qualified healthcare professional before starting any medical treatment. In an emergency, attend the nearest emergency department \u2014 in Thailand the emergency number is 1669.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u0623\u0634\u0647\u064f\u0631 \u0645\u0646 \u0622\u0644\u0627\u0645 \u0627\u0644\u0645\u062b\u0627\u0646\u0629\u060c \u0648\u062f\u0648\u0631\u0627\u062a \u0645\u062a\u0643\u0631\u0631\u0629 \u0645\u0646 \u0627\u0644\u0645\u0636\u0627\u062f\u0627\u062a \u0627\u0644\u062d\u064a\u0648\u064a\u0629\u060c \u0648\u0645\u0632\u0627\u0631\u0639 \u062a\u0633\u062a\u0645\u0631 \u0641\u064a \u0627\u0644\u0638\u0647\u0648\u0631 \u0628\u0646\u062a\u064a\u062c\u0629 \u0633\u0644\u0628\u064a\u0629. \u064a\u0648\u0636\u062d \u0627\u0644\u062f\u0643\u062a\u0648\u0631 \u0633\u0648\u0631\u0627\u0648\u064a \u0641\u064a\u0631\u0627\u0633\u0648\u0628\u0648\u0646\u060c \u0623\u062e\u0635\u0627\u0626\u064a \u0627\u0644\u0645\u0633\u0627\u0644\u0643 \u0627\u0644\u0628\u0648\u0644\u064a\u0629 \u0641\u064a \u0645\u0633\u062a\u0634\u0641\u0649 \u0628\u0627\u0646\u0643\u0648\u0643\u060c \u0645\u062a\u0644\u0627\u0632\u0645\u0629 \u0622\u0644\u0627\u0645 \u0627\u0644\u0645\u062b\u0627\u0646\u0629 \u2014 \u0648\u0644\u0645\u0627\u0630\u0627 \u062a\u064f\u062e\u0637\u0623 \u063a\u0627\u0644\u0628\u0627\u064b \u0639\u0644\u0649 \u0623\u0646\u0647\u0627 \u0639\u062f\u0648\u0649\u060c \u0648\u0643\u064a\u0641 \u064a\u062a\u0645 \u0639\u0644\u0627\u062c\u0647\u0627 \u0641\u0639\u0644\u064a\u0627\u064b.<\/p>","protected":false},"author":185281453,"featured_media":10025,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"advanced_seo_description":"Chronic bladder pain that doesn\u2019t respond to antibiotics? Dr. Soarawee explains bladder pain syndrome (interstitial cystitis) \u2014 its diagnosis criteria, causes, and stepwise treatment options.","jetpack_seo_html_title":"Bladder Pain Syndrome (Interstitial Cystitis): Causes & Treatment | Dr. Soarawee Urology","jetpack_seo_noindex":false,"jetpack_seo_schema_type":"","_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_wpcom_ai_launchpad_first_post":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"{title}\n\n{excerpt}\n\n{url}","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"_wpas_customize_per_network":false,"jetpack_post_was_ever_published":false},"categories":[1367],"tags":[1458,1460,1459],"class_list":["post-1787","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-female-urology","tag-bladder-pain-syndrome","tag-chronic-bladder-pain","tag-pain-bladder"],"jetpack_publicize_connections":[],"jetpack_likes_enabled":false,"jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/pgZdrK-sP","jetpack_featured_media_url":"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/04\/Bladder-Pain-Syndrome.webp?fit=1200%2C630&ssl=1","_links":{"self":[{"href":"https:\/\/drsoaraweeurology.com\/ar\/wp-json\/wp\/v2\/posts\/1787","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/drsoaraweeurology.com\/ar\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/drsoaraweeurology.com\/ar\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/ar\/wp-json\/wp\/v2\/users\/185281453"}],"replies":[{"embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/ar\/wp-json\/wp\/v2\/comments?post=1787"}],"version-history":[{"count":26,"href":"https:\/\/drsoaraweeurology.com\/ar\/wp-json\/wp\/v2\/posts\/1787\/revisions"}],"predecessor-version":[{"id":11817,"href":"https:\/\/drsoaraweeurology.com\/ar\/wp-json\/wp\/v2\/posts\/1787\/revisions\/11817"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/ar\/wp-json\/wp\/v2\/media\/10025"}],"wp:attachment":[{"href":"https:\/\/drsoaraweeurology.com\/ar\/wp-json\/wp\/v2\/media?parent=1787"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/ar\/wp-json\/wp\/v2\/categories?post=1787"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/ar\/wp-json\/wp\/v2\/tags?post=1787"}],"curies":[{"name":"\u0648\u0648\u0631\u062f\u0628\u0631\u064a\u0633","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}