Cystitis

Cystitis refers to an inflammation of the bladder as a result of infection or irritation. The bladder receives urine produced by the kidneys through tubes called ureters. When you urinate, urine passes out of your body through a tube called the urethra.

Cystitis generally affects the bladder. In these cases, it is known as a lower urinary tract infection (UTI). However, if the infection reaches the ureters or kidneys it is known as an upper urinary tract infection. This is a more serious condition.

Around a third of women will experience cystitis at least once before the age of 24. Men and children can also develop cystitis, but this is less common.

Men generally contract cystitis later in life. The condition can be more serious in men because it is linked to other health problems, including an enlarged prostate.

Interstitial cystitis is a slightly different kind of condition. It is a chronic inflammation of the bladder wall that is not caused by an infection.

There are various symptoms of cystitis, including:

• Stinging and/or burning when urinating
• Need to pass urine more often than usual, even if small amounts are passed
• Cloudy or dark urine
• Bloody urine
• Pain or discomfort in lower back or lower abdomen
• General malaise (discomfort)

It can be painful when you have cystitis. Mild cases usually resolve themselves within four to nine days and symptoms clear within two to three days.

In severe cases you should contact your GP. If you have severe pain or fever it is important to seek medical attention as you may require treatment with antibiotics.

Some of the symptoms described above are also linked to sexually transmitted infections (STIs) such as chlamydia. Anyone who thinks that they may have contracted an STI should see their doctor or visit a sexual health clinic.

It can be easy to confuse cystitis with certain kinds of STI. However it is important to note that the following symptoms are not related to cystitis and may be the sign of a different infection:

• Yellow or strange-smelling discharge
• Lumps or bumps on the genitals
• Scabs or sores

If you experience any of these symptoms, see a doctor or visit your local sexual health clinic.

A common cause of cystitis is bacteria, which enters the urethra from surrounding skin before moving up to the bladder and causing infection and irritation. Many cases of cystitis are caused by E. coli bacteria, which usually lives harmlessly in your bowel.

The reason that women suffer higher rates of cystitis than men is explained by physiology. In females, the urethra is closer to the anus, where bacteria from the bowel is likely to collect. This means that the bacteria can more easily pass into the urethra.

Another factor is that the female urethra is shorter than the male one. This makes it easier for the bacteria to travel up to the bladder and cause an infection.

Other factors also raise the likelihood of diagnosis, including:

• Being sexually active
• Using spermicide-coated condoms that can change the pH of the vagina
• Having experienced the menopause, which can alter the lining of the vagina and make bacterial infections more likely
• Having a urinary catheter, which can allow bacteria to enter directly into the bladder
• Having diabetes, which can encourage bacteria to grow due to higher levels of sugar in urine
• Having a condition that stops you from properly emptying your bladder, including bladder or kidney stones, an enlarged prostate, or being pregnant/giving birth
• Using irritants, such as certain soaps that can irritate the urethra or bladder

Be aware that cystitis is not dangerous or contagious, but it can be painful.

You can also get cystitis if you are not able to empty your bladder properly. This can happen during pregnancy or as a result of certain health issues such as kidney stones.

Cystitis may also occur if the urethra is damaged by sex, perfumed soap or talcum powder. Kidney infections can also be responsible.

Cystitis and sex

The link between cystitis and sex is particularly intriguing. Having sex can increase the chances of contracting cystitis, but the infection cannot be passed to your partner during intercourse.

This means that cystitis is not categorised as a sexually transmitted infection (STI), however, the condition can be caused by thrush and STIs such as chlamydia or gonorrhoea.

In some cases otherwise healthy women will not need treatment for cystitis. The condition can clear up by itself if you look after yourself. It is important that women visit a doctor in the following cases:

• There is no improvement in symptoms after two to three days
• There is blood in your urine
• You are pregnant or believe you could be pregnant
• You are over 65 years old
• You are vomiting, feel sick or have a high temperature
• Your lower back or abdomen feel painful
• The cystitis keeps recurring
• You have kidney stones or any other problem with your urinary system
• You are diabetic

Men or children who contract cystitis should see a doctor. Some men get cystitis due to an enlarged prostate, a condition that should be checked.

It can be more difficult to spot cystitis in children, but it's important to seek medical attention if you suspect your child has contracted the condition. Medical staff will check for any abnormalities in the urinary system in order to stop kidney problems developing in the future.

When you go in to see your doctor they will ask you for a urine sample, which will be tested.

For mild cases of cystitis it is usually possible to treat the condition yourself. You should try the following:

• Take paracetamol or a different non-prescription painkiller
• Drink a glass of water with half a teaspoon of bicarbonate of soda in it. This will make your urine less acidic
• Drink a lot of fluid to help flush the infection out

If you have to see a doctor for cystitis it is likely that they will prescribe a course of antibiotics. Always take your medication exactly as prescribed.

Should your symptoms persist, contact your doctor. Some infections may be resistant to common antibiotics.

Another possibility is that you have interstitial cystitis, a chronic inflammation of the bladder wall that isn't caused by an infection. If this is the case your doctor will provide information and advice as to how to manage the condition.

Some people are unfortunate enough to experience recurrent cystitis, and there are a number of things you can do to try and prevent infections.

Cranberry juice

The first is to drink cranberry juice or take tablets containing cranberry extract. There is some scientific evidence that cranberry can help to prevent recurrent cystitis.

Always seek medical advice before using cranberry. Avoid juices that are high in sugar, which can encourage bacteria growth. Anyone who is taking blood-thinning medication such as warfarin should be aware that cranberry also has a thinning effect on the blood.

Long-term antibiotics

Anyone who experiences recurrent cystitis may be given antibiotics to take at a low dose for six to 12 months. You may be given antibiotics to take immediately after sex if your infection is linked to sexual activity.

Avoiding spermicide

Spermicide can encourage cystitis. Try to use alternative methods of contraception.

Oestrogen cream

Women who have been through the menopause may be given oestrogen cream to apply to the vagina. This can reduce the risk of cystitis.

You can also try some of the following methods to cut the risk of infection:

• Pass urine after sex
• Increase fluid intake
• Wear loose clothing
• Wipe front to back, rather than back to front, after passing urine
• Pass urine as soon as you need to, rather than waiting
• Wash your genitals before sex and ask your partner to do the same
• Wear cotton underwear rather than nylon
• Avoid perfumed soaps or deodorant around your genitals
• Avoid bubble baths
• Seek prompt treatment for vaginal infections such as thrush or trichomoniasis, which can encourage cystitis

If you find that there are certain triggers for cystitis, for example tea or coffee, avoid these triggers.