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Cystitis

Cystitis is a common infection of the bladder occurring more often in women than men. In many cases, it settles without an antibiotic. The infection however can be severe and track backwards up the urinary tract to involve the kidneys. Simple measures can prevent cystitis but they are not full proof.

Long description

Cystitis is an infection which many people diagnose and manage themselves. It can affect anyone, at any time and at any age. However, it is more likely to occur in women when they first become sexually active. Women who are pregnant, have had many children or who are elderly are also more likely to get cystitis. Cystitis has probably been with us for as long as people walked the earth. Documents from Ancient Egypt describe the symptoms and recommend treatment without understanding the processes behind the disease

Causes

Urine emerges from a small tube-like structure called the urethra. The urethra connects to the bladder which stores the urine we “manufacture”. A man’s urethra is longer than a woman’s. A common bacterium which causes cystitis is E. coli – normally present in the intestines. The openings for the intestines and the urinary tract lie in close proximity.  The shorter urethra of the woman makes it easier for E. coli and other bacteria to enter the urethra, overgrow and cause infection. If there is a structural defect of the bladder (e.g. the bladder valves) this can also lead to infection. The sugary urine of diabetics is a favourable environment for bacteria. So, diabetics are prone to get cystitis.

Symptoms

The classic symptom is a burning or stinging sensation on passing urine. There may be more frequent excursions to the toilet and the urine may be particularly smelly and cloudy. Cystitis-sufferers may also notice small amounts of blood. However, symptoms are not a must to have cystitis. An elderly person may be suffering from cystitis and not have any symptoms.

Infection from the bladder may tract back along one of the ureters – the tube-like structures which connects it to the kidneys. If infection of the kidney (pyelonephritis) occurs, there may be pain at the loin and even chills and shivering. Nausea, vomiting and diarrhoea may also occur. Fortunately, cystitis does not often develop into kidney infection.

Treatment

Simple measures such as drinking plenty of water and cranberry juice can help relieve the symptoms of cystitis. Cranberry juice is thought to create a hostile environment for the bacteria. It prevents them sticking to the bladder wall.  If simple measures do not help, then the GP may prescribe antibiotics. A 3-day course is often enough to resolve cystitis.

If a woman gets cystitis during pregnancy she should see her GP as kidney infection is more likely to develop. She will also be treated with antibiotics to prevent this happening

Some people complain of recurrent bouts of cystitis. It is important to make sure there is no underlying condition such as diabetes or a structural defect of the bladder which leads to the infection. A bladder specialist (urologist) can do investigations to try to determine the cause. Often no underlying cause is found. In this case, a low dose of antibiotic taken each day helps to prevent cystitis rather than treat each time the infection inevitably occurs.

Prevention

Scrupulous hygiene when going to the toilet can help prevent cystitis. Some people are prone to get cystitis when they use toiletries such as bubble baths and perfumed shower gels. These should be avoided. Good control of diabetes makes cystitis and other infections less likely. Repairing vaginal prolapses in women will also reduce the likelihood of infection. Some people regularly drink Cranberry juice to prevent cystitis.

 

Cystitis is common but the odds are stacked against women compared to men. At least half of women suffer from infection somewhere in the urinary tract (usually the bladder) at some point their lives. Fortunately, cystitis is easily treated. On a scale of 1 to 5, it probably sits between 1 and 2.

In: General Medicine,