What is cystitis?

Strictly speaking, cystitis means an inflammation of the bladder, but in reality it can often be used to indicate an infection of the urine which may form in any part of the urinary system and not just in the bladder alone.

What causes it?

Cystitis occurs when bacteria enter the bladder via the short passage which leads from the external opening in the body (the urethra). The condition affects up to 80% of women at some stage in their lives, and the first and most obvious reason for this is because the urethra in the female is much shorter and more exposed than in men. It leads to an opening in the vagina whereas the male urethra travels down inside the penis to its tip. Among the causes of cystitis are:

  • Pregnancy. Many women who have never suffered from cystitis find that they have frequent bouts of infection during pregnancy. A small number of women (less than 20%) have bacteria present in their urine at all times, and it is this group who are particularly prone to cystitis in pregnancy. Cystitis does not have an adverse affect on the pregnancy or the baby, but an acute attack can cause premature labour.
  • Sexual intercourse. If there is insufficient lubrication of the vaginal canal during intercourse, the result may be friction and damage to the urethral passage and the bladder which may lead to cystitis. The hormone oestrogen is responsible for providing the natural lubrication found in the vagina, and there is a gradual reduction in oestrogen after the menopause. This is one of the reasons why cystitis is particularly common among sexually active post-menopausal women.
  • Poor toilet hygiene habits. Because of the close proximity of the anus to the vaginal canal, all young girls should be taught the basic principles of good toilet hygiene from a very early age. The most important principle to remember is to always wipe from front to back - never the other way round - to prevent harmful bacteria around the anus from entering the vaginal area where they can make their way into the urethra and from there to the bladder.
  • Insufficient emptying of the bladder. Many older people find it difficult to completely empty the bladder, and this condition is known as urine-retention. Failure to empty the bladder can result in the remaining urine becoming infected with bacteria, causing cystitis. It is a very bad practice to go to the toilet in a hurry. Everyone, regardless of age, should take their time while visiting the toilet and try to ensure that they completely empty the bladder at every visit.

What are the symptoms?

Anyone who has ever suffered an acute attack of cystitis will be well aware of the symptoms if they recur, and will seek medical advice as quickly as possible. The first and most obvious symptom is an intense desire to urinate every few minutes. When urination does take place it will only be in minute amounts, but it will be accompanied by very severe pain. Traces of blood may also be present in the urine, and there may be pain in the lower abdomen and a general feeling of being unwell.

How is it diagnosed?

The first thing your GP will seek is a urine sample which may be sent for laboratory analysis. A small number of people suffer from recurring bouts of cystitis, even when there is no evidence of infection present. In such cases, further medical investigations may be warranted.

What is the treatment?

Once the bacteria responsible for the infection have been identified, the preferred treatment is by way of a course of antibiotics for a minimum of five days. It is very important to complete the entire course of antibiotics, even if the symptoms have disappeared. Failure to do so may result in a further flare-up of the condition as there may still be bacteria present in the bladder. Most people find that there is a rapid relief in the symptoms of cystitis within 24 to 48 hours of starting antibiotic treatment.

There are some self-help remedies which can be used to reduce the possibility of contracting cystitis. Among them are:

  • drink plenty of fluids to keep the kidneys flushed out. Water and cranberry juice are recommended.
  • pass urine as soon as possible after sexual intercourse to flush out any harmful bacteria which may have entered the urethra.
  • use a lubricant during intercourse if the vaginal passage is particularly dry.
  • always wipe the vaginal and anal area from front to back after visiting the toilet, and never the other way round.
  • if an attack of cystitis is suspected, drink as much fluid as possible to keep the kidneys flushed out, and make an appointment with your GP as soon as possible.
  • during the initial stages of cystitis, when the pain and discomfort is very severe, it may help to go to bed for a couple of hours with a hot water bottle.

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