Cystitis is a generic term used to describe a variety of infections of the bladder. It can also be used to describe many different infections of the lower urinary tract. Cystitis, also known as a urinary tract infection (UTI), occurs when bacteria enters the bladder through the urethra, adheres to the bladder wall and starts multiplying. At this point, the immune system gets involved, and the body begins to fight off the infection. Although cystitis is typically not a serious illness, if it is untreated and spreads from the bladder to the kidneys, a potentially damaging infection can take control.
Women tend to be more prone to cystitis because of their anatomy. Their urethras, which are the tubes that carry urine from the bladder to the outside of the body, are naturally shorter than men’s. Approximately 20 to 40% of women experience cystitis at some point in their life. The bacterium that most often causes cystitis is E.coli, which is common in the intestines. Cystitis occurs when this bacteria makes its way up the urethra into the bladder.
Another common cause of cystitis is urine retention. This occurs in people who have trouble emptying their bladder completely. The urine that sits in the bladder is a breeding ground for bacteria. Hygiene is another factor, and women should always wipe from front to back after a bowel movement to prevent bacteria from the anus from reaching the urethra. Congenital deformities, especially in men, can prevent the complete emptying of the bladder. Children with vesicoureteral reflux also are at risk for retaining urine due to the formation of their urethras.
Catheterization is another common cause of cystitis. Frequent changing of a catheter may cause small injuries to the tissue, providing entry points for bacteria. In general, catheters tend to introduce outside bacteria into the urethra on a regular basis.
Men with enlarged prostates can be more prone to cystitis, because the prostate interferes with urination. Pregnancy is another factor that increases the risk of cystitis, as well as frequent sexual activity, some sexually transmitted diseases and parasites. Post-menopausal women, as well as diabetics, are at increased risk as well. Recent studies have shown that certain blood types predispose some women to more frequent bouts of cystitis.
When women insert a tampon there is a slight risk of bacteria entering via the urethra.
When a urinary catheter is changed there may be damage to the area.
The patient does not empty his/her bladder completely, creating an environment for bacteria to multiply in the bladder. This is fairly common among pregnant women, and also men whose prostates are enlarged.
Sexually active women have a higher risk of bacteria entering via the urethra.
Part of the urinary system may be blocked.
Other bladder or kidney problems.
During the menopause the lining of a woman's urethra gets thinner as her levels of estrogen drop. The thinner the lining becomes, the higher the chances are of infection and damage.
A woman's urethra opening is much nearer the anus than a man's. Consequently, there is a higher risk of bacteria entering the urethra from the anus.
Urine may have traces of blood
Urine is dark and/or cloudy
Urine has a strong smell
Pain just above the pubic bone
Pain in the lower back
Pain in the abdomen
Only small amount of urine is passed each time
Frequent need to urinate
Burning sensation when urinating
Older women may feel weak and feverish but have none of the other symptoms mentioned above
When children have cystitis they may have any of the symptoms listed above, plus vomiting and general weakness.
Other illnesses or conditions may have the same symptoms as cystitis. They include:
Urethritis (inflammation of the urethra)
Urethral syndrome
Some bacterial infections
Prostatitis (inflammation of the male prostate gland)
Gonorrhea
Chlamydia
Candida (thrush)
Children and men should always see their GP if they have cystitis symptoms. Women should always see their GP the first time they have cystitis symptoms, and also if they have the condition more than three times in one year.
The symptoms of cystitis usually clear up without treatment within 4-9 days. There are some self-help treatments that can ease the discomfort of any symptoms, or your GP may prescribe antibiotics.
If you've had cystitis before and you're sure that you have mild cystitis and don't need to see your GP, there are treatments that you can try yourself.
Over-the-counter (OTC) painkillers, such as paracetamol or ibuprofen. These can reduce pain and discomfort. Always read the label and check with your pharmacist first, particularly if you have any other medical condition, you are taking other medicines, or you're pregnant or breastfeeding.
Drinking plenty of water is often recommended as a treatment for cystitis. There's no evidence that this is helpful, although drinking around 1.2 litres (6-8 glasses) of water a day is generally good for your health. Also avoid alcohol.
Try to abstain from marital intercourse until your cystitis has cleared up because having sex can make it worse.
The following treatments are no longer recommended because there isn't enough evidence of their effectiveness:
urine alkanising agents, such as sodium bicarbonate or potassium citrate
drinking cranberry juice – although this may help to prevent outbreaks of recurrent cystitis
Find out some useful tips on preventing cystitis.
If your symptoms are moderate or severe, your GP may prescribe a short course of antibiotics. This will usually involve taking a tablet 2-4 times a day, for three days.
For a more complicated case of cystitis, such as cystitis with another underlying infection, you may be given antibiotics for 5-10 days. Find out more about cystitis complications.
Research suggests that antibiotics can shorten an attack of cystitis by 1-2 days.
If your cystitis symptoms are only mild, your GP may prefer not to prescribe antibiotics to avoid ‘antibiotic resistance’. This is when the bacteria that cause cystitis adapt and learn to survive the antibiotics. Over time, this means that the treatment becomes less effective.