Cystitis

Definition

Cystitis is an inflammation and an infection of the urinary bladder. It is an infection caused by bacteria (approx. 70% caused by Escherichia coli, a bacterium found in the lower gastrointestinal tract) that go up the urinary tract until they reach the bladder. The cause of cystitis is usually found to be in a contamination by feces.

Epidemiology

Cystitis affects more often women than men, this is based on an anatomical difference, men have a longer urethra, which allows better protection, so they are less affected by this problem, excepting those who have prostate problems.
Women are specially affected by cystitis, since they have a urinary system that facilitates the contamination by bacteria.
– 10% to 20% of women are affected yearly by cystitis, making it a leading cause of medical consultation.
– 10% of women with cystitis may suffer from recurrent cystitis, in this case a medical consultation is more than required.

Causes

Cystitis is generally caused by bacteria that go up the urinary tract. Certain situations can facilitate its development:
– A poor hygiene, particularly in the female genital area.
– Sexual intercourse by women
– Deformity in the urinary system
– Bladder stone(bladder lithiasis)
– Diabetes (type I or II)
– The use of catheters
– Pregnancy (due to the pressure applied on the bladder by the foetus, which prevents a complete emptying)
– Stress
– Constipation
– Menopause

Symptoms

A person with cystitis has a constant urge to urinate. The urine volume is usually very small (pollakiuria). Burning sensations or pain during urination (dysuria) is frquent. Pain can also be felt at the back or at the lower abdomen.
The urine might also have a foul smell and occasionally there is blood in the urine.
Usually a cystitis doesn’t carry major consequences but in certain cases it may cause complications, as the development of kidney infections.
In case symptoms appear (blood in the urine, etc.) go immediately to your physician.

Diagnosis

A diagnosis of cystitis can rely on an anamnesis (symptoms and signs) or in certain critical cases (pregnancy, etc.) on clinical tests (e.g. urinanalysis) where the specimen is sent to a hospital laboratory to grow and examine the bacteria. Ultrasound scanning or x-rays can also be made in the hospital. Only a physician can make a diagnosis and he is the only one who can decide upon it.

Diagnosing a UTI is more and more a matter of clinical judgment. The Dutch guideline (NHG, the Netherlands) states that a woman herself can easily recognize the symptoms if she have had already a UTI in the past.

Complications

Cystitis rarely leads to complications. However, if the treatment is incorrect or non-existent the bacteria can reach the kidney, in this case we are dealing with nephritis or a cystopyelonephritis. This complication can be problematic and place the kidneys at risk, so in case of doubt regarding cystitis always consult with a physician.

When to consult a physician ?

It is absolutely necessary to consult a physician in case of blood in the urine, strong pain or high fever, cystitis that causes pain or fever during three days, cystitis in a man (risk of prostate hypertrophy), cystitis in a child or a pregnant woman. If there is a recurrence of the cystitis, it is also recommended to consult a physician.
Please be aware that this is not an exhaustive list. In case of symptoms please consult a physician.

Treatment

Drugs
After having confirmed a diagnosis and excluded complications risks, a physician usually prescribes antibiotics like norfloxin for a short time period (e.g. for three days). Other type of antibiotics as amoxicillin or fosfomycin can also be prescribed.
Word of caution: Please follow the prescribed duration of the treatment, i.e. if you don’t feel any more symptoms or pain associated with cystitis, continue the therapy as indicated by the physician until the end (end the box of tablets). Otherwise you are contributing to increasing the resistance to antibiotics.
To cure the pain associated with cystitis, anti-inflammatories drugs (e.g. ibuprofen) can be taken.
Treatment of recurrent cystitis
To cure recurrent cystitis the physician may prescribe a low dose of antibiotics to be taken daily over a period of 6 to 12 months.

Herbal medicine

There are many herbal plants to prevent and treat cystitis.

However, these plants should be taken with the advice of a professional (pharmacist, physician,…) who will judge their merits based on symptoms, frequency and duration of cystitis.
Indeed antibiotics are often prescribed by a physician in cases of bacterial infections. Note the positive role of plants with berries (cranberries) in terms of the prevention of recurrent cystitis.

Below you can find the most frequently used plants for cystitis prevention and treatment.
Plants used in prevention of recurrent cystitis
– Cranberry
– Bilberry

Plants to treat cystitis
– Birch
– Heather
– Nettle
– Horsetail
– Grapes Bearberry (Uva Ursi)
Read also: anti-cystitis herbal tea

Prevention

– Drink a lot of liquid (at least 2 pints – 1 litre per day). To prevent recurrent cystitis you can also drink cranberry juice (250 ml each day), this treatment appears to be very effective.
– Avoid fatigue and stress, they may be responsible for the appearance of cystitis by weakening the immune system. Take for example vitamins or tonics to strengthen the immune system. Boost your immune system by going to the sauna, by eating fruits (rich in vitamins, but avoid citrus) or probiotics (yogurt, Lactobacillus …).
You can also take medication based on echinacea, vitamin C or immunostimulating drugs based on extracts of germs like E-coli bacteria to strengthen the immune system.
– Avoid citrus fruits, because these fruits are imported from countries, where they are picked not yet ripe, and once here arrived they then mature but retain their acidity. This acid is not tolerated by everyone, causing stomach-ache and cystitis.That is why should be avoid at all costs.
– Dress warmly and avoid wearing too tight, too short or synthetic underwear (preferred cotton underwear). It should be noted that fashion does not help girls with sweaters that often leave the belly exposed (be careful in winter!) since cold weakens the immune system and increases the risk for cystitis.
– Change your underwear regularly. They can be a source of infectious agents.
– Treat and prevent constipation problems as quickly as possible, in fact, constipation can lead to an intestine fermentation which could lead to spread of bacteria to the urinary tract.
– Urinate when the need arises, it is not advisable to “retain” because sensitive germs can proliferate more easily.
– Have a good toilet hygiene, use of too irritating soaps or cosmetics may, on the contrary, encourage the entry of infectious agents. Women and girls must dry themselves from front to back, towards the anus –not the other way around – to avoid leading bacteria from their intestine into their urethra.
– Sometimes sex can promote the occurrence of cystitis, it is advisable to drink before the intercourse and to urinate immediately afterwards (empty bladder). This allows an “elimination” of certain germs that may cause cystitis.
– If you are in menopause, you should be aware that vaginal dryness (symptom of menopause) can promote urinary tract infections. Talk to your doctor if this should be the case in order to act preventively.

Tipps

– Drink a lot: 1.5 to 2 liters of fluid per day, since as happens during colds, this allows a dilution and elimination of infectious germs. This effect is particularly useful in the urinary tract and bladder. Avoid drinking sodas or other soft drinks, choose water, juice or cranberry-based teas.

– You can apply a hot-water bag to the lower abdomen to relieve pain during cystitis.

News

• Symptoms of cystitis might be caused by bacterial infection, interview
• New mechanism of E.Coli in case of cystitis, interview

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