Cystitis – Symptoms, Causes and Treatment

Cystitis is the inflammation of the urinary bladder. Most common cause behind this inflammation is a bacterial infection, and it is called as urinary tract infection (UTI). A bladder infection can be very painful and irritating, and it can become a serious health condition if the infection reaches to your kidneys.

Other factors behind the development of cystitis are:
Reaction to certain drugs, radiation therapy or some irritants, like feminine hygiene spray, spermicidal creams or l using a catheter for long time. Cystitis may also occur as a complication of another illness.

Generally, bacterial cystitis is treated by antibiotics. Treatment for other types of cystitis depends on the fundamental cause.

Sign and symptoms of cystitis often have:(1)

  • A strong and continuous urge to urinate
  • A burning sensation during urination
  • frequent urination with small amounts of urine
  • Blood in the urine (hematuria)
  • Passing cloudy or strong-smelling urine
  • Discomfort in pelvic areas
  • A feeling of pressure in the lower abdomen
  • Low-grade fever

In young children, new episodes of random daytime wetting also may be a sign of a urinary tract infection (UTI). Night time bed-wetting on its own isn’t probably to be related to a UTI.

When to see a doctor

Seek immediate medical help if you are experiencing signs and symptoms similar to a kidney infection, including:

  • Back pain or side pain
  • Fever and chills
  • Nausea and vomiting

If you have urgent, frequent or painful urination that lasts for many hours or longer or if you notice blood in your urine(hematuria), talk to your doctor. If you’ve been diagnosed with a UTI in the past and you develop symptoms that are similar to previous UTI, visit to your doctor.

You also need help of your doctor if symptoms of cystitis come back after you have finished a course of antibiotics or . You may require a different type of medication.

If your child starts having daytime wetting issuess, talk to their pediatrician.

Cystitis is rare in healthy men and should be investigated by the doctor.

Causes

Your urinary system consists of your kidneys, ureters, bladder and urethra. All have a role in excreting waste from your body. Your kidneys — a bean-shaped paired organs located retroperitonealy — filter waste products from your blood and regulate the water ion balance in your body. Paired tubes called ureters carry urine from your kidneys to the bladder, where it’s stored until it removes from your body through the urethra.(2)

Bacterial cystitis

UTIs usually occur when bacteria outside the body enter the urinary tract through the urethra and begin to grow. Most common bacteria for causing cystitis is Escherichia coli (E. coli) bacteria.

Bacterial bladder infections may occur in women due to a sexual intercourse. But also sexually inactive girls and women have chances to get lower urinary tract infections because the female genital area often have UTI causing bacteria.Also females have shorter urethra than males that makes easier for the bacteria to reach the bladder and cause cystitis or UTIs in female

Although ,bacterial infections are the most common cause of cystitis, a number of non infectious factors may also lead to inflammation of bladder or cystitis. Some of these factors include:

  • Interstitial cystitis. It is a chronic form of bladder inflammation, also called as painful bladder syndrome and it’s cause is not clear. Most cases are found in women. The condition can not be easy to diagnose and cure.
  • Drug-induced cystitis. Certain medications, especially ,the chemotherapy drugs such as cyclophosphamide and ifosfamide, can lead to inflammation of your bladder as the broken-down components of the drugs leave your body.
  • Radiation cystitis. Radiation treatment of the pelvic area can cause inflammation in bladder tissue.
  • Foreign-body cystitis. Using a catheter for longer duration can make you susceptible to bacterial infections and tissue damage, both of which result in inflammation.
  • Chemical cystitis. Some people may be more sensitive to chemicals contained in certain products, such as bubble bath, feminine hygiene sprays or spermicidal creams, and may develop an allergic-type reaction inside the bladder, leading to inflammation.
  • Cystitis associated with other conditions. Cystitis may sometimes occur as a complication of other disorders, such as diabetes or kidney stones.

Risk factors

Some people are more susceptible than others to develop bladder infections or repeated urinary tract infections such as women. Reason behind it is physical anatomy. Women have a shorter urethra, which reduces the distance for bacteria thus bacteria easily reach the bladder.

Women who are at highest risk of UTIs are those who:

  • Are sexually active. Due to sexual intercourse bacteria can pushed into the urethra.
  • Use certain types of birth control. Women using diaphragms are at higher risk of developing UTI. Diaphragms that have spermicidal agents additionally increase your risk.
  • Are pregnant. Hormonal changes during pregnancy may increase the risk of a bladder infection.
  • Have experienced menopause. Changed hormone levels in post menopausal women are generally related with UTIs.

Other risk factors common in both men and women are :

  • Interference with the flow of urine. This can occur in conditions such as a stone in the bladder or, in men, an enlarged prostate or any other obstructions.
  • Changes in the immune system. This can occur due to certain conditions, like diabetes, HIV infection and cancer treatment. A reduced immune system can increases the risk of bacterial and, sometimes viral bladder infections.
  • Prolonged use of bladder catheters. These tubes may be required in people with chronic illnesses or in older adults. Long-term use can result in increased danger to bacterial infections as well as damage to bladder tissue.

In men without any susceptible health issues, cystitis is rare.

Complications

When treated immediately and properly, bladder infections rarely cause any complications. But if not treated timely left, they can cause some serious complications such as:

  • Kidney infection. An untreated bladder infection can result in kidney infection, also known as pyelonephritis . Kidney infections may cause permanent damage to your kidneys.Young children and older adults are at the largest risk of kidney damage due to bladder infections as their symptoms are often ignored or misunderstood with other conditions.
  • Blood in the urine. With cystitis, you may excrete blood cells with your urine that can be viewed only with a microscope (microscopic hematuria) and that generally disappears with treatment. If blood cells remain in urine after treatment, your doctor may recommend a specialist to find out the cause.Blood in the urine that you can see (gross hematuria) is rare and only seen in typical, bacterial cystitis, but this sign is more common with chemotherapy- or radiation-induced cystitis.

Prevention

Cranberry juice or tablets containing proanthocyanidin are often prescribed to help lower the risk of repeated bladder infections for some women. But research in this area is unclear. Some smaller studies showed a little benefit, but larger studies found no noticeable benefit.

As a home remedy, don’t take cranberry juice if you are taking the blood-thinning medication like warfarin (Coumadin). Possible interactions between cranberry juice and warfarin can cause bleeding.

Although these preventive self-care measures are not clearly studied, doctors sometimes suggest these habits for repeated bladder infections:

  • Drink lots of liquids, particularly water. Drinking lots of fluids is mainly important if you are getting chemotherapy or radiation therapy, especially on treatment days.
  • Urinate frequently. If you feel the urge to urinate, don’t delay in urination.
  • Wipe from front to back after defecation. This prevents spreading of bacteria from anal region to vagina and urethra.
  • Take showers rather than tub baths. If you’re susceptible to infections, taking shower rather than tub bath may help to control them.
  • Gently wash the skin around the vagina and anus. Do this on regular basis but don’t use harsh soaps or wash too vigorously. The delicate skin around these areas can become irritated.
  • Empty your bladder immediately after intercourse. Drink lots of water to help flush bacteria.
  • Don’t use deodorant sprays or feminine products in the genital area. These products can irritate the urethra and bladder.

Diagnosis

If you develop the symptoms of cystitis, consult with your doctor immediately. Doctor will discuss about your signs and symptoms and your medical history, also your doctor may suggest certain tests, such as:

  • Urine analysis. For a suspected bladder infection, your doctor may ask for a urine sample to find out whether bacteria, blood or pus is present in your urine. If present, he or she may suggest a urine bacterial culture.
  • Cystoscopy. During this test, your doctor inserts a cystoscope (a thin tube with a attached light and camera ) into your urinary bladder through the urethra to monitor your urinary tract for signs of disease.
  • With the help of a cystoscope, your doctor can also take a small sample of tissue (biopsy) for laboratory analysis. But this test most likely won’t be required if this is the first time you’ve had signs and symptoms of cystitis.
  • Imaging. An imaging test is generally not required, but in some instances, particularly when no evidence of infection is found — imaging may be helpful. For example, an X-ray or ultrasound may help your doctor to find out other probable causes of bladder inflammation, such as a tumor or any structural abnormality.

Treatment

Cystitis caused by bacterial infection is usually treated with antibiotics. Treatment for noninfectious cystitis depends on the primary cause.

Treating bacterial cystitis

Antibiotics are the first line of treatment for cystitis caused by bacteria. Type of drugs and duration of it’s use depend on your overall health and the bacteria present in your urine.

  • First-time infection. Symptoms usually improve noticeably within a day or so of antibiotic treatment. Although,you’ll probably required to take antibiotics for three days to a week, depending on the severity of your infection.No matter what the duration of treatment is, take the complete course of antibiotics recommended by your doctor to ensure that the infection is completely cured.
  • Repeat infection. If you have frequent repeating UTIs, your doctor may prescribe longer antibiotic treatment or refer you to a specialist or urinary tract disorders (urologist or nephrologist) for an evaluation, to see if urologic abnormalities may be leading to the infections. For some women, having a single dose of an antibiotic after sexual intercourse may be helpful.
  • Hospital-acquired infection. Hospital-acquired bladder infections can be a challenge to treat because bacteria present in hospitals are usually very resistant to the common types of antibiotics used to treat community-acquired bladder infections. Because of this, different types of antibiotics and different treatment plans may be required.

Postmenopausal women may be especially susceptible to cystitis. As a part of your treatment, your doctor may prescribe a vaginal estrogen cream ,if you are able to use this medication without increasing your risk of other health issues.

Treating interstitial cystitis

With interstitial cystitis, the cause of inflammation is unsure, so there is no single treatment that give best result in every case. Therapies used to ease the signs and symptoms of interstitial cystitis are:

  • Medications that are taken orally or inserted directly into your bladder
  • Procedures that change your bladder to improve symptoms, such as stretching the bladder with water or gas (bladder distention) or surgical procedures.
  • Nerve stimulation, which uses mild electrical pulses to relieve pelvic pain and, in some cases, reduce urinary frequency

Treating other forms of noninfectious cystitis

If you are hypersensitive to some chemicals in products such as bubble bath or spermicides, avoid these products. It may help lowering symptoms and prevent further occurance of cystitis.

Treatment of cystitis that develops as a complication of chemotherapy or radiation therapy focuses on pain management, usually with medications, and hydration to flush out bladder irritants.

Lifestyle and home remedies

Cystitis can be painful, but you can follow some steps to relieve your discomfort:

  • Use a heating pad. A heating pad kept on your lower abdomen area can soothe and possibly reduce feelings of bladder pressure or pain.
  • Stay hydrated. Drink lots of fluids to keep yourself hydrated. Say no to coffee, alcohol, soft drinks with caffeine and citrus juices as well as spicy foods until your infection goes away. These items can irritate the bladder and aggravate a frequent or urgent need to urinate.
  • Take a sitz bath. Soak in a bathtub of warm water (sitz bath) for 15 to 20 minutes to get rid off your pain or discomfort.

For repeated bladder infections, take advice of your doctor to develop a plan to lower recurrences and the discomfort caused bycystitis.

Cholecystitis – Symptoms, Causes and Prevention

Pancreatitis – Symptoms, Causes and Treatment