Definition

Cystitis is the inflammation of the urinary bladder, which is a component of the urinary system consisting of the kidneys, ureters, bladder, and urethra. The urinary system functions to filter waste products from the blood and eliminate them through urine. Inflammation of the bladder is primarily caused by urinary tract infections, although other factors can contribute. Cystitis can affect anyone but is more prevalent in females. It can result in discomfort pain, and may lead to serious complications if not properly managed.

Causes

The most common cause of cystitis is urinary tract infection (UTI). UTIs occur when bacteria from outside the body enter the urethra, travel to the bladder, and proliferate. The predominant causative bacterium is Escherichia coli (E. coli), which originates from the gastrointestinal tract. Inflammation can also arise due to bacterial overgrowth in the body, leading to an excessive amount of bacteria and subsequent infection.

In addition to infections, cystitis can result from several other factors, including:

• Interstitial cystitis: Characterized by chronic bladder inflammation, particularly common in women. The precise cause remains unclear.
• Drug-induced: Certain medications, notably chemotherapy drugs, contain harsh components that need to be excreted through urine, irritating the bladder wall.
• Radiation: Pelvic radiation therapy can induce changes in bladder tissue, leading to inflammation.
• Foreign objects: Objects entering the urinary tract, such as catheters, create a conducive environment for bacterial growth.
• Chemical substances: Individuals sensitive to certain soaps or feminine products may experience inflammation. Contraceptive methods like diaphragms with spermicides can also contribute. Allergic reactions may trigger inflammation.
• Other medical conditions: Cystitis may arise as a complication of underlying diseases such as diabetes, kidney stones, prostate enlargement, spinal nerve trauma, HIV, or cancer.

Risk factor

Females are more susceptible to cystitis than males due to anatomical differences, such as a shorter urethra located near the vagina and anus. Female individuals have a higher risk of cystitis if they are:

• Sexually active
• Using specific contraceptives like diaphragms or spermicidal condoms
• Pregnant, as hormonal changes during pregnancy can increase susceptibility to infections
• Menopausal, as hormonal changes during this stage are associated with a higher risk of urinary tract infections
• Wiping the genital area from back to front after using the bathroom

Although cystitis is more common in women, men can also experience it, especially if they have:

• Urinary flow obstruction due to blockages such as kidney stones or prostate enlargement
• Changes in the immune system due to conditions like diabetes, HIV, or cancer
• Prolonged use of urinary catheters, particularly in hospitalized patients or the elderly
• A history of radiation therapy or chemotherapy

Symptoms

Symptoms of cystitis, caused by inflammation, include:

• Pain and burning sensation during urination
• Increased urinary frequency, with reduced urine volume
• Dark and cloudy urine
• Strong-smelling urine
• Presence of blood in the urine
• Pain in the lower abdomen or back
• Pressure in the lower abdomen
• Pain during sexual intercourse
• Mild fever

Warning signs indicating a potential kidney infection include:

• Nausea and vomiting
• Pain in either side of the lower back
• Chills and high fever

Diagnosis

The diagnosis of cystitis is typically established by examining symptoms and conducting tests to confirm inflammation. Some tests that a doctor may perform include:

• Urine test or urinalysis: This test aims to detect bacteria, blood, or pus in the urine.
• Urine culture: This test identifies the type of bacteria causing the infection.

If the cause of cystitis is not an infection, additional tests may be performed, such as:

• Cystoscopy using a cystoscope: A cystoscope, a small tube-like instrument with a camera and light at the end, is inserted through the urethra to examine the tissues and walls inside the urethra and bladder. Tissue samples (biopsies) can be taken for analysis in the laboratory. This examination is typically reserved for cases of recurrent cystitis.
• Imaging with X-ray or ultrasound: These imaging techniques can be used to look forother causes other causes of cystitis, such as tumors or anatomical abnormalities.

Management

The management of cystitis depends on the cause of inflammation, whether it is from infection or noninfection.

Infection:

As bacterial infection is the primary cause of cystitis, doctors typically prescribe antibiotics to address the infection. For initial infections with symptoms, antibiotics are usually prescribed for 3 to 7 days, with the duration adjusted based on the severity of the case. Completing the full course of antibiotics is crucial, even if symptoms improve. Additionally, doctors may recommend pain relievers, such as paracetamol, to alleviate discomfort. In cases of recurrent infections, low-dose antibiotics may be prescribed for a longer duration. Your doctor may also refer you to a urology specialist or internal medicine doctor for further evaluation and management.

Non-Infection:

For cases not related to infection, therapy is tailored to the underlying cause. In conditions like interstitial cystitis, where the cause of inflammation is unclear, definitive treatment may not be available. Instead, management focuses on lifestyle changes and symptom relief. This may include avoiding triggers such as spicy foods, smoking, and alcohol. Self-care treatments that can be done at home include:

• Drinking more water
• Applying a warm cloth or warm water bottle to the abdomen to reduce discomfort
• Avoiding sexual intercourse until recovery
• Steering clear of bladder-irritating drinks like coffee, alcohol, and fruit juices
• Urinating more frequently
• Avoiding the use of soap or feminine wash that may cause irritation
• Taking warm baths to reduce pain and discomfort

Complications

Cystitis rarely leads to serious complications if properly treated. However, some complications include:

• Chronic cystitis: This condition involves long-term inflammation of the bladder that may become resistant to antibiotic treatment over time.
• Kidney infection (pyelonephritis): If bacteria continuously ascend the ureter and reach the kidneys, it can lead to a kidney infection. This condition, more likely to occur in children and the elderly, has the potential to cause permanent damage to the kidneys.

Prevention

Cystitis can often be prevented by implementing lifestyle changes and maintaining good genital hygiene. Here are some preventive measures:

• Clean the genital area from front to back after urination
• Urinate after sexual intercourse to flush out bacteria
• Drink plenty of water to help flush out bacteria from the urinary tract
• Urinate more frequently and avoid holding it for prolonged periods
• Clean the genital area with water before and after sexual intercourse
• Change damp or wet underwear regularly and opt for cotton underwear to allow for better airflow
• Ensure the genital area stays dry and clean throughout the day
• Avoid using irritating products for the genital area, such as feminine products, diaphragms with spermicides, and harsh soaps
• Limit consumption of alcohol, coffee, or sugary beverages, as they can irritate the bladder and increase the risk of infection

When to see a doctor?

If you experience symptoms of cystitis as described above, it's important to seek medical attention. Additionally, seek immediate medical care if:

• Symptoms do not improve within 3 days of home care.
• The pain worsens and significantly interferes with your daily activities.
• You are pregnant and experiencing symptoms of cystitis.
• You have symptoms suggesting a kidney infection, such as fever, chills, or pain in the lower back.
• You have a history of recurrent urinary tract infections.

Looking for more information about other diseases? Click here!