All about cystitis

The different types of cystitis, its symptoms, and treatment


Cystitis is a medical term for bladder inflammation. While most of the time, inflammation is caused due to bacterial infection, often it can be caused by secondary factors. It is very common in women, and very rare in men. More than 50% of women experience cystitis at least once in their lives.

Mechanism of Action

The urinary bladder is a part of the kidney system, which stores urine that leaves the kidneys. Urine is emptied out of the body through a thin tube termed as the urethra. The length of urethra is very short in women, positioning the tube close to the vaginal opening. Any foreign body can travel up the urethral tube to the urinary bladder and cause infection. The infection often causes the bladder to swell up and become painful. While the condition itself isn’t contagious or dangerous, it can be very discomforting.

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Symptoms of Cystitis

Signs and symptoms of cystitis include but are not limited to:

  • Fever
  • Feeling of distention, bloating or pressure in the lower abdomen
  • Feeling of discomfort in the pelvic region
  • Presence of strong smell or cloudy precipitates in the urine
  • Presence of blood in the urine
  • Feeling of burning when passing urine
  • Frequent feeling of pressing need to urinate

Immediate help and medical attention should be sought if the patient experiences nausea or vomiting, chills and fever, or pain in the side or back in addition to the symptoms above.

Types and Causes of Cystitis

Cystitis can be of many types depending on the nature of the inflammation. It can either be of infectious nature or non-infectious nature. Cystitis of infectious nature is termed as bacterial cystitis and can be classified into further types such as honeymoon cystitis. Cystitis of non-infectious nature can be classified further into subtypes such as interstitial cystitis, drug-based cystitis, radiation-based cystitis, biomaterial-based cystitis, chemical-based cystitis and secondary cystitis.

Bacterial Cystitis

Bacterial cystitis is commonly termed as a UTI, or urinary tract infection. It is caused by the invasion of bacteria into the urethra. This type of inflammation is commonly caused by E. Coli. E. Coli can be found in the food we intake. When these bacteria are excreted out by the rectum, they might remain around the anal region. Any form of external body, such as a partner, sexual objects or improper wiping can create a path for these bacteria to enter the vaginal region. Since the urethra of women is very short, the bacteria can travel up the tract in no time and cause cystitis.

Honeymoon Cystitis

When cystitis occurs as an aftereffect of sexual activity, it is termed as honeymoon cystitis or the honeymoon disease. If a woman contracts cystitis after having sex for the first time, or after a very long period of sexual inactivity, it is termed as honeymoon cystitis. Bacteria from your partner can transfer into the urethra which can cause inflammation in the lower urinary bladder. It is more common in women who are in their twenties.

Interstitial Cystitis

Interstitial cystitis is often caused by unknown factors. Researchers believe multiple factors of various nature such as psychological, genetic, allergic or neurological nature might be responsible for interstitial cystitis. In this form of cystitis, the bladder lining called urothelium gets damaged. It can commonly be viewed as the ulcer of the urinary bladder. The affected patient suffers from extreme pain in the bladder. It is diagnosed when other possible causes of cystitis are ruled out.

Drug Cystitis

Drug based cystitis occurs as a medicinal reaction. Drugs of chemotherapeutic nature especially are responsible for drug-based cystitis. Medicines containing ifosfamides and cyclophosphamides are broken down by the kidney into components that are responsible for bladder inflammation.

Radiation Cystitis

Radiation based cystitis is caused as a consequence of radiation therapy. Radiotherapy of lower abdominal and urinary tract tumours can cause changes in the tissue located in the urinary bladder. This can lead to cystitis.

Biomaterial Cystitis

Foreign materials such as birth control diaphragms, sexual objects and catheters can cause tissue damage and expose the urinary region to bacteria and inflammation.

Chemical Cystitis

Harsh chemicals found in bubble baths, spermicidal agents and feminine products can cause an allergic reaction in the urinary tract, causing cystitis and inflammation.

Secondary Cystitis

Secondary cystitis occurs as an aftermath of underlying conditions and diseases such as spinal cord injuries, enlarged urinary tract organs, kidney stones or diabetes. This kind of cystitis can only be treated by treating the underlying conditions.

Chronic Cystitis

The unfortunate condition when bladder infection becomes recurrent is termed as chronic cystitis. Women are affected by chronic cystitis more than men, especially in women older than 30 years of age. There is no significant cause of chronic cystitis which makes it difficult to treat. Often, this type of cystitis is due to an underlying condition such as diabetes. If it is not due to an underlying condition, then bacteria are responsible for the infection.

The vaginal area is responsible for maintaining the balance between healthy bacteria while keeping invasive bacteria out of the body. Disruption in this balance can make women prone to cystitis. This disruption can either be due to improper hygiene, or secondary conditions such as kidney stones, diabetes, urological surgeries and congenital abnormalities. It can also develop from acute/mild cystitis if it remains untreated for a long time.

Risk Factors for Cystitis

Some women are more prone to developing cystitis than others. Women who have irregular sexual routines, for example, can develop cystitis more frequently. Women who use diaphragms as a birth control option are also at risk, especially if the diaphragm is coated with spermicidal agents. Women with an altered reproductive system, such as pregnant women or menopausal women, who undergo changes at hormonal levels also need to be careful about cystitis.

Other uncommon risk factors for cystitis for both women and men include changes in the immune system, kidney stones, enlarged prostate, improper flow in urine and prolonged usage of bladder catheters.

Complications of Cystitis

Cystitis never causes any problems if treated properly on time. In rare cases, if the infection remains untreated for a long time, it can develop into more complicated disease such as kidney infection. The bacteria present in urethra might multiply and expand all the way to your kidney. Infections in the kidney can damage kidneys permanently. Another complication that can arise due to bladder complication is blood in the urine, which can only be observed at the microscopic level and not visually present.

Diagnosis of Cystitis

Cystitis can be confused with other urinary tract infections, therefore, an appropriate diagnosis is required. There are two ways to confirm the presence of cystitis. A doctor may request a urine analysis test through urine sample to view the severity of inflammation by confirming the presence of pus, blood or bacteria in the urine. Your doctor might also request urine bacterial culture to confirm the origin of bacteria present. Another way to confirm inflammation is through cystoscopy. Your doctor might insert a thin tube with a camera to explore the inner condition of your urinary tract.

Treatment with Drugs

Antibiotics such as Trimethoprim and Nitrofurantoin are the best line of action against cystitis. The drug and dosage of antibiotics depends on individual health and the severity of infection. If the infection occurs for the first time, then antibiotics can treat it in a day. Recurrent infections require longer periods of time. Regardless of when the infection clears, it is necessary to complete the full prescribed course of antibiotics. If you leave the course incomplete, the bacterial infection will return again.

In the case of interstitial cystitis, the underlying cause is not clear. Due to this, prescribing a single course of treatment can be very hard. Other alternative strategies of treatments such as nerve stimulation, bladder stretching and topical treatments might be required. Usually, doctors focus on flushing bacteria out of urinary bladder as the primary treatment strategy.

Home Remedies and Treatments

Cystitis can be very painful. There are a few ways to reduce the pain through home remedies. When the pain is severe, use a heating pad on your lower abdomen. This will help reduce bladder pain and pressure. Another home remedy is to increase your water intake. Aim for at least 2 litres of water daily in order to keep yourself hydrated. Until your infection clears, avoid any form of spicy foods, citrus juices, soft drinks, alcohol and coffee as they can irritate bladder infection more. Lastly, taking a Sitz bath for fifteen minutes can also alleviate discomfort and pain.

Preventing Cystitis

A common prevention strategy for women is cranberry juice. It is recommended that women should incorporate cranberry juice in their diet to reduce their risk of acute and recurrent cystitis. Another way to prevent cystitis is by drinking plenty of water and keeping yourself hydrated. Women should also not hold their urinary urges. Frequent urination can help prevent infection as well, especially after any form of sexual activity.

Hygiene is very important for preventing inflammation and healthy urinary bladder. Avoid any harsh chemicals or strong feminine washes, and prefer showers over baths. Also, when wiping after urination, it is better to use a front to back movement rather than back to front movement. This avoids an invasion of bacteria and reduces the risk of inflammation.

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