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Cystitis is a painful condition that is common in women - its been estimated that more than half the women will get cystitis at some time. It can also affect men and children, but this is less common. Although it is painful, if treated, it usually lasts no longer than a day or two, and does not usually cause any long-term problems. But if you get repeated bouts, you should see a doctor.
Cystitis is an inflammation of the bladder (the bag in which urine is stored after it leaves the kidneys). When the bladder is full, urine is passed out of the body through a narrow tube called the urethra.
The causes of cystitis
About half of cases of cystitis are caused by infection. The infection is usually caused by bacteria that are normally present in the anus (back passage). These can get into the urethra when, for example, tampons are inserted, or during sexual intercourse, or when the bottom is wiped from back to front. The bacteria travel up the urethra and multiply in the bladder, causing infection and inflammation.
Women get cystitis more than men because the anus and the opening of the urethra are closer to each other, and a woman's urethra is shorter than a mans.
Cystitis may also be caused or encouraged to develop by:
- bruising of the urethra during vigorous sex
- poor hygiene on the part of either or both sexual partners
- wearing very tight trousers
- having a catheter fitted
- using a diaphragm as a form of contraception
- the chemicals in some products (such as soaps, bubble bath and vaginal deodorants)
- holding on too long before urinating
- the lower levels of hormones in women after the menopause
Symptoms can vary, but they can include any or all of the following:
- a strong urge to urinate, even when your bladder is empty
- passing frequent small amounts of urine
- stinging or burning when passing urine
- dark or cloudy urine
- strong-smelling urine
- blood in the urine
- dull pain in the lower back or abdomen
- feeling generally unwell or having a fever
These symptoms can also be due to other infections, such as a sexually-transmitted disease (STD). If you think this might be the case - for example, if you and your sexual partner have symptoms - you should consult a doctor.
You can usually treat cystitis yourself in the following ways.
- Drink a lot of water to help flush out the bacteria, to dilute the urine and reduce the burning sensation. Drink 600ml (one pint) of water every hour for the first four hours, then 300ml (half a pint) every two hours for the next eight hours
- Make the urine less acidic by drinking a glass of water with a teaspoon of bicarbonate of soda dissolved in it. Products from the pharmacist that contain sodium citrate (such as Cystemme) have the same effect. (However, neither of these is suitable if you have high blood pressure or heart trouble.)
- Take a painkiller, such as paracetamol, aspirin or ibuprofen, for the pain. Holding a covered hot water bottle over your abdomen may also help
- Avoid having sex and drinking alcohol while the attack lasts
- Cranberry juice or capsules are believed by many to help fight cystitis. Its yet to be completely proven, but research is underway to investigate this
You should see a doctor if:
- there is blood in your urine
- you feel no better after 24 hours
- you are or may be pregnant
- you develop a temperature
- you have pain in the lower back or severe abdominal pain
- the cystitis keeps coming back
Children and men who get cystitis should always be seen by a doctor. Cystitis in men can be caused by an enlarged prostate or a congenital problem with the bladder (one you were born with). In children, there is the possibility of an abnormality in the urinary system, and this needs to be checked.
To diagnose cystitis, the doctor is likely to ask for a sample of urine, which will be tested to identify any bacteria present. A quick test using a dipstick is now common, but otherwise the doctor may need to send a sample to a laboratory for analysis.
You may be prescribed an antibiotic. If you are, you should always take the full course to get rid of the bacteria completely, even if the symptoms clear up before the antibiotics are finished.
If cystitis is left untreated, you could develop chronic cystitis. This means that the attacks last longer and occur again and again. Women who get repeated attacks may need to have an X-ray or an ultrasound scan to check whether there may be an abnormality in the urinary tract.
If antibiotics do not work at all, it is possible that you have a kind of cystitis called interstitial cystitis (IC). This is a chronic inflammation of the bladder wall that is not caused by infection and does not respond to antibiotics. This condition is yet to be fully understood.
By making some simple changes to your daily routine, you can help prevent cystitis.
- Drink at least one to two litres (three or four pints) of water or bland liquid every day
- Pass urine as soon as you need to, rather than trying to hang on
- Wipe from front to back after using the toilet
- Make sure you empty your bladder completely by sitting up straight on the toilet
- Avoid perfumed soaps, vaginal deodorants, bubble baths, etc.
- Avoid wearing tight trousers.
- Wear cotton, rather than synthetic, underwear
- Avoid or cut down on alcohol, fruit juices, tea and coffee, or spicy food
- To help prevent cystitis related to sex:
- Wash your hands and genitals before sex
- Try to urinate immediately after sex
- Use a lubricant to reduce friction and bruising
- Avoid touching the anus
The Interstitial Cystitis Support Group (UK)
Interstitial Cystitis Association
National Kidney and Urologic Diseases Information Clearinghouse
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