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Encyclopaedia


Cystitis

Introduction

Cystitis is inflammation of the bladder, usually caused by a bladder infection.

It's a common type of urinary tract infection (UTI), particularly in women, and is usually more of a nuisance than a cause for serious concern. Mild cases will often get better by themselves within a few days.

However, some people experience episodes of cystitis frequently and may need regular or long-term treatment.

There's also a chance that cystitis could lead to a more serious kidney infection in some cases, so it's important to seek medical advice if your symptoms don't improve.

Signs and symptoms of cystitis

The main symptoms of cystitis include:

  • pain, burning or stinging when you pee
  • needing to pee more often and urgently than normal
  • urine that's dark, cloudy or strong smelling
  • pain low down in your tummy
  • feeling generally unwell, achy, sick and tired

Possible symptoms in young children include a high temperature (fever) of 38C (100.4F) or above, weakness, irritability, reduced appetite and vomiting.

When to see your GP

Women who have had cystitis before don't necessarily need to see their GP if the condition returns, as mild cases often get better without treatment. You can try the self-help measures listed below, or ask your pharmacist for advice.

You should see your GP if:

  • you have symptoms of cystitis for the first time
  • your symptoms don't start to improve within a few days
  • you get cystitis frequently
  • you have severe symptoms, such as blood in your urine
  • you're pregnant and have symptoms of cystitis
  • you're a man and have symptoms of cystitis
  • your child has symptoms of cystitis

Your GP should be able to diagnose cystitis by asking about your symptoms. They may test a sample of your urine for bacteria to help confirm the diagnosis.

What causes cystitis?

Most cases are thought to occur when bacteria that live harmlessly in the bowel or on the skin get into the bladder through the urethra (tube that carries urine out of your body).

It's not always clear how this happens, but it can be caused by:

  • having sex
  • wiping your bottom after going to the toilet – particularly if you wipe from back to front
  • inserting a tampon or urinary catheter (a thin tube inserted into the urethra to drain the bladder)
  • using a diaphragm for contraception

Women may get cystitis more often than men because their anus (back passage) is closer to their urethra, and their urethra is much shorter, which means bacteria may be able to get into the bladder more easily.

Treatments for cystitis

If you see your GP with cystitis, you'll usually be prescribed antibiotics to treat the infection. These should start to have an effect within a day or two.

If you've had cystitis before and don't feel you need to see your GP, you may want to treat your symptoms at home.

Until you're feeling better, it may help to:

  • take paracetamol or ibuprofen
  • drink plenty of water
  • hold a hot water bottle on your tummy or between your thighs
  • avoid having sex

Some people find it helpful to try over-the-counter products that reduce the acidity of their urine (such as sodium bicarbonate or potassium citrate), but there's a lack of evidence to suggest they're effective.

If you keep getting cystitis, your GP may give you an antibiotic prescription to take to a pharmacy whenever you develop symptoms, without needing to see your doctor first. Your GP can also prescribe a low dose of antibiotics for you to take continuously over several months.

Preventing cystitis

If you get cystitis frequently, there are some things you can try that may stop it coming back. However, it's not clear how effective most of these measures are.

These measures include:

  • not using perfumed bubble bath, soap or talcum powder around your genitals – use plain, unperfumed varieties
  • having a shower, rather than a bath – this avoids exposing your genitals to the chemicals in your cleaning products for too long
  • going to the toilet as soon as you need to pee and always emptying your bladder fully
  • staying well hydrated – drinking plenty of fluids may help to stop bacteria multiplying in your bladder
  • always wiping your bottom from front to back when you go to the toilet
  • emptying your bladder as soon as possible after having sex
  • not using a diaphragm for contraception – you may wish to use another method of contraception instead
  • wearing underwear made from cotton,rather than synthetic material such as nylon, and not wearing tight jeans and trousers
 

Drinking cranberry juice has traditionally been recommended as a way of reducing your chances of getting cystitis. However, large studies have suggested it doesn't make a significant difference.

Interstitial cystitis

If you have long-term or frequent pelvic pain and problems peeing, you may have a condition called interstitial cystitis.

This is a poorly understood bladder condition that mostly affects middle-aged women.

Unlike regular cystitis, there's no obvious infection in the bladder and antibiotics don't help. However, your doctor may be able to recommend a number of other treatments to reduce your symptoms.

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Symptoms

Cystitis can cause problems with peeing and make you feel unwell.

Symptoms of cystitis in adults

Cystitis in adults can cause:

  • pain, burning or stinging when you pee
  • needing to pee more often and urgently than normal
  • feeling like you need to pee again soon after going to the toilet
  • urine that's dark, cloudy or strong-smelling
  • pain low down in your tummy
  • feeling generally unwell, achy, sick and tired
  • blood in your urine

In adults, cystitis doesn't usually cause a high temperature (fever). If you have a temperature of 38C (100.4F) or above and pain in your lower back or sides, it may be a sign of a kidney infection.

Symptoms of cystitis in children

It can be difficult to tell whether a child has cystitis, because the symptoms can be vague and young children cannot easily communicate how they feel.

Possible symptoms of cystitis in young children may include:

  • a high temperature (fever) of 38C (100.4F) or above
  • weakness and tiredness
  • irritability
  • reduced appetite
  • vomiting

Children with cystitis can sometimes also have symptoms usually found in adults, such as pain when peeing, peeing more often than normal and pain in their tummy.

When to see your GP

You should see your GP if you or your child have symptoms of cystitis for the first time.

Cystitis isn't usually a cause for serious concern, but the symptoms can be similar to several other conditions, so it's important to get a proper diagnosis.

If you're a woman who has had cystitis before, you don't necessarily need to see your GP again. Cystitis is very common in women and mild cases often get better on their own. Speak to a pharmacist if you need any advice about treating cystitis.

However, you should see your GP if your symptoms are severe or don't start to get better in a few days, you get cystitis frequently, or you're pregnant.

Children and men should always be seen by a GP if they have symptoms of cystitis, as the condition is less common and could be more serious in these groups.

Interstitial cystitis

You should see your GP if you have long-term or frequent pelvic pain and problems peeing, as you may have a condition called interstitial cystitis.

This is a poorly understood bladder condition that mostly affects middle-aged women.

Unlike regular cystitis, there's no obvious infection in the bladder and antibiotics don't help. However, your doctor may be able to recommend a number of other treatments to reduce your symptoms.

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Causes

Cystitis is usually caused by a bacterial infection, although it sometimes happens when the bladder is irritated or damaged for another reason.

Bacterial infections

Most infections are thought to occur when bacteria that live harmlessly in the bowel or on the skin get into the bladder through the urethra (tube that carries urine out of your body) and start to multiply.

Cystitis is much more common in women than men, probably because the anus (back passage) is closer to the urethra in women and the urethra is much shorter.

It's not always obvious how the bacteria get into the bladder, but it can be caused by:

  • having sex
  • wiping your bottom after going to the toilet – particularly if you wipe from back to front
  • inserting a tampon or urinary catheter (a thin tube inserted into the urethra to drain the bladder)
  • using a diaphragm for contraception

What can increase your risk?

There are a number of things that can increase your chances of developing an infection in your bladder. Some of these are outlined below.

Not being able to empty your bladder

If you're unable to empty your bladder fully, any bacteria that get inside may not be flushed out when you go to the toilet and can multiply more easily.

You may not be able to empty your bladder fully if:

  • you have a blockage in your urinary system, such as a bladder stone
  • you're pregnant, as the baby may be pressing on your bladder
  • (in men) you have an enlarged prostate gland that presses on the urethra

Menopause

For women who have been through the menopause, or are going through it, the lining of the urethra can shrink and become thinner because of a lack of the hormone oestrogen.

The natural balance of bacteria in the vagina may also change, which can allow potentially harmful bacteria to become more common.

This can make the urethra more vulnerable to infection, which could spread into the bladder.

Diabetes

You're more likely to get cystitis if you have diabetes – a condition where the level of sugar in your body becomes too high.

High levels of sugar in your urine can provide a good environment for bacteria to multiply, so any bacteria that get into the bladder are more likely to cause cystitis.

Other causes of cystitis

Cystitis can also be caused by damage or irritation to the urethra and bladder.

This can be the result of:

  • friction from sex
  • chemical irritants, such as those in perfumed soap or bubble bath
  • damage caused by a catheter or surgery on your bladder
  • radiotherapy to your pelvis or treatment with certain chemotherapy medicines

Cystitis has also been linked to recreational use of the drug ketamine.

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Treatment

Mild cystitis will usually clear up on its own within a few days, although sometimes you may need to take antibiotics.

See your GP for advice and treatment if:

  • you have symptoms of cystitis for the first time
  • your symptoms don't start to improve within a few days
  • you get cystitis frequently
  • you have severe symptoms, such as blood in your urine
  • you're pregnant and have symptoms of cystitis
  • you're a man and have symptoms of cystitis
  • your child has symptoms of cystitis

Women who have had cystitis before don't necessarily need to see their GP if the condition returns, as mild cases often get better without antibiotics. You can try the self-help measures below or ask your pharmacist for advice.

Things you can try yourself

If you've had cystitis before and don't feel you need to see your GP, the following advice may help to relieve your symptoms until the condition clears up:

  • take over-the-counter painkillers, such as paracetamol or ibuprofen – always read the medicine information leaflet beforehand to check whether you can take it, and check with your pharmacist if you're not sure
  • drink plenty of water –it's been suggested this may help flush the infection out of your bladder and some people find it helpful, although it's not clear how effective it actually is
  • use a hot water bottle – holding a hot water bottle on your tummy or between your thighs may reduce any discomfort
  • don't have sex until you're feeling better, because it may make the condition worse

Some people find drinking cranberry juice or using products that reduce the acidity of their urine (such as sodium bicarbonate or potassium citrate) reduce their symptoms, but there's a lack of evidence to suggest they're effective.

These products are also not suitable for everyone. Check with your GP or pharmacist before trying them if you're taking any other medication.

Antibiotics

In some cases, your GP may prescribe a course of antibiotics. This will usually involve taking a tablet or capsule two to four times a day for three days.

Antibiotics should start to have an effect quite quickly. Return to your GP if your symptoms haven't started to improve within a few days.

Most people won't have any side effects from antibiotic treatment, but possible side effects can include feeling or being sick, itching, a rash and diarrhoea.

If cystitis keeps coming back

If you keep getting cystitis (known as recurrent cystitis) your doctor may prescribe stand-by antibiotics or continuous antibiotics.

A stand-by antibiotic is a prescription you can take to a pharmacy the next time you have symptoms of cystitis, without needing to visit your GP first.

Continuous antibiotics are taken for several months to prevent further episodes of cystitis. These may be prescribed:

  • if cystitis usually occurs after having sex – you may be given a prescription for antibiotics to take within two hours of having sex
  • if cystitis is not related to having sex – you may be given a low-dose antibiotic to take for a trial period of six months

Your doctor may also recommend some measures you can take to prevent cystitis, although it's not clear how effective these are.

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The information on this page has been adapted by NHS Wales from original content supplied by NHS Choices.
Last Updated: 26/10/2015 09:56:44

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