cystitis or cystitis

Cystitis is an inflammation of the bladder, usually caused by a urinary tract infection. It affects more women than men and can occur at any age.
During urination, the urine collected in the bladder flows out of the body via the so-called urethra.

If the outflow of urine is painful or causes discomfort, the cause could be a bladder infection.

If left untreated, it can lead to a serious kidney infection.

Most bladder infections are caused by bacteria that live in the gut. They are safe as long as they remain in the intestine, but cause problems when they reach the urethra and through it the bladder. This circumstance can occur during sexual intercourse or if the genital area is cleaned from back to front after defecation.

Who develops a bladder infection?

Women are eight times more likely than men to develop cystitis because the tube from which urine flows (urethra) is closer to the woman’s anus.
Up to 15% of women have cystitis every year and about half of women have an attack of cystitis at least once in their lives.
Other risk factors for cystitis include diabetes mellitus, pregnancy, and sexual activity.

Who is at risk of developing a bladder infection?

Infection by gut bacteria is by far the most common cause of cystitis, especially in women who have a short urethra.
Normally, the urine is sterile, which means that there are no microorganisms, such as bacteria, in it.
However, it is possible to have bacteria in the bladder without symptoms, especially in the elderly.

Causes of cystitis

Incomplete emptying with subsequent residual urine can lead to infection. The causes can be: certain medications (for example, antidepressants), immobility and difficulty in bladder control.

Risk factors for cystitis

Hygiene
After urination, women should dry themselves from front to back, towards the anus, and not in the other direction, to prevent the most common gut bacteria from ending up in the urethra.

Congenital malformations of the urinary system
With repeated infections of the urinary system, especially in young people, it is necessary to look for a possible congenital (since birth) malformation of parts of the urinary system, which prevents complete emptying of the bladder.

People with a catheter
Anyone who wears a catheter to drain urine has bacteria in the bladder that usually do not cause symptoms.
When changing catheters, small injuries can occur, which increase the risk of infections.

Men with enlarged or inflamed prostate
An enlargement of the prostate (gland in men) in old people prevents complete emptying of the bladder.
Other diseases such as prostatitis (infection of the prostate) and urethritis (infection of the urethra) can cause similar symptoms in younger men.

Pregnancy
Urinary tract infections (kidney, bladder, urethra, and ureters) are most common during pregnancy.
There are several reasons why pregnant women often have a bladder infection.
Under the influence of progesterone (one of the pregnancy hormones), the bladder becomes larger and more relaxed, so it does not empty as thoroughly as before.
In addition, the growing uterus expands, pressing against the urethra, causing narrowing, which makes it difficult for urine to pass.
If the bladder does not empty completely, the bacteria in the urine can multiply and cause an infection.

Other causes of cystitis

“Wedding night” cystitis
Cystitis in women is associated with increased sexual activity.
We all carry bacteria on the skin and during sexual intercourse, bacteria near the urethral opening can enter this and the bladder and cause cystitis.
A woman should go to the toilet after sexual intercourse and empty the bladder to “dispose of” any bacteria that might remain in the urethra.

Infection by sexual transmission
Infections such as gonorrhea and chlamydia can cause symptoms similar to cystitis.
In addition, in these cases, vaginal discharge or bloody discharge after sexual intercourse is usually observed.

Parasites
Especially in people who have been to North Africa or the Middle East.
The bladder can be affected by parasites, as in schistosomiasis.
The symptoms are similar to cystitis, but there are no bacteria in the urine.

In postmenopausal
women Due to the lack of female sex hormones in postmenopausal women, there are a number of changes throughout the body. One consequence of this is that the urinary system is more easily irritated by cystitis.

Diabetes
Women with diabetes are more likely to develop cystitis.

Symptoms and signs of cystitis are common:

• A strong and persistent urge to urinate
• Sensation of burning sensation when urinating
• Frequent leakage of small amounts of urine
• Bloody urine (hematuria)
• Leakage of cloudy urine with a strong, foul odor
• Abdominal discomfort
• Feeling of pressure in the abdomen
• Mild fever.

Symptoms in children
Symptoms of cystitis in children may include:

• Weakness
• Irritability
• Decreased appetite
• Vomit
• Pain when urinating.

Cystitis may occur in young children, but bedwetting is not associated with urinary tract infection.

Could it be something else?

Sexually transmitted diseases (STIs) are often caused by infections of the urethra and are similar to the symptoms of cystitis.
People over the age of 25 should get tested for chlamydia.
Other causes of cystitis include kidney stones.

Diagnosis of cystitis

If you have the symptoms of a bladder infection, you should see a doctor as soon as possible.
In addition to discussing the signs, symptoms and medical history, the doctor may prescribe:

Urine tests
If a bladder infection is suspected, the doctor may ask for a urine sample to determine if there is any bacteria, blood, or pus in the urine.

Cystoscopy
Examining the bladder with a cystoscope (a thin tube with illumination connected to a camera) that can be inserted into the bladder through the urethra helps diagnose.

What is the right therapy for cystitis?

Antibiotics
Treatment over three to five days is the usual treatment in most cases in women.
Symptoms usually improve within a day or two of starting treatment. Taking antibiotics shortens the duration of symptoms by about a day on average. The doctor may also prescribe taking the antibiotics only if symptoms worsen or do not improve after a few days.

Example of drugs prescribed for infectious cystitis:

• Enoxacin (Enoxor)
• Levofloxacin (Levaquin, Tavanic)
• Ciprofloxacin (Ciprofloxacin, Ciprofloxacin Mayne, Ciprofloxacin M.G., Ciprofloxacin Pliva, Ciprobay)
• Nalidixic acid (nalidixic acid, nalidixic acid).

Not treating cystitis may be an option (if you’re not pregnant or don’t have any other medical conditions).
The immune system often fights the infection independently. Without antibiotics, bladder infections (especially mild cases) can pass on their own in a few days. However, without medication, symptoms can sometimes last up to about a week.

Paracetamol or ibuprofen
These medications reduce pain or discomfort and can also lower fever.
Drinking a lot is a traditional way to rid the bladder of bacteria.
However, there is no proof of the effectiveness of this therapy.

Drinking blueberry juice or ingesting urinary alkalizing substances (such as potassium citrate or bicarbonate) has not been scientifically shown to improve symptoms of cystitis.
These products are sometimes sold as a treatment for cystitis.
If the symptoms worsen or develop a high fever, you should consult a doctor.
If symptoms do not improve with antibiotic treatment, or if symptoms recur within two weeks of taking antibiotics, a doctor should be consulted.

What can be done to prevent cystitis?
If you only have occasional bouts of cystitis, you don’t need to do anything or you can change your lifestyle.
In case of recurrent cystitis, the following measures can help:

Hygiene
There is no evidence that poor hygiene leads to cystitis.
However, some women wash their anus and vagina too often, and this can do more harm than good.
Too many washes can easily damage the skin on the genitals.
The bacteria thrive better on previously damaged skin.
Rubbing the vagina for too long during the shower can alter the normal balance of protective mucus and allow the bacteria to multiply.

It has been proven that the anus and adjacent skin are gently cleansed once a day with soap and water.
It is best to clean the anus from front to back after defecation.
The reason for this is that the bacteria are pushed backwards from the anus and not towards the urethra.
Drinking a lot can help prevent a bladder infection, but after the onset of symptoms, this is no longer useful.

Underwear
Wear cotton underwear and change it once a day. Do not wear tight-fitting pants or tights.
This avoids heat accumulation, moisture and lack of air circulation in the genital area, which promote the growth of bacteria.
It is recommended to wash underpants twice in a row before putting them back on to eliminate any trace of bacteria.

Natural remedies for cystitis

Blueberry juice or taking tablets containing proanthocyanidins may help reduce the risk of recurrences or chronic bladder infections in some women.
There are conflicting results from scientific studies and it is therefore difficult to determine whether blueberry juice really helps or rather has a placebo effect.
Blueberry juice should be avoided when taking warfarin, a blood thinning medication.

Although these home remedies have not yet been sufficiently studied, some doctors recommend for repeated bladder infections:

Drink a lot, especially water
Drinking plenty of fluids is especially important when undergoing chemotherapy or radiotherapy, especially on treatment days.

Frequent urination
If there is an urge to urinate, you should not wait long before going to the toilet.

Shower rather than bathe
Those prone to infections should take a shower instead of a bath to avoid cystitis.

Avoid the use of deodorant sprays or products for the female genital area. These products can irritate the urethra and bladder.

Nutrition for cystitis

Patients with cystitis often experience worsening symptoms when consuming certain foods and beverages, especially caffeinated beverages such as coffee, black tea, and soda.
Foods that should be avoided in the diet are: alcoholic beverages, citrus fruits and fruit juices, sugar, even if contained in artificial sweeteners, and chili. But this varies from person to person.

In addition to confectionery, dairy products and gluten should also be avoided, as these are difficult to digest in the intestine, where the body’s defences are formed, and therefore promote the development of diseases and infections.

The meat available in the supermarket today is not healthy and should therefore be avoided. The same applies to fish from aquaculture.

It is recommended to eat plenty of seasonal fruits and vegetables, dried fruits, legumes and whole grains.

Cystitis associated with sexual intercourse

Some women notice that they develop cystitis a day or two after sexual intercourse.
This can be caused by the movements during sexual intercourse that push the bacteria into the bladder.
There may also be slight damage to the urethra, which promotes the growth of the bacteria.
This is all the more likely if the vagina is too dry during intercourse. The normal mucus in and around the vagina may also be altered when spermicides or contraceptives such as a diaphragm are used.

The following measures can reduce the risk of cystitis after sexual intercourse:

• After intercourse, you should go to the toilet and empty the bladder.
• If the vagina is dry, you should use a lubricant before inserting the penis.
• Some people prefer to take a single dose of an antibiotic within two hours of intercourse.
• Do not use spermicides and/or diaphragms for contraception, the condom is an excellent method of preventing cystitis.

How long does the disease last? When does the cystitis pass?

The vast majority of women experience improvement within a few days of the onset of cystitis.
However, if symptoms do not improve despite taking an antibiotic, an alternative antibiotic may be needed.
The bacteria that cause the bladder infection may be resistant to certain types of antibiotics.

In some cases, an untreated cystitis can spread upwards into the urinary tract and affect the kidneys. This can lead to pyelonephritis: inflammation and infection of the kidney.
In more severe bladder infections, the recovery time depends on the clinical situation. Patients can become seriously ill if the infection spreads from the urinary system into the blood, a condition called urosepsis. Antibiotics administered intravenously are usually effective. Usually, patients with urosepsis require lengthy therapy with antibiotics.

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