inflammation of the bladder, usually caused by an infection of the urinary tract. It affects more women than men and can occur at any age. 
When we urinate, the urine stored in the bladder goes outside the body through a tube called the urethra.

If the descent of the urine is painful or causes discomfort, you could have cystitis.

If left untreated, cystitis can lead to severe kidney infection. 
Most cystitis is caused by bacteria that live in the gut. 
They are harmless while remaining in the intestine, but cause problems when they reach the urethra and bladder. This can occur during sexual intercourse or when we clean the genital area from back to front after defecation.


Who develops cystitis?

Women are eight times more likely to have cystitis compared to men, since in women the tube from which the urine descends (urethra) is closer to the anus. 
Up to 15% of women have cystitis every year and about half of women have cystitis at least once in their lifetime. 
Other risk factors for cystitis are diabetes mellitus , pregnancy, and being sexually active.


Who is at risk for cystitis?

Infection of intestinal bacteria is by far the most frequent cause of cystitis, especially in women who have a short urethra. 
Normally, the urine is sterile, that is, there are none of the microorganisms such as bacteria. 
However, there may be bacteria in the bladder without having symptoms, especially in the elderly.


Causes of cystitis

Inadequate emptying, which results in stagnant urine may lead to infection. The causes may be: certain medications (eg antidepressants), immobility and discomfort in bladder control.


Risk factors

After urinating, females should wipe from front to back, toward the anus, not to the contrary, to prevent major intestinal bacteria from reaching the urethra.

Congenital deformities of the urinary system
In the case of repeated infections of the urinary system, especially among the young, it is necessary to look for possible congenital deformities (present from birth) somewhere in the urinary system that prevent the complete emptying of the bladder.

People with a catheter
Who has a catheter to drain urine has bacteria in the bladder, usually without symptoms. 
During catheter replacement, minor lesions may appear that increase the risk of infection .

Men with a enlarged or inflamed prostate
An enlarged prostate (male gland) we elderly prevents complete emptying of the bladder. 
Other diseases such as prostatitis (prostate infection) and urethritis (urethral infection) can cause similar symptoms in young men.

Urinary tract infections (kidneys, bladder, urethra and ureters) are more common during pregnancy. 
There are several reasons why cystitis is common in pregnant women. 
Under the influence of progesterone (one of the hormones of pregnancy), the bladder becomes larger and more relaxed, so it can not be emptied well as before. 
In addition, the growing uterus stretches and moves toward the urethra, causing the tube to stretch, so the passage of urine can become difficult. 
If the bladder does not empty properly, the bacteria in the urine can multiply and cause an infection.


Other causes

cystitis Cystitis in women is associated with increased frequency of sexual activity. 
All of us have bacteria on the skin and during intercourse, these bacteria near the opening of the urethra can penetrate the urethra and bladder where they can cause cystitis. 
A woman should go to the bathroom to empty the bladder after intercourse to ‘eliminate’ any bacteria that may remain in the urethra.

Sexually Transmitted
Infection Gonorrhea and chlamydia infections can cause cystitis-like symptoms. 
In addition, in these cases we usually notice a vaginal and blood discharge after intercourse.

Especially among people who have been in North Africa or the Middle East. 
The bladder can be infested with parasites , such as schistosomiasis (also known as bilharziasis). 
The symptoms are similar to those of cystitis, but there is no bacteria in the urine.

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

Women with diabetes are more likely to have cystitis.

The signs and symptoms of cystitis are usually:


Symptoms in children

Symptoms of cystitis in children may include:

In young children may check cystitis, but urinary incontinence is not related to urinary tract infection.


Could it be something else?

The sexually transmitted infections (STIs) are often caused by infection of the urethra and symptoms similar to cystitis. 
It is important for people younger than 25 to take the Chlamydia test. 
Other causes of cystitis include  kidney stones .


Diagnosis of cystitis

If you experience symptoms of cystitis, talk to your doctor as soon as possible. 
In addition to discussing the signs, symptoms, and medical history, your doctor may prescribe these tests:

If the doctor suspects a bladder infection, he or she may ask for a urine test to checkfor bacteria, blood, or pus in the urine.

Inspection of the bladder using a cystoscope (a thin tube with a lumen and a collegiate camera) that can be inserted through the urethra into the bladder helps with the diagnosis.


What is the treatment for cystitis?

Antibiotic Medications
A three to five day cure is the normal treatment for most women. 
Symptoms generally improve within one or two days of starting treatment. 
On average, taking antibiotics reduces the duration of symptoms by about one day. 
One possibility that your doctor may give you is a prescription for antibiotics to be taken only if the symptoms worsen or do not improve after a few days.

Examples of medications prescribed for infectious cystitis: 
• Levofloxacin, 
• Ciprofloxacin (Cipro) 
• Nalidilic acid (Naluril)

Not treating cystitis may be an option (unless you are pregnant or if you have other illnesses). 
Often, the immune system can eliminate the infection by itself. Without antibiotics, cystitis (especially mild) can pass within a few days. However, the symptoms can last for about a week without a medication.

Paracetamol or ibuprofen
These medicines reduce pain or discomfort and can also lower fever. Drinking lots of water is a traditional remedy to rid the bladder of bacteria. However, there is no evidence of the usefulness of such treatment. It has not been scientifically proven that drinking blueberry juice or taking products to alkalize the urine (such as potassium citrate or potassium bicarbonate) improves the symptoms of cystitis. These types of products are sometimes sold as a treatment for cystitis. If symptoms worsen or a high fever develops , a doctor should be consulted.

In addition, if symptoms do not improve at the end of antibiotic treatment or if symptoms occur within 2 weeks after taking antibiotics, it is necessary to  consult a doctor.


What can we do to avoid cystitis?

If there is only an occasional attack of cystitis, you do not need to do anything or change your lifestyle. 
In case of recurrent cystitis, the following actions may help:

There is no evidence that poor hygiene can cause cystitis. 
In fact, some women wash their anus and vagina a lot and it can do more harm than good. 
Many washes can slightly damage the skin of the genitals. 
Bacteria thrive best on damaged skin. 
If we rub the vagina a lot with our fingers during the bath, we can alter the normal balance of the protective mucus and allow the bacteria to multiply. 
One common-sense approach is to wash the anus and the surrounding skin gently once a day with soap and water.

Cleaning the anus from front to back after having defecated is the most helpful advice. 
The logic is that the bacteria in the anus are pushed back and not into the urethra. 
Drinking lots of water can help prevent cystitis, but after the onset of symptoms is not necessary.

Wear cotton underwear and change at least once a day. Do not wear tight pants or pantyhose. 
This avoids hot and humid conditions and the lack of air around the genitals that encourage the growth of bacteria. 
We recommend washing the panties twice before using to remove all traces of bacteria.


Natural Remedies for Cystitis

Blueberry juice or proanthocyanidin-containing tablets may help reduce the risk of recurrent or chronic bladder infections for some women. 
There are contradictory results from scientific studies that make it difficult to understand whether blueberry juice actually helps or whether there is only a placebo effect. 
Avoid blueberry juice when taking warfarin which is an anticoagulant blood medication.

Even if these preventative home remedies have not been properly studied, for repeated cystitis doctors sometimes recommend:

Drink plenty of fluids, especially water. 
Drinking lots of fluids is especially important during chemotherapy or radiation therapy, especially on treatment days.

Urinate often. 
If you feel like urinating, do not wait to go to the bathroom.

Taking a shower instead of bath in the tub
Who is sensitive to infections should take a shower instead of a shower to avoid cystitis.

Avoid using sprays of deodorants or feminine products on the genital area. These products can irritate the urethra and the bladder.


Diet for cystitis

Patients with cystitis often experience a worsening of symptoms with consumption of certain foods and beverages, especially caffeinated beverages such as coffee, tea and soft drinks. 
In the diet the foods to avoid are: alcoholic beverages, citrus fruits and juices, sugars although they may be in artificial sweeteners and chili, but they vary from person to person. 
The best way to discover foods that worsen symptoms is to use a diet of elimination.


Cystitis linked to sexual intercourse

Some women notice that they get sick from cystitis within a day or two after intercourse. 
This may be due in part to the movements during sexual intercourse that can push the bacteria into the bladder. 
There may also be slight damage to the urethra that encourages the growth of bacteria. 
This is most likely if the vagina is dry during intercourse. The normal mucus in and around the vagina can be disrupted, even if you use spermicides or contraceptives like the diaphragm.

With the following treatments, the possibility of cystitis after intercourse can be reduced:

  • After sexual intercourse, go to the bathroom to empty the bladder.
  • If the vagina is dry, use a lubricant prior to penetration.
  • Some people prefer to take a single dose of antibiotic within two hours after intercourse.
  • Do not use spermicides and / or diaphragm contraception, the condom is an excellent method of preventing cystitis.


How long does cystitis take?

The vast majority of women get better within a few days of the onset of cystitis. 
However, if the symptoms do not improve despite antibiotics, an alternative antibiotic may be needed. 
The bacteria that cause cystitis may be resistant to some types of antibiotics. 
In some cases, an untreated bladder infection may spread upward in the urinary tract and kidneys, causing pyelonephritis : inflammation and infection of the kidney. 
For more severe bladder infections, the time to heal depends on the clinical situation.
Patients can become seriously ill if the infection spreads from the urinary system to the blood, a condition called urosepse. Intravenous antibiotics are generally effective. Generally patients diagnosed with urosepse need a longer antibiotic treatment.

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