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Cystitis is a condition characterized by inflammation of the bladder, often triggered by a bacterial infection, leading to a urinary tract infection (UTI). UTIs can affect various parts of the urinary system, including the kidneys, ureters, bladder, and urethra. Bladder infections occur when bacteria from the perineum (the area between the vagina/penis and rectum) enter the urethra and subsequently spread to the bladder. This can result in painful and bothersome symptoms. If left untreated, the infection can potentially spread to the kidneys, leading to more severe health complications.
Cystitis can also result from reactions to specific medications or radiation therapy. Irritants to the bladder, such as certain hygiene products, spermicide jelly, or long-term catheter use, can also lead to cystitis. Additionally, it may occur as a complication of another underlying illness.
The standard treatment for bacterial cystitis involves taking antibiotic medication. On the other hand, treatment for other types of cystitis depends on the underlying cause.
Symptoms
In young children, experiencing sudden instances of daytime wetting may be a potential sign of a urinary tract infection (UTI). However, it’s crucial to note that a UTI is unlikely to be the sole cause of nighttime bed-wetting.
Cystitis, or a urinary tract infection (UTI), can present with the following signs and symptoms:
- Persistent and intense urge to urinate.
- Pain or a burning sensation during urination.
- Frequent urination with small amounts passed each time.
- Presence of blood in the urine (hematuria).
- Cloudy or strong-smelling urine.
- Pelvic discomfort or pain.
- Pain in the lower abdomen area.
- Low-grade fever.
Seek immediate medical help if:
- You experience signs of a kidney infection, such as back or side pain, fever, chills, nausea, and vomiting.
- You have urgent, frequent, or painful urination lasting for several hours or notice blood in your urine.
Contact your healthcare provider if:
- You’ve been diagnosed with a UTI in the past and develop symptoms similar to a previous UTI.
- Cystitis symptoms come back after completing antibiotic treatment, as you may need a different type of medicine.
- Your child starts having daytime wetting accidents.
- You’re a man with any concerning symptoms, as cystitis is rare in otherwise healthy men.
Causes
There are several causes of cystitis, which are often classified as bacterial and noninfectious.
- Bacterial cystitis: UTIs commonly result from the intrusion of bacteria from the external environment into the urinary tract via the urethra, where they rapidly multiply. The leading cause of cystitis, an inflammation of the bladder, is typically a strain of Escherichia coli (E. coli) bacteria. Nonetheless, various other bacterial types can also lead to infections. Women may experience bacterial bladder infections after sexual intercourse, while even non-sexually active individuals can develop UTIs due to the presence of bacteria in the female genital region, which can be a source of cystitis.
- Noninfectious cystitis: Cystitis is primarily caused by bacterial infections, but it’s important to recognize that the inflammation of the bladder can also be attributed to various noninfectious factors, such as:
- Interstitial cystitis: This condition predominantly affects women. The diagnosis and treatment can be challenging. The exact cause of this persistent bladder inflammation, also known as painful bladder syndrome, remains unclear.
- Drug-related cystitis: When the body eliminates the disintegrated components of certain medications, like chemotherapy drugs used in cancer treatment, it can lead to inflammation of the bladder.
- Radiation cystitis: Inflammatory alterations in bladder tissue can occur due to pelvic radiation therapy.
- Foreign-body cystitis: The risk of bladder inflammation is higher with extended use of catheter. Usage can cause bacterial infections and tissue damage.
- Chemical cystitis: An allergic-type reaction can occur within the bladder, causing inflammation in some people who may be extra sensitive to chemicals found in certain products like bubble baths, personal hygiene spray, or spermicidal jelly.
- Cystitis associated with other conditions: As a complication of health issues like diabetes, kidney stones, an enlarged prostate, or spinal cord injury, cystitis may occasionally develop.
Risk factors
Certain factors may contribute to a higher risk of developing cystitis, or UTIs, such as:
- Gender: While anyone can experience cystitis, women are more susceptible to developing bladder infections or recurrent urinary tract infections compared to men. This increased vulnerability is due to their shorter urethra, which provides a shorter path for bacteria responsible for infections to reach the bladder.
- Engagement in sexual activity: Bacteria can enter the urethra during sexual intercourse.
- Using certain types of birth control: The risk of developing a UTI is higher when using a diaphragm, and this risk is further elevated if the diaphragm contains spermicide.
- Pregnancy: Pregnant women are more susceptible to developing bladder infections due to hormonal changes.
- Menopause: Menopause may alter hormones which can contribute to the occurrence of UTI.
- Prolonged usage of urinary catheters: Long-term use of catheters can increase the susceptibility to bacterial infections and may also lead to damage to the bladder tissue. Nevertheless, in individuals with chronic illnesses or older adults, the use of these tubes may become necessary.
- Obstruction with the flow of urine: Having a stone in the bladder or an enlarged prostate may result in bladder inflammation.
- Changes in the immune system: Diabetes, HIV infection, and cancer treatment are conditions that may increase the risk of having cystitis.
Diagnosis
The diagnosis of bladder inflammation often involves discussing the signs and symptoms and assessing one’s medical history. The healthcare provider may request several tests to confirm the diagnosis or develop a treatment plan.
The tests may include:
- Urinalysis: This test examines the appearance, concentration, and content of urine, which includes checking the urine for symptoms of infection such as bacteria, blood, or pus. A urine sample is often collected in a sterile cup. If bacteria are discovered, a urine culture may be performed.
- Urine culture: This test determines the type of bacteria that is causing the infection as well as the antibiotics to which the bacteria is sensitive.
- Imaging test: Usually, an imaging test is not required for cystitis. However, in certain instances, imaging can be beneficial. For example, your healthcare provider may use an X-ray or ultrasound to identify other possible causes of bladder inflammation, such as tumors or anatomical issues.
Treatment
Antibiotics are typically used to treat cystitis caused by bacterial infection. The healthcare provider will prescribe an antibiotic based on the type of bacteria discovered during the urine testing. Other types of cystitis are often treated depending on the cause.
- Treating bacterial cystitis: To effectively treat the condition, antibiotics must be taken as prescribed. The specific medication to be used and how long they are taken for are determined by the overall health and the germs discovered in the urine. Antibiotics that are widely used include nitrofurantoin, sulfonamides, amoxicillin, quinolone, among others.
- First-time infection: Antibiotics are often taken for three to seven days. It is recommended to take the pills as directed by the healthcare provider and avoid stopping the medication early, even if there is an improvement in the condition. This ensures complete eradication of the infection. Symptoms frequently improve dramatically within the first few days of taking antibiotics.
- Repeat infection: In some cases, taking a single dose of antibiotics after sexual activity may be suggested as a preventive measure for recurring infections. In most cases, a longer course of antibiotics is prescribed for recurrent UTIs. A specialist to investigate any potential urologic problems that could be causing the infections may be necessary.
- Hospital-acquired infection: This type of infection requires the use of alternative antibiotics and treatment approaches to address the situation effectively. Treating hospital-acquired bladder infections can be difficult due to the resistance of hospital bacteria to common antibiotics used for community-acquired infections.
- Treating interstitial cystitis: Interstitial cystitis is a condition where the cause of inflammation is unclear. To help with the symptoms, you might take pills, have medication put directly into your bladder, or try nerve stimulation with mild electrical pulses to reduce pelvic pain and frequent urination. Surgery is a last-resort option and may not always work to relieve pain and other symptoms. It’s essential to try other treatments first before considering surgery.
- Treating other forms of noninfectious cystitis: For individuals sensitive to chemicals in products like bubble bath or spermicide, avoiding these items can help alleviate symptoms and prevent recurrent cystitis episodes. Adequate hydration by drinking plenty of fluids is also essential to flush out potential bladder irritants. In instances where cystitis develops as a complication of chemotherapy or radiation therapy, the main approach to treatment is managing pain through medication.
