Cystitis
 
Cystitis is a painful condition that is common in women. 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.

What is cystitis?

Cystitis is an inflammation of the bladder, a part of the urinary system. This system consists of the kidneys, the bladder itself (a ´bag´ in which urine is stored after it leaves the kidneys), the ureters, which carry urine from the kidneys to the bladder, and a narrow tube called the urethra. When the bladder is full, urine is passed out of the body through the urethra.

The causes of cystitis
About half of all 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. 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 man’s.
 
Cystitis may also be caused or made more likely to develop by:
 
 - bruising of the urethra, 
 - poor hygiene, 
 - 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

Symptoms can vary, but they can include any or all of the following: 
 
 - a strong urge to urinate, even when the 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 infection (STI). If an STI is supected – for example, if both sexual partners have symptoms – visit a GP or genito-urinary medicine (GUM) clinic.

When to see a doctor

A GP should be consulted if:
 
 - there is blood in the urine, 
 - there is no improvement in symptoms after 24 hours, 
 - you are or may be pregnant, 
 - symptoms are accompanied by a high temperature, 
 - there is 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 (one present at birth) with the bladder. 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 by sending 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 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 not yet fully understood.

Preventing cystitis

By making some simple changes in your daily routine, cystitis can be prevented.
 
 - Drink plenty of water 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 the bladder is completely emptied 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. 
 - Go and empty your bladder as soon as possible after sex. 
 - Use a lubricant to reduce friction and bruising. 
 - Avoid touching the anus as this may spread the bacteria.