Cystitis is an inflammation of the urinary bladder, most often due to a bacterial infection. The irritation of cystitis prompts the bladder nerves to signal a sudden and urgent need to urinate, even though the bladder may be relatively empty. Urination is accompanied often by pain or a burning sensation, and if the infection is severe, only small amounts of urine may pass, usually containing blood. Other possible symptoms include a low grade fever and pain in the pubic area. Most bladder infections are caused by Escherichia coli, bacteria that normally live in the intestines. Chlamydia, a sexually transmitted organism, also causes cystitis. These can invade the bladder through the urethrathe tube through which urine leaves the body. Women are especially vulnerable to cystitis because the female urethra is short about two inches compared with 8 to 10 inches in men and is located near the vagina and anus where bacteria can flourish. Also, sexual activity can cause bacteria to be introduced into the urethra, resulting in “honeymoon cystitis.” An over sized diaphragm, which may apply pressure to the urethra and bladder, also promotes cystitis. Other contributing factors include the hormonal changes of menopause and allergic reactions to tampons, spermicides, and lubricants .
Diagnostic Studies And Procedures
Diagnosis is based on a physical examination and analysis of a urine sample to identify the causative bacteria. A nonprescription home kit, available at most pharmacies, contains urine dipsticks that can confirm a bacterial Cranberry juice can help prevent recurrent cystitis, because it acidifies the urine, creating an environment that is inhospitable for bacteria. infection. A doctor’s visit will still be necessary, however, because home tests do not indicate the causative organism.
Ideally, therapy should not begin until after a culture has identified the organism, enabling a doctor to prescribe the best antibiotic to eradicate it. In some cases, however, a broad spectrum antibiotic such as sulfamethoxazole with trimethoprim (Bactrim or Septra) or nitrofurantoin (Macrodantin and others) may be prescribed to quickly alleviate symptoms while awaiting results of the urine studies; lab tests may be repeated several days later to make sure that the drug has worked. The duration of antibiotic therapy varies. Some doctors prescribe a single large dose; others favor a 7- to 10- day course, or an even longer regimen for recurring infections. It is important to take the full course, even though symptoms may disappear within a few days . Some doctors recommend that women who have recurrent cystitis take a low dose antibiotic on a continuing basis as a preventive measure. Urinary pain usually abates within a few hours of starting antibiotic therapy. If not, a bladder analgesic such as phenazopyridine (Pyridium) may help.
Alternative therapies will not cure the infection but may relieve symptoms.
Needles along the bladder, liver, kidney, and spleen meridians are usually helpful in relieving the pain of cystitis.
Alfalfa, which is reputed to be a natural diuretic, is often used to treat urinary tract infections.
Either sarsaparilla or cantharis may be advocated for painful urination. Cystitis, or bladder infection, is common in women because the urethra, vagina, and rectum are so close together that bacteria from the rectum and vagina can easily enter the urethra.
Warm sitz baths can help soothe urinary burning sensations as well as ease pain.
Antibiotics that are prescribed to treat cystitis often kill beneficial bacteria as well, resulting in a vaginal yeast infection and diarrhea. Nutrition therapists advise taking acidophilus capsules three times a day or eating yogurt with active acidophilus cultures. Some also recommend drinking cranberry juice because it appears to contain a bacteria killing compound; it also acidifies the urine. However, it may cause bladder irritation.
The following self care measures can alleviate cystitis pain, hasten healing, and prevent recurrent infections:
- Drink at least 8 to 10 glasses of fluids daily to help flush out the bladder. However, avoid alcohol and caffeine, which cause bladder irritation.
- Women should urinate and then drink a full glass of water before sexual intercourse. Wait for an hour afterward and then urinate again; this allows the bladder to fill and wash out bacteria.
- Do not use vaginal deodorants or other potentially irritating substances.
- Wear cotton underwear and avoid tight garments to allow the genital area to remain dry. Avoid sitting around in a wet bathing suit.
- If you use a diaphragm, make sure you are fitted correctly or consider some other birth control method. Also, use sanitary pads instead of tampons.
- After a bowel movement, always wipe from front to back, this reduces the spread of bacteria from the rectum to the urethra.
Other Causes of Urinary Problems
Painful urination may be caused also by a bladder disorder called interstitial cystitis, by a sexually transmitted disease such as gonorrhea or, in men, by prostate enlargement. Blood in the urine may be triggered by a stone in the urinary tract, or cancer of the bladder, kidney, or prostate.