Cystitis: Causes, symptoms, and treatments

Cystitis is a type of urinary tract infection (UTI) that causes inflammation in your bladder. It is most often caused by a bacterial infection in the urinary tract. When your bladder becomes inflamed, its ability to store and release urine normally can be affected. This leads to uncomfortable symptoms such as pain or burning when you urinate, and a frequent or urgent need to go.

Most cases are acute, meaning the symptoms are often severe but do not tend to last long. Symptoms typically resolve within a few days when treated. However, in some people, cystitis can become recurrent. Rarely, it can develop into a chronic condition, which may cause long-term changes in the bladder lining.

Cystitis can also be classified as infectious (caused by bacteria or other pathogens) or non-infectious (caused by irritation, medications, or other factors). Prompt diagnosis and management are important to relieve symptoms and prevent complications.

Cystitis can cause a range of symptoms, but some may overlap with other urinary or pelvic conditions, so experiencing them does not always mean you have cystitis. Common signs that may suggest cystitis include:

• pain or discomfort when you urinate
• needing to urinate more often
• feeling an urgent need to urinate
• urine that is dark, cloudy or smelly

In many cases, cystitis goes away on its own after a few days. However, if your symptoms do not improve after 48 hours, or if you are pregnant, you should speak to a doctor.

You should seek medical advice urgently if you experience any of the following along with the urinary symptoms:

• high temperature
• vomiting
• back pain
• shivering or shaking
• blood in your urine
• stomach pain
• generally feeling unwell

These signs may indicate a more serious infection, such as a kidney infection. They should be assessed promptly by a doctor or nurse.

Cystitis occurs when bacteria, usually from the bowel or skin, enter the urethra and travel up to the bladder. The urethra is the tube that carries urine from your bladder to outside your body. While these bacteria normally do not cause any problems when they’re in the bowel or on the skin, they can lead to infection if they get into the bladder.

The most common cause of cystitis is Escherichia coli (E. coli), a type of bacteria that usually lives in the intestines. E. coli is responsible for approximately 70 to 95% of cases of uncomplicated UTIs in women.

You are more likely to develop cystitis when certain activities or conditions make it easier for bacteria to enter the urethra, such as:

• having sex
• using a female diaphragm for contraception
• wiping your bottom from back to front after the toilet
• having a catheter in the bladder
• use of certain drugs, such as ketamine

➤ Chronic ketamine use can irritate and damage the bladder and urinary tract, causing symptoms similar to a urinary infection – such as pain, frequent urination, or blood in the urine – even though bacteria are not involved. This is sometimes called ketamine‑induced uropathy (KIU), and it may require different treatment than a usual bacterial urinary infection.

Factors that increase your risk of cystitis

Women are generally at higher risk of cystitis than men because their urethra is shorter and closer to the anus, making it easier for bacteria to reach the bladder. After menopause, lower levels of oestrogen can make the tissues of the vagina and urinary tract drier and thinner, which can increase susceptibility to urinary tract infections. National Institute for Health and Care Excellence (NICE) guidelines recognise lower oestrogen levels as a known risk factor for recurrent urinary tract infections.

When you are pregnant, changes to the urinary tract – including pressure from the growing uterus and slower urine flow – can make it harder to empty the bladder completely. This increases the risk of infection, so UTIs (including cystitis) are more common during pregnancy.

Certain medical conditions, such as diabetes, can also increase the risk of developing cystitis.

You may experience recurrent cystitis for a few reasons. These include:

• a history of bladder or kidney problems – for example, kidney stones or conditions that prevent the bladder from emptying completely
• use of diaphragms for contraception – these can make it easier for bacteria to reach the urethra
• hormonal changes – for example, during menopause, reduced oestrogen levels can weaken the tissues of the vagina and urinary tract, making them more prone to irritation and infection

➤ If you keep getting cystitis, it’s important to see a doctor. They can help determine the cause, arrange any necessary tests and provide advice or treatment to help prevent further infections.

Bacterial cystitis vs interstitial cystitis

Interstitial cystitis (IC), also known as bladder pain syndrome (BPS), is a chronic condition not caused by bacteria. People with IC/BPS often experience bladder pressure or pain, frequent urination, and a persistent urge to urinate, sometimes lasting months or years. Unlike bacterial cystitis, IC/BPS does not respond to antibiotics.

You can reduce your chances of getting cystitis by adopting a few simple habits. Helpful steps to prevent cystitis include:

• going to the toilet as soon as you feel the urge to urinate and fully emptying your bladder each time
• avoiding or limiting fizzy drinks or drinks that contain caffeine
• avoiding or limiting foods that may irritate the bladder, like citrus fruits, spicy foods, or “trigger” foods identified for you personally
• staying hydrated by drinking enough water each day
• wiping your bottom front to back when you go to the toilet
• urinating as soon as possible after sex
• using alternatives to a female diaphragm, such as male condoms, for contraception

If you have mild cystitis, there are several home remedies and medicines that can help relieve your symptoms while your body clears the infection. To help relieve cystitis symptoms, try to:

✓ drink plenty of water

✓ avoid having sex until you feel better

✓ avoid drinks that can irritate the bladder, such as caffeine and alcohol

✓ hold a hot water bottle over your lower tummy to help relieve discomfort

You can also consider medication to help relieve cystitis symptoms such as:

✓ over the counter painkillers (paracetamol) to reduce fever and discomfort

✓ antibiotics, including nitrofurantoin (also known as MacroBID), to clear the bacteria causing cystitis

✓ potassium citrate or sodium citrate powder, which help reduce pain, lower the acidity of urine and help clear bacteria

A doctor will be able to advise the best course of treatment for you to relieve your cystitis symptoms. Antibiotics usually work fast and you should notice an improvement in your cystitis symptoms in 1 or 2 days.

Cystitis is most often treated with medications that help clear the infection and relieve symptoms. The treatment you may be prescribed depends on the severity of your symptoms and whether you have any other health conditions.

For bacterial cystitis, antibiotics are usually prescribed to target the infection and help eliminate the bacteria causing the inflammation. Common antibiotics used to treat cystitis include nitrofurantoin and fosfomycin.

Most people feel better within a few days of starting treatment.

Nitrofurantoin

Nitrofurantoin is a commonly prescribed antibiotic for uncomplicated cystitis. It works by stopping the growth of bacteria in the urinary tract. You normally take it for a short period (usually 3 to 7 days) and is effective in treating most cases of cystitis caused by E. coli.

Fosfomycin

Fosfomycin is another antibiotic that may be prescribed, particularly if you cannot take nitrofurantoin (due to allergies or other health issues). It is often taken as a single dose, which makes it a convenient option for some people. Like nitrofurantoin, fosfomycin works by stopping bacteria from growing, helping clear the infection.

If you're experiencing cystitis symptoms, Asda Online Doctor offers a convenient and discreet service to help diagnose and treat your condition. You can consult with a doctor online and receive a prescription for the right treatment.