How should cystitis be managed?

Cystitis refers specifically to an inflammation of the bladder wall, it is a fairly common lower urinary tract infection and is a frequent complaint of women that should not be taken lightly. It should not be treated without medical advice or supervision. Cystitis can range from a very simple problem to treat to a very serious medical condition requiring detailed investigation and appropriate treatment.
 

This is why it’s important to consult with a gynaecologist such as Mr Ahmed Ismail if you come across symptoms. We sat down with him to discuss the signs of this condition, its causes and available treatment options.

 

What is Cystitis?

Cystitis is inflammation of the bladder mucosa, resulting in a urinary tract infection (UTI). The cells in the bladder differ in nature to cells in the rest of the body. I.e. they’re non-permeable so don’t allow any fluid to profuse, thus maintaining the reservoir of fluid (urine).
 

Urine is an irritant; if it exits the bladder wall into the pelvis of the abdomen, it can be extremely uncomfortable and abrasive, which is why the nature of the epithelium (bladder lining) is watertight. When this is damaged, it causes Cystitis. Cystitis could be a symptom of various pathological problems such as polyps, ulcers, stones or cancer.
 

Causes of Cystitis

There are a few types of cystitis, both pathological and non-pathological.
 

Pathological cystitis

• Bacterial Cystitis is commonly associated with women (it can affect men but this is less common) because post-menopause the vaginal area becomes devitalized. The tissues have less nourishment and resilience and there’s less oestrogen to protect the area; this makes it easier for bacteria to develop. If bacterial, once treated, it’s cured.
   
• Inflammation and naturally occurring bladder stones (sands) may also be a factor. If this is the case, you need to cure the cystitis immediately once and for all, otherwise, it will become chronic.
   
• E-Coli, Cystitis and pregnancy. The bladder is located in the pelvis, where the uterus, fallopian tubes etc. exist. A very common cause of bacterial Cystitis is E-Coli, which can travel from the bladder into the genital area, uterus, tubes and ovaries, and cause numerous problems. If left untreated, it can result in Pelvic Inflammatory Disease and adhesions, potentially resulting in future fertility problems.
   

Non-bacterial (E.g. Honeymoon Cystitis)

• Rough sex, (sex of high frequency and vigorous/abrasive intensity) can make cystitis recur. In this instance, some women treat the symptoms with lubricants and Ibuprofen so that they can keep having sex without feeling pain. DON’T do that. Covering the pain may help temporarily, but the underlying abrasions and inflammation etc. will continue and eventually the lubricant will stop working and the pain will return.
   

Symptoms of Cystitis

The main symptoms may include a strong, persistent urge to urinate and a burning sensation when urinating. Also, one of the common signs of cystitis is passing frequent, small amounts of urine. Sometimes, urine becomes darker and can include blood (haematuria). Patients experience pelvic discomfort, a feeling of pressure in the lower abdomen and painful intercourse.
 

Treatment of Cystitis

• Drinking two litres of clear fluid such as water a day helps flush out the infection and reduces symptoms, preventing bladder stagnation and diluting the hyper-concentration of fluids within the affected area.
   
• A balanced diet with lots of water, fruits and vegetables which will flush the body and reduce irritants in the bladder, as well as protecting against and clearing bladder infections by allowing water to pass more efficiently.
   
• Drinking cranberry juice will also help to restore the bladder’s natural PH balance and soya capsules will provide beneficial estrogenic effects. Avoid consuming excessive amounts of peppers and very spicy foods.
   
• Non–steroidal anti-inflammatory drugs will help to alleviate inflammation and relieve pain caused by the infection or trauma. However, it won’t treat the infection itself or kill the bacteria, which will keep multiplying and thriving.
   

Antibiotics are effective. However, today, they are used too frequently and readily prescribed to treat a multiplicity of infections. The problem with this is that over time the population (and the infections themselves) become immune to them. Consequently, scientists and doctors are constantly researching and creating new variations in an attempt to keep antibiotics working. One of the biggest factors in this is that people stop taking the course of medication as soon as they think they are cured, as soon as the symptoms have disappeared. This isn’t the case. Incomplete treatment of bacterial bladder infection will result in relapse and frequently recurrent Cystitis. The bacteria will remain present most of the time and due to the on-off nature of taking the treatment, it may become resilient to the antibiotics, making subsequent treatment more complicated and potentially resulting in related infections (e.g. kidney infection).
 

Cystitis is just one of Mr Ahmed Ismail ’s many areas of expertise in gynaecology and obstetrics. Visit his Top Doctors profile to learn more and to book a consultation.