Cystitis: a Self-Help Guide

Cystitis

Introduction

Cystitis is quite a common condition among women. Knowing more about it can help you prevent it happening or take prompt action to reduce the symptoms if you do have an attack.

What is cystitis?

Cystitis means an inflammation of the bladder. The bladder is the muscular bag which stores urine after it has been produced by the kidneys before it is released by the water passage (the urethra). With cystitis it is often the case that the bladder and the urethra are both inflamed. Cystitis most commonly affects women, but it can also affect men and children although this is quite rare. Cases of men or children suffering cystitis should always be referred to a doctor.

What causes cystitis?

The inflammation in cystitis has many causes. It is often due to infection,but may also result from mechanical trauma or bruising.

Infection

Around half of all cases of cystitis are caused by germs reaching the usually germ-free urethra. These germs are normally found in the bowel. In women the openings of the bowel (anus) and bladder (urethra) are very close together.It is very easy for bacteria around the anus to reach the urethra and travel up to the bladder where they multiply and irritate the bladder lining. Bacteria may be pushed into the urethra when tampons are being inserted, during sexual intercourse or from wiping your bottom from back to front.

Mechanical trauma

Vigorous sexual activity may cause very minor damage to your body(mechanical trauma). Wearing very tight jeans and sexual intercourse are two common causes of bruising of the urethra. All may cause cystitis. Women who use the contraceptive diaphragm are also prone to this type of inflammation.

Chemical irritants

Symptoms of cystitis may be due to using perfumed soaps, bath foams or oils,talc, vaginal deodorants and douches or contraceptive creams. Some women find that things such as strong tea, coffee, alcohol, fruit juice or highly spiced dishes make their cystitis worse.

Hormone deficiency

After the menopause, the lining of the urethra and the bladder become thinned due to hormone (oestrogen) deficiency. This thin lining is more likely to become infected and traumatised.

Other causes

An attack may be linked to ‘holding on too long’ before passing urine, or wearing tight fitting trousers or underwear—creating the warm, moist conditions that germs love.

How do I know if I have cystitis?

If you have any of the following symptoms you may be suffering from cystitis. The severity of the symptoms vary from person to person:

  • a frequent urge to pass urine, but when you do so you pass only small amounts
  • pain or burning/stinging feeling when you pass urine
  • needing to get up several times during the night to pass small amounts of urine
  • dark or clouding looking urine which may contain blood
  • strong or even fishy smelling urine
  • the urge to pass urine is so strong that you can’t get to the lavatory in time
  • a dull ache or pain in the lower back or abdomen
  • generally feeling unwell, sick or feverish.

What should I do if I havean attack of cystitis?

At the first sign of an attack it is worth taking immediate action:

  • Drink as much fluid as you can to flush out the system, dilute the urine and reduce any stinging. For the first four hours try to drink a pint of water every hour even if the attack starts in the middle of the night. Then drink half a pint every two hours for the next eight hours. Drink bland fluids such as water, weak tea or fruit squash (avoid orange juice and carbonated drinks).
  • Making the urine less acid will reduce any discomfort—try a teaspoon of bicarbonate of soda dissolved in a glass of water or preparations containing citrate (your local chemist will be pleased to help you). But women with high blood pressure or heart trouble should not take either bicarbonate of soda orcitrate without first consulting their doctor.
  • Go to the lavatory as much as you need to, don’t try to ‘hold on’.
  • Keep warm and place a well-covered hot water bottle over your tummy or between your thighs. A second one at your lower back may also help.
  • Take one or two aspirin or paracetamol tablets for the pain.
  • Avoid alcohol and sexual intercourse until you feel better.
  • Rest as much as possible.

Section three: How can I prevent an attack of cystitis?

There are many causes of cystitis and it is not always possible to pin down the exact reason for an attack. However, there are a number of self-help measures you can include in your daily routine, which may help prevent attacks in the future.

Drink at least 3–4 pints of bland liquid every day—this will help keep your bladder ‘flushed’ free of bacteria.

Go to the lavatory when you feel the need, don’t try to ‘hang on’. This prevents stress to the bladder which can encourage an attack.

Always wipe yourself from front to back after using the lavatory, this helps stop germs spreading from the anus to the urethra.

Avoid vaginal deodorants and douches, perfumed soaps, bubble bath and talc—these may irritate the urethra. Showering rather than bathing may be helpful.

Avoid tight trousers or underwear, especially if they’re made from artificial fibres. Choose cotton underwear with stockings and looser clothes such as skirts. This helps prevent the warm moist conditions and rubbing, which encourages germs to spread.

Avoid, dilute or cut down on liquids and foods you suspect may make your cystitis worse, such as alcoholic drinks, fruit juices, strong tea or coffee or highly spiced dishes.

If your cystitis flares up after sex:

  • make sure you wash your genital area and your hands before any sexual contact
  • try to pass urine immediately after as this helps flush out any germs
  • if your vagina feels dry during sexual intercourse use a lubricant such as KY Jelly to ease the problem of friction and lessen the chances of bruising
  • avoid touching the area around your back passage
  • if you use the contraceptive diaphragm, try using the pill, a coil or condoms instead.

After the menopause, hormone (oestrogen ) creams prescribed by your doctor may help.

When should I seek advice from my doctor?

Having cystitis for the first time can seem rather frightening, but do remember that it is not usually a serious threat to your health. Using the self-help measures described above should stop or prevent an attack of cystitis. However, you should see a doctor at once if:

  • there is blood in your urine
  • the symptoms are no better after 24 hours of self-help measures
  • you are or may be pregnant
  • you develop a temperature
  • you develop pain in the lower back or severe abdominal pain
  • the symptoms keep coming back.

You may need to give a sample of urine to find out if you have an infection and you may need an antibiotic.

Men and children with cystitis should always see a doctor.

What will happen if the symptoms don’t improve or I keep getting attacks?

Some women get recurrent attacks of cystitis. This may be due to a number ofreasons:

  • The germs may be resistant to the antibiotic your doctor has prescribed.The antibiotic can be changed once the result of the urine test is known.
  • There may be an abnormality in the urinary tract making repeated infections more likely—further tests or referral to hospital may be necessary.
  • The symptoms may not be due to cystitis at all. Vaginal infection such as thrush can cause discomfort when passing urine, but not the need to go more often. Sexually transmitted disease can cause the same discomfort, so, especially if your partner has symptoms you should both go to your doctor for help.

It is worth remembering that even with all the advances in modern medicine there is not always a ‘miracle cure’ for cystitis and attacks may well continue. Trying to prevent attacks by looking at your lifestyle and seeing what you can do to help yourself and also following the self-help advice outlined in this leaflet as soon as you have an attack are useful ways of minimising the effects of cystitis. Some women who have recurrent attacks may feel depressed, or needunderstanding and care from their partners. They should not be afraid of expressing their feelings to their doctor or their partner.

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