Cystitis means inflammation of the bladder. It is usually caused by
bacteria. Cystitis is more common in women than men probably because the
tube leading out of the bladder, the urethra, is relatively short in women.
The inflammation causes dysuria, (pain during micturition - emptying of the
bladder) and frequency or shortened intervals between micturition.
Haematuria, blood in the urine, may occur with severe cystitis but there are
other causes and early, careful medical assessment is always essential.
At one time we thought that infection was confined to a
single organ but we now believe that it usually involves
other parts of the system. Thus infection is unlikely to be
confined to the bladder but may involve the urethra and
kidneys: we therefore now call these episodes 'urinary tract
infections'. On occasion the infection may reach the kidneys
and be severe (pyelonephritis) resulting in severe loin pain
and fever. Recurrent episodes of pyelonephritis can lead to
renal (kidney) damage.
When urinary tract infection is suspected, a mid-stream
sample of urine is usually sent to the laboratory to confirm
the diagnosis, determine the type of bacteria and check the
sensitivity of the organism to the more common antibiotics.
Cystitis usually responds quickly to an appropriate
antibiotic.
Cystitis is a common problem in women. A study in Sweden found that 40% of
women aged between 21 and 70 years had received treatment within the
previous two years. More than one half the women treated for urinary tract
infection have a further attack within the next two years.
Interstitial
cystitis (IC), also known as painful bladder syndrome, is a
chronic, painful, inflammatory condition of the bladder wall
that affects over one million people in the United States. The
cause is unknown and there is no cure, but there are many
available treatment options to help relieve symptoms.
Although IC
is not as well known, it is as common as Parkinson's disease or
Type I diabetes.
This is usually the result of frequent intercourse. There may not be true
infection but just inflammation at the base of the bladder, which is
situated close to the front wall of the vagina. Antibiotics may help if
there is infection but a few days abstention may be required.
One study found that more than 50% of women emptied their bladders more
frequently than three hourly and 11% more frequently than every two hours.
Fourteen percent of women emptied their bladders more than once during the
night.
What is a urinary tract infection (UTI)?
A urinary tract infection (UTI) is a
bacterial infection that can affect any part of the urinary
tract. Urine is usually sterile - it should not have
bacteria in it. When bacteria get into the
bladder or kidney and multiply in the urine, they cause
a UTI. The most common type of UTI is a bladder infection
which is also often called cystitis. Another kind of UTI is
a kidney infection, known as pyelonephritis, and is much
more serious. Although they cause discomfort, urinary tract
infections are usually quickly and easily treated by
antibiotics.
There are a number of symptoms that would suggest a
urinary tract infection. The most common symptom is pain or
a burning sensation during voiding (micturition). Another
common symptom is the need to empty the bladder frequently.
There may be a need to empty the bladder during the night (nocturia).
The physical signs include pyrexia (elevated body
temperature) and cloudy smelly urine. UTIs are more common
in sexually active women, those with a tendency to infection
due for example to diabetes and those born with a congenital
anatomical malformation of the urinary tract. Women are more
prone to urinary tract infection as the urethra (the exit
tube from the bladder) is relatively short and closer to the
anus allowing ascending infection. Some women find that they
are liable to develop a UTI if, during sexual intercourse,
their partner enters their vagina from behind. This is
because in this position it is more likely that bacteria
from around the anus may be pushed forward towards the
urethra. It is possible to have bacteria in the urinary
tract without symptoms (asymptomatic bacteruria).
Dipsticks have been developed to allow a quick diagnosis
of UTI. No combination of dipstick and/or symptoms
adequately predicted an infection to the point that a
recommendation to dispense with the need for a culture in
one urogynecology population could be made.0810
The diagnosis of urinary tract infection is confirmed by
culture of a mid-stream urine sample (MSU). The most common
pathogen is E.coli.
Antibiotics, including trimethoprim, cephalosprins,
nitrofurantoin and penicillins such as amoxicillin usually
prove to be effective treatments. Urine culture will
demonstrate antibiotic sensitivity of the causative bacteria
if first line treatment fails. In severe infections,
including pyelonephritis, intravenous antibiotic
administration may be required.
If a patient has recurrent UTIs, further investigation of
the urinary tract, including ultrasound of the kidneys and
bladder and x-rays (IVP) may be indicated.
Cranberries have been used widely for several decades for
the prevention and treatment of urinary tract infections (UTIs).
There is some evidence that cranberry juice may decrease the
number of symptomatic UTIs over a 12 month period,
particularly for women with recurrent UTIs. The large number
of dropouts/withdrawals in clinical studies indicates that
cranberry juice may not be acceptable over long periods of
time. It is not clear what is the optimum dosage or method
of administration (e.g. juice, tablets or capsules). Further
properly designed studies with relevant outcomes are needed.0807
Related Medical Abstracts - Click on the paper
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Support Groups
Members of a support group, provide each other with
various types of help for a particular shared difficulty.
The support may take the form of providing relevant
information, relating personal experiences, listening to
others' experiences, providing sympathetic understanding and
establishing social networks. A support group may also
provide ancillary support, such as serving as a voice for
the public or engaging in advocacy. Support groups maintain
interpersonal contact among their members in a variety of
ways. Support groups also maintain contact through printed
newsletters, telephone chains, internet forums, and mailing
lists.
Support groups offer companionship and information for
people coping with diseases or disabilities. Support groups
may not be appropriate for everyone, and some find that a
support group actually adds to their stress rather than
relieving it.
Evaluation of the quality of Web sites is discussed in (internet information).
You may find that several general women's health sites may
help you (internet information).
The following are more specialised relevant Web sites:-
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