Urine Infections (UTI) Cystitis

Urine infections or UTI’s can affect different parts of your urinary tract. If your bladder is affected it’s called cystitis, if the urethra is affected it’s called urethritis and if the kidneys are infected it’s called a kidney infection. Urine infections are common, irritating conditions that usually affect women, though men and children can also be affected.

In this section we are looking at cystitis for more information on urethritis click here, for more information on kidney infections click here.

Over half the women in the U.K. will suffer from cystitis at some stage in their lives and though it can be painful, it doesn’t usually cause any long-term complications. Cystitis is more common in women when they are pregnant and after the menopause.

What causes cystitis?

The most common cause of cystitis is when bacteria, that usually lives harmlessly in the anus, enter the urethra and travel into the bladder causing inflammation. The bacteria which cause’s most cystitis infections is Escherichia coli (E.coli). Bacteria can get into your urinary tract during sexual intercourse, when inserting tampons or by wiping/washing your bottom from back to front. Women who use the contraceptive diaphragm may also be at risk of cystitis.

If the bladder is not emptied fully this can also cause bacteria to multiply, this is especially common in pregnant women because of the pressure on the pelvic area.

After the menopause women have a reduction in female sex hormones and so the lining of the urethra and the bladder become thinner and so are more likely to become infected and damaged. Women also produce less mucus after the menopause and without the mucus bacteria are more likely to multiply. Women generally are more likely to get cystitis than men as their urethra is shorter than a mans and is closer to the back passage, meaning bacteria hasn’t got as far to travel.

In women physical damage or bruising often caused by vigorous or frequent sex can also lead to cystitis this is sometimes known as ‘honeymoon cystitis’.

Diabetes can also increase the risk of cystitis as raised sugar levels can encourage bacteria to multiply quicker than normal.

Men who have an enlarged prostate gland are more at risk of getting cystitis, this is because the prostate prevents the bladder from completely emptying. When the bladder is not completely emptied the small drop that is always left behind may contain bacteria (a cause of cystitis).

What symptoms are linked with cystitis?

Symptoms of cystitis can range from mild, or you may experience symptoms that affect your daily life. The most common symptoms associated with cystitis are as follows:

• Pain (often burning) or stinging when passing urine.
• Feeling of wanting to pass urine, often urgently and more often than usual and yet having very little urine to pass.
• Urine may be dark or cloudy and contain blood.
• Strong or fishy smelling urine.
• A high temperature and a general feeling unwell and tired.
• A dull ache or pain in the lower back or abdomen.

These symptoms can also be a sign of another type of infection, such as a sexually transmitted disease. If you are worried about any symptoms you have, you should visit your doctor.

Children who have cystitis are more likely to get a high temperature, have little appetite and may even have sickness.

How is cystitis diagnosed?

If you have mild cystitis and and you recognise the symptoms, you should be able to diagnose and treat it yourself. However, you should see your doctor if you are not sure you have cystitis, symptoms do not improve or your symptoms are severe. A doctors will ask you about your symptoms and may examine you. To confirm a cystitis diagnosis your doctor may carry out a urine test, this will usually be a stick dipped in your urine. However, if a more detailed analysis is required your sample may be sent to a laboratory to help identify the presence of any bacteria. We sell a urine dip stick test for cystitis on this website that can help identify if you have cystitis. For more information or to purchase click here.

If a woman gets repeated infections, then the doctor should refer her for further tests such as an ultrasound or x-ray.

What treatment is available for cystitis?

If you have mild cystitis, it will usually clear by itself in 2-4 days. You can help by drinking lots of water (or any other bland liquid) as this will help to flush out bacteria and dilute your urine, so that when you pass urine it will not sting as much. However, try to avoid drinking anything, which contains caffeine such as coffee.

You can also try using products that alkalise your urine such as sachets containing potassium citrate or mix 1/2 a teapsoon of bicarbonate of soda in a glass of water, these might help improve the burning pain when you urinate. Ensure you check with your pharmacist if they are suitable and if you suffer from heart problems, avoid bicarbonate soda at all costs.

If you are in pain, try placing a hot water bottle wrapped in a towel, on your lower back or between your thighs. Painkillers, such as ibuprofen and paracetamol may also help to relieve the pain, ask your pharmacist for advice. Painkillers can be purchased from this website click here for more information.

If your cystitis has not cleared up within a day or so you should consult your doctor as you may require antibiotics. Antibiotics that are usually used to treat cystitis are trimethoprim and nitrofurantoin. If antibiotics don’t work your doctor may refer you for further tests.

Pregnant women, children and men with cystitis should always see their doctor. If your symptoms do not improve after the first few days of treatment, then return to your GP.

Women who get cystitis more than twice a year may benefit from medium or long-term antibiotic use. If you have recurrent cystitis your doctor may prescribe stand-by antibiotics or continuous antibiotics. A stand-by antibiotic is a prescription you can take to a pharmacy the next time you have symptoms of cystitis, without needing to visit your GP first. Continuous antibiotics are taken for several months to prevent further episodes of cystitis.  Your GP will prescribe appropriately, depending on symptoms and any known trigger (ie sexual intercourse).

Is there anything I can do to prevent future attacks of cystitis?

To prevent future infections, you should avoid anything that might cause irritation such as:

• Nylon tights and underwear (choose cotton underwear instead).
• Tight trousers and jeans.
• Perfumed soap, talcum powder or deodorants in the genital area.
• Bubble bath and bath oils.
• Avoid using spermicidal lubes when using a condoms or diaphragms.

You should also try the following:

• After you have been to the toilet always wipe from front to back.
• Wash your genital area morning and night.
• Try to pass water before and after sex.
• Take showers instead of baths.
• Try to drink at least 3 pints of liquid a day.
• Drink cranberry juice, as some research has shown it might be able to stop bacteria from clinging to the cells lining the bladder.
• Pass water as soon as you feel the need – don’t “hang on”. The bladder only stays clean and free from bacteria if it is emptied regularly.

What happens if cystitis is left untreated?

The bacteria that cause symptoms of cystitis can also produce the same effects over a longer period if left untreated. This is known as chronic cystitis. This can happen when the initial course of antibiotic treatment is not completed, allowing some of the bacteria to remain, or when some germs have a resistance to treatment. Chronic symptoms of cystitis can also be experienced when there is some abnormality in the urinary tract, such as a bladder stone.

If left untreated the bacteria can spread into the kidneys causing a kidney infection to develop.

If you develop cystitis when you are pregnant it can lead to you going into early labour. Women are screened for infections during antenatal appointments to prevent this happening.