• Acute Cystitis

    (Bladder Infection)

    Definition

    Cystitis is an infection of the bladder. The bladder is part of the urinary tract. The bladder collects the urine from the kidneys.
    The Urinary Tract
    The Urinary Tract
    Copyright © Nucleus Medical Media, Inc.

    Causes

    Your urinary tract normally contains no microorganisms. However, sometimes bacteria or yeast from your lower intestines or rectal area enter your urinary tract. This usually happens through your urethra. The urethra is a tube that allows urine to pass out from the bladder. When bacteria or yeast cling to your urethra, they can multiply and infect your urethra. They can then travel up and infect your bladder.
    Most cases of cystitis are caused by bacteria from your rectal area. In women, the rectum and urethra are fairly close to each other. This makes it relatively easy for bacteria to make their way into the urethra. Some women develop cystitis after a period of frequent sexual intercourse. This happens because bacteria enter the urethra during sex and cause infection.

    Risk Factors

    A risk factor is something that increases your chance of getting a disease or condition.
    Risk factors include:

    Symptoms

    Symptoms of cystitis vary from person to person and can range from mild to severe. They include:
    • Frequent and urgent need to urinate
    • Passing only small amounts of urine
    • Pain in your abdomen, pelvic area, or lower back
    • Burning sensation during urination
    • Leaking urine
    • Increased need to get up at night to urinate
    • Cloudy, bad-smelling urine
    • Blood in your urine
    • Low-grade fever
    • Fatigue

    Diagnosis

    The doctor will ask about your symptoms and medical history. A physical exam will be done. A sample of your urine will be tested for blood, pus, and bacteria. If bacteria are present in your urine, you will likely be diagnosed with cystitis.
    Children and men who develop cystitis may require additional testing. The doctor will use a cystoscope to check for structural differences in your urinary system that increase the likelihood of infection.

    Treatment

    Bacterial cystitis is treated with antibiotic drugs. Antibiotics (usually trimethoprim/sulfamethoxazole, nitrofurantoin, or fluoroquinolones) will be prescribed for at least 2-3 days and perhaps for as long as several weeks. The length of the treatment depends on the severity of the infection and your personal history. You will probably start to feel better after a day or two. However, it is important that you complete the entire course of medication. Otherwise, the infection is likely to return. You may have your urine checked after you finish taking the antibiotic. This is to make sure that the infection is gone.
    If you experience more infections, your doctor may prescribe stronger antibiotics or have you take them for a longer period of time. He or she may also recommend that you take low-dose antibiotics as a preventive measure, either daily or after sexual intercourse. If you still experience recurrent infections, you may be referred to a specialist.
    Phenazopyridine (Pyridium) is a medicine that decreases pain and bladder spasms. This medication is generally available without a prescription. It can usually relieve symptoms effectively while waiting for medical treatment to work. Taking phenazopyridine will turn your urine and sometimes your sweat an orange color

    Prevention

    Here are some steps you can take to keep bacteria out of your urinary tract:
    • Drink plenty of liquids.
    • Include cranberry juice in your diet. Some studies support the use of cranberry juice to prevent urinary tract infections.
    • Urinate when you have the urge. Do not resist it.
    • After sexual intercourse, empty your bladder and then drink a full glass of water.
    • Wash genitals daily.
    • If you're a woman, always wipe from the front to the back after having a bowel movement.
    • Avoid using douches and feminine hygiene sprays.
    • Avoid wearing tight underwear or clothing.

    RESOURCES

    National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) http://www.niddk.nih.gov

    National Kidney Foundation http://www.kidney.org

    Urology Care Foundation http://www.urologyhealth.org

    CANADIAN RESOURCES

    Health Canada http://www.hc-sc.gc.ca

    The Kidney Foundation of Canada http://www.kidney.ca

    References

    Cranberry. EBSCO Natural and Alternative Treatments website. Available at: http://www.ebscohost.com/healthLibrary. Updated September 17, 2012. Accessed October 17, 2012.

    Interstitial cystitis/painful bladder syndrome. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://kidney.niddk.nih.gov/kudiseases/pubs/interstitialcystitis. Published September 2011. Updated June 29, 2012. Accessed October 17, 2012.

    Kahn BS, Stanford EJ, et al. Management of patients with interstitial cystitis or chronic pelvic pain of bladder origin: a consensus report. Curr Med Res Opin. 2005;21(4):509-516.

    Katchman EA, Milo G, et al. Three-day vs longer duration of antibiotic treatment for cystitis in women: systematic review and meta-analysis. Am J Med. 2005;118(11):1196-1207.

    Parsons M, Toozs-Hobson P. The investigation and management of interstitial cystitis. J Br Menopause Soc. 2005;11(4):132-139.

    Phatak S, Foster HE Jr. The management of interstitial cystitis: an update. Nat Cin Pract Urol. 2006;3:45-53.

    Urinary tract infection (UTI) in adults. EBSCO DynaMed website. Available at: http://dynamed.ebscohost.com. Updated August 31, 2012. Accessed October 17, 2012.

    5/6/2011 DynaMed's Systematic Literature Surveillance http://dynamed.ebscohost.com: Barbosa-Cesnik C, Brown MB, et al. Cranberry juice fails to prevent recurrent urinary tract infection: results from a randomized placebo-controlled trial. Clin Infect Dis. 2011;52(1):23-30.

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