Cystitis is classified as an inflammation of the lining of the bladder which normally occurs due to an infection or an irritation. It usually affects the bladder only and is thus also referred to as lower urinary tract infection (UTI). However, sometimes the infection can go higher affecting the uterus and kidneys. In such cases the infection becomes more serious and is known as upper urinary tract infection. The urethra and bladder are normally sterile, but when infected by bacteria they become inflamed and irritated.

Cystitis affects about one in three women before the age of 24. Bacteria can reach the bladder quickly in women as opposed to men, because they have a much shorter urethra, and therefore are more susceptible to infection. In women the vaginal, anal and urethral openings are in close proximity, which makes the transferring of bacteria a lot easier.

Trimethoprim for cystitis

Signs and symptoms of cystitis

Cystitis manifests itself in different ways. Some of the symptoms include:

  • A burning or stinging sensation when passing urine
  • Need to pass urine frequently
  • Urine with a very strong smell
  • Cloudy or dark colored urine
  • passing of very small amounts of urine
  • Blood or pus may be seen in urine
  • The lower back or lower abdomen experiences tenderness or pain
  • Chills
  • Fever
  • Nausea
  • A general feeling of being unwell


Causes of Cystitis

The main cause of cystitis is bacteria which normally gets into the urethra via the surrounding skin and move up into the bladder, causing an infection or irritation. Most of these bacteria usually live harmlessly in the bowel. The most common type of bacteria causing cystitis is Escherichia coli (E. coli).

Women get affected more by cystitis than men and it can affect people of all ages. Women are affected more because the urethra in women is nearer the anus opening. This is where the bacteria from the bowel collect making it easier for them to be transferred from the surrounding skin to the urethra. The second reason why women get more infected is because their urethra is much shorter than that of men. This means there is less distance for the infection to travel all the way to the bladder.

Other causes of cystitis are stress, allergies to some foods, pre-menstrual syndrome, medications and some chemicals used in soaps or deodorants. During intercourse especially when it is vigorous, the urethra may be bruised leading to cystitis infection. In other instances, the infection can be transmitted via sexual intercourse from an infected partner to the other. A combination of the indirect causal factors such as stress and dryness of the vagina can also lead to a recurrence of cystitis.


Diagnosing Cystitis

If acted on quickly, the symptoms can go away without the need to consult a physician although a simple dose of trimethoprim is recommended to clean the infection out.  If a woman has any of the symptoms of Cystitis that last longer than 24 hours she needs to see her health care professional. Questions will be asked by the doctor, including the sexual habits and history, to determine the causes of the Cystitis. A ‘mid-stream’ urine sample will be taken. This is done in mid- flow so as to minimise the contamination of bacteria from around the vaginal area. The physician will then conduct a litmus test to see if there is an infection present. The sample will then be sent to a laboratory for detailed analysis.


Cystitis Treatment

 A course of antibiotics is used to treat Cystitis. The doctor will often treat the symptoms with a ‘broad spectrum’ antibiotic like Trimethoprim. Even if your symptoms do not persist it is important to take the full course to prevent a re-occurrence of the infection.

Additionaly, the following self help practises will hold you in good stead:

  • Drinking a glass of water with about half a teaspoon of bicarbonate soda added. This water will make the urine less acidic and so do products containing sodium bicarbonate or potassium citrate. In addition to drinking plenty of water, adequate rest and exercise is needed.
  • Drinking plenty of fluids to help in flushing out the infection.
  • Taking of painkillers for example paracetamol and ibuprofen can be used to ease the discomfort.
  • Avoiding alcohol, coffee, tea and any other drinks with high levels of caffeine

Recurrent Infection - About one fifth of women with a first time infection will experience a recurrence within six months. There are preventative strategies that are encouraged e.g. if a woman experiences infection after engaging in sexual activity, a single dose anti-biotic may be prescribed by the doctor to take after sex. Low dose, long term antibiotics may be best for other women with a history of recurrence. A referral to a Urologist will sometimes be required to rule out the possibility of any abnormality in the urinary tract.

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