What is Cystitis ?
A bacterial urinary tract infection is a very common disorder for women and is a frequent complaint in urgent care clinics. The diagnosis of urinary tract infection is actually an umbrella for three diagnoses. These are pylonephritis (kidney infection), ureathritis an infection of the urethra more common in males, and cystitis the all too common bladder infection. Knowing the causes, treatment and prevention will better equip one to avoid an infection, as well as knowing when to seek treatment. Although there is a fifty fold increase in (UTI’s ) in women from the age of twenty to fifty this actually reverses to men when that fifty-year-old mark comes around. This is due to prostate problems in men. A urinary tract infection which is also referred to as cystitis is an infection of the bladder. The lining of the bladder can become inflamed to the point of mild shedding of red blood cells, hence blood in your urine. There are two major types of bacteria that can be targeted with antibiotics. These are gram negative and gram positive bacteria that respond differently to different antibiotics. The bacteria responsible for most (UTI’s) are of the gram negative variety. Sexually active women are at higher risk, as well as diabetics for developing (UTI’s) or cystitis. Approximately ninety -five- percent of all (UTI’s) occur from colonization of bacteria and ascending from the vaginal area to the meatus ( the opening where one urinates from) and into the bladder. This is why it is important to urinate shortly after intercourse. It is important to note that cystitis is NOT a kidney infection. A kidney infection is called Pyelonephritis and presents with different symptoms.
What are the Symptoms of Cystitis?
Symptoms are usually of sudden onset. Classic symptoms are burning during urination, lower abdominal pressure, may or may not have lower back pain, a feeling of urgency, not feeling as if you can empty your bladder after urinating, blooding upon wiping after urinating, and frequency to urinate. All or one or two of these symptoms can be present. Fever is not associated with cystitis and is more reflective of a kidney infection.
How does one prevent Cystitis?
Prevention primarily is first focused at understanding the mechanism of the infection. The area is a warm moist environment, hence conditions are perfect for the colonization and growth of bacteria. Teaching young girls the appropriate mechanism of wiping after a bowel movement front to back is imperative, urinating after intercourse ( the act itself can advance bacteria towards the meatus ( the opening where one urinates from) and some urologists advise urinating before and after intercourse. Cotton underwear have been a culprit in holding moisture and promoting bacteria growth as well as poor hygiene. Bubble baths, although highly rumored to be a causative agent of cystitis have not proven to be a cause but are responsible for allergic reactions to the genital area. Increasing fluids, good hygiene, urinating after intercourse, and proper wiping techniques are the main preventions that one can implement in reducing urinary tract infections.
What is the treatment for Cystitis?
Antibiotics are still an effective means for treating urinary tract infections. The most common antibiotics prescribed are Bactrim, Cipro,and Macrobid. There are others used that can be effective but are just not up to par with the ones mentioned. Interestingly some bacteria in the last five years have become resistant to Cipro. The research has panned out that women who eat a lot of red meat may have a higher incidence of this. Why? Farmers are feeding cattle Cipro in their feed troughs which translates into us getting our fair share of this antibiotic. Antibiotics once were given for uncomplicated cystitis for seven to ten days. We now know that only three days of an antibiotic is very effective and there is no need for longer term treatment. Ask your clinician to do a urine culture. This will give you and your clinician direct feedback to the type of bacteria, and what antibiotics will kill the offending agent. A repeat urinalysis is NOT recommended by urologists. This repeat urinalysis is only needed in resistant bacteria, complicated cystitis, and those individuals who have a history of recurrent infections. If you are coming in for a visit due to symptoms please try and hold your urine as long as possible. It is recommended by many urologists to try and hold your urine for at least two hours before giving a sample. This ensures a more accurate specimen.
Home treatment; is rather basic. Prevention and always drink plenty of water. Cranberry juice does change the Ph in the urine which makes it more acidic and more difficult for the bacteria to colonize. This works best in the first day or two of symptoms, and at least four to six eight ounce glasses are recommended. If the pain is too severe Pyridium is a great medication for numbing the meatus and will make one more comfortable. It will turn your urine a dark orange color, so do not fret. This medication should be taken with food, and is usually only given for the first couple of days. If symptoms present or persist please see your clinician.