CYSTITIS: causes, symptoms, remedies and treatments of cystitis in men, women and in pregnancy

Cystitis

There cystitis it's a'inflammation of the wall of the bladder which can lead to continuous discomfort and a feeling of urgency in the act of urinating.
Cystitis usually results from ainfection bacterial of the first part of the urinary tract and is a fairly common pathology. While cystitis isn't typically a serious condition, it can be bothersome and can even lead to complications if it's not properly treated. Bacterial cystitis is termed acute cystitis, while interstitial cystitis is a type of cystitis chronic with persistent and disabling symptoms.
This article will look at the main causes of cystitis, its symptoms, the ways in which it is diagnosed and treated, including natural and home remedies, and how it can be prevented.

What is cystitis?

What is cystitis? Cystitis is inflammation of the bladder wall, and in most cases it is triggered by a bacterial infection. In some cases, mild cystitis tends to resolve within a few days. However, the symptoms often persist and it is necessary to consult a doctor to carry out the appropriate diagnostic investigations, such as urinalysis and urine culture, and the most appropriate therapeutic interventions, such as empirical antibiotic therapy and then targeted antibiotic therapy based on the any available antibiogram. Then there are some tricks and remedies useful for relieving symptoms and for the prevention of cystitis itself.

How do you get cystitis? Cystitis can occur when the normally sterile, microbial-free urethra and bladder become infected with bacteria. The bacteria adhere to the bladder wall and cause a state of irritation and inflammation of the affected area. Cystitis affects people of both genders and all ages. However, it is generally more common among women than men because women have shorter urethra. Cystitis in men, although less frequent, has equally significant symptoms and complications and must be treated in the same way as in women.

What causes cystitis? About 80 percent of all urinary tract infections are caused by bacteria from the gut making it to the urinary tract. Most of these bacteria are part of the healthy gut flora, but once they enter the sterile space in the urethra and bladder, they can cause a urinary infection such as cystitis. Urinary infections are the most common hospital infections in Italy, particularly in patients using urinary catheters.

Hemorrhagic cystitis

We talk about hemorrhagic cystitis when to inflammation of the bladder is accompanied by the leakage of mixed urine a blood, sometimes also in the form of actual blood clots. The presence of blood in the urine is said hematuria, macrohematuria when it is visible to the naked eye, microhematuria when it is reported only on urinalysis.
Hemorrhagic cystitis is the consequence of damage to the blood vessels mucosa bladder, and can result from inflammation from bacterial infection, but also be related to treatment chemotherapy (for example with alkylating drugs such as cyclophosphamide), to one radiation therapy or in the presence of a tumor of the bladder. The therapy of haemorrhagic cystitis varies according to the cause, but in all cases it makes use of abundant hydration and pain relieving and anti-inflammatory therapy.

Interstitial cystitis

There interstitial cystitis it is a type of chronic cystitis characterized by pain, urgency and frequency of urination. It is also called syndrome of the pelvic pain and it is not a type of urinary tract infection. The genesis of pain and other signs and symptoms of interstitial cystitis seems to be linked to an alteration of the cells of the bladder wall, which in contact with the acid substances contained in the urine, generates an increase in nervous sensitivity at the level of the bladder mucosa.

Symptoms of cystitis

What are the main ones symptoms of cystitis? The manifestations of this frequent inflammation of the lower urinary tract are multiple and often of a nuanced nature; in general, however, they have common characteristics with i symptoms of infection of the urinary tract. THE symptoms of cystitis elle women are similar to symptoms in man, taking into account the fact that it is a very frequent pathology in the female sex and therefore women know how to recognize the symptoms more quickly and safely than the male counterpart, not used to this type of pathology. The following are the symptoms more common of the cystitis:

  • temperature, sometimes higher in the evening (serotin fever)
  • traces of blood in the urine (hematuria or macrohematouria)
  • dark urine
  • urine cloudy
  • strong-smelling urine at times foul-smelling urine
  • abdominal pain, located just above the pubic bone, in the lower back or throughout the abdomen
  • burning sensation while urinating (urinary burning)
  • pollakiuria (you urinate very often or in any case you feel the need to urinate frequently)
  • pain when urinating (dysuria)
  • feeling of urgency to urinate (urge urination)
  • diarrhea

Individuals Senior citizens they may feel faint and have a fever, but may not experience any of the other symptoms mentioned above. They may also have an altered mental state, confusion and sleepiness. People with cystitis frequently experience the urge to urinate, but are only able to pass small amounts of urine. This type of symptom is similar to what i experience males suffering from benign prostatic hypertrophy or prostatitis, which is an inflammation of the prostate, often secondary to a bacterial infection. The diagnosis of cystitis in men it will therefore be placed in the difference diagnosis with prostatic pathologies. When i children have cystitis, may have the symptoms listed above, but also others such as vomiting, easy irritability, drowsiness and general weakness.

The presence of blood in the urine, Often described improperly by patients as cystitis with blood or bloody cystitis, it should not scare but it is undoubtedly indicative of a significant inflammation and is a symptom that must always be brought to your doctor. Even the abdominal pain, which can be described as "bladder pain" or "bladder pain", is indicative of an important irritation of the bladder mucosa and is a signal that needs further investigation and adequate therapy.

cystitis-inflammation-bladder

Cystitis is nothing more than inflammation of the bladder, usually due to bacterial infection. It is more common in women and the elderly.

 

There are also other diseases or conditions that have symptoms similar to bacterial cystitis, such as:

  • Urethritis, which is inflammation of the urethra
  • Upper urinary tract infection, such as nephritis, pyelonephritis, pyelitis, cystopyelitis
  • Chronic bladder pain syndrome, also called interstitial cystitis
  • Prostatitis or inflammation of the prostate gland
  • Benign prostatic hyperplasia
  • Gonorrhea, commonly referred to as drainage
  • Chlamydial infections, a frequent cause of vaginal, cervical or urethral infection
  • Genital or vaginal candida

Causes of cystitis

How cystitis comes? There are many possible causes of cystitis. Most of them are infectious in nature and are generally triggered by the entry of bacteria into the genital and urinary tract, which can be favored by predisposing conditions such as prolonged use of a bladder catheter, as in the case of cystitis from catheter. Let's see which are the main ones causes of cystitis and of risk factors most relevant.

  • bacterial infection: over 90% of cystitis are caused by germs such as:
    • Escherichia coli
    • Coagulase negative staphylococci
    • Staphylococcus saprophyticus
    • Klebsiella pneumoniae
    • Proteus mirabilis
    • Citrobacter
    • Morganella
    • Enterococci
    • Pseudomonas and other gram negative bacteria
  • fungal infection: the type of fungus usually conivolto in fungal cystitis is Candida, especially the type Candida albicans
  • Viral infectionsAlthough very rare, there are also viral cystitis that can be linked to an adenovirus infection or, in immunosuppressed subjects, by viruses of the genus Polyomavirus.
  • Chemotherapy: some alkylating chemotherapy agents, such as cyclophosphamide is ifosfamide, they can cause mucositis with chemical cystitis.
  • Radiotherapy: the effect of radiation on the bladder mucosa can cause irritation and inflammation with symptoms very similar to infectious cystitis.
  • Bladder neoplasm
Cystitis-escherichia-coli

A microscope photo of Escherichia coli, the main cause of urinary tract infections.

Risk factors include:

  • The use of a tampon (eg tampax): When inserting a tampon, there is a minimal risk of bacteria entering through the urethra.
  • Insertion and prolonged use of a urinary bladder catheter: there is the possibility that the catheter will transport bacteria along the urinary tract and then favor their permanence.
  • Using the diaphragm for birth control: There is a higher incidence of cystitis among women who use the diaphragm, compared to women who do not.
  • Full bladder: If the bladder is not emptied completely, a favorable environment for the proliferation of bacteria can be created. This is quite common among pregnant women and men with prostate problems.
  • Sexual activity: Sexually active women have a higher risk of receiving bacteria that enter the urethra after intercourse
  • Morphological or functional alterations of the bladder or kidneys such as to favor a partial blockage of the urinary system, which prevents a correct flow of urine such as kidney stones (lithiasis), prolapses, obstructions, compression (for example the compression that the uterus exerts on the bladder in pregnant women)
  • Frequent or too intense sex: This increases the chances of physical damage to the mucous epithelium of the urinary tract and genitals, which in turn increases the likelihood of bacterial contamination and cystitis. This condition is sometimes called honeymoon cystitis.
  • Low Estrogen Levels: During menopause, estrogen levels drop, and a woman's urethral wall becomes thinner. The thinner it becomes, the more likely you are to get an infection. After menopause, the risk is even higher.
  • Female: The opening of the female urethra is closer to the anus than that of a man, so there is a greater risk of bacteria passing from the anus to the urethra.
  • Mucus reduction: During menopause, women's bodies produce less mucus in the vaginal area. This mucus normally acts as a protective layer against bacteria, lacking it can facilitate their proliferation.
  • Radiation therapy: Damage to the bladder can cause radiation cystitis.
  • Women on hormone replacement therapy (HRT) have a lower risk of developing cystitis than menopausal women.

How long does cystitis last? Depending on the type of cause, the duration may vary from a few days (as in the case of an uncomplicated urinary infection) up to weeks / months in the case of chronic cystitis or relapsing cystitis.

Cystitis and contagion

Cystitis is not a pathology contagious: it is in fact very unlikely that a person suffering from cystitis will be able to pass it on to family members, cohabitants or work colleagues. Nevertheless, since the genesis of cystitis is at least partly favored by sexual intercourse followed by an incorrect intimate hygiene, having intercourse during cystitis probably involves an increase in the possibility of onset of urinary tract infection even in the partner, even though we can't talk about real infection.

Cystitis in pregnancy

In pregnancy, the risk of cystitis is greater: in fact, in addition to the risk linked to the particular anatomy of the female urinary system, with the short urethra and the shorter perineum with the urethral opening near the vaginal meatus and the anus, there are other physiological characteristics that increase the frequency of cystitis in pregnant women:

  • increase in circulating female hormones, in particular progesterone, with a decrease in the tone of the smooth muscle and therefore of the sphincters, including the ureteral one, which therefore allows germs to enter more easily and reduces the “washing out” power of the urinary jet.
  • mechanical compression of the gravid uterus on the ureter, reducing the possibility of a complete emptying of the bladder after urination (urination).
  • presence of increased sugar in the urine in all expectant mothers who develop gestational diabetes during pregnancy.

The therapy of cystitis in pregnancy it does not differ from the treatment of bacterial cystitis in general, except that only antibiotics and drugs allowed in pregnancy as they have no teratogenic effect on the fetus will be used.

Cystitis in children and infants

The development of cystitis in newborns and in children it is a frequent occurrence, and is mainly caused by bacteria such asEscherichia coli, Streptococci, Staffylococci and gram negative such as Klebsiella pneumoniae, Proteus mirabilis and Haemophilus Influenzae.
There cystitis in children it is frequent due to favoring factors such as the difficulty in maintaining adequate intimate hygiene (diaper use and incontinence do not help in this sense), the difficulty of children and infants in communicating symptoms, which can be vague or non-specific such as lack of appetite (inappetence), tendency to sleep (lethargy), nausea and vomiting, irritability, low-grade fever. The therapy is obviously based on antibiotics and antipyretics, administered at a pediatric dosage.

Cystitis Diagnosis

For the purpose of diagnosing the cystitis, the doctor will ask the patient a few questions, then perform a urine test which will allow a urinalysis, a very quick test whose results are available in a few hours. There are even faster tests, called stick on urine  or urinary stick, which allow, by immersing a strip of paper with reagents in a test tube containing urine, to know in an approximate but instantaneous way some important parameters such as the presence of bacteria and white blood cells, glucose or proteins in the urine.

You can also performuroculture or urine culture, a test on a urine sample that is used to determine the type of bacteria that may be found there. After finding out which specific bacterium is causing the infection, the doctor can start an antibiotic therapy or modify the one already in place, using theantibiogram.Sometimes, in doubtful cases, doctors may also request tests for sexually transmitted infections, as these conditions often have symptoms similar to those of cystitis.

At the level of blood and urine analysis during cystitis we could find:

  • high white blood cells
  • elevated C reactive protein in the blood
  • High blood ESR
  • Initial signs of kidney failure with high creatinine and high urea
  • Presence of white blood cells in the urine (leukocyturia)
  • Presence of bacteria in the urine (bacteriuria)
  • Protein in the urine above normal levels (proteinuria)
  • evidence of Escherichia coli in urine during culture, or other germs listed above

The diagnosis of cystitis occurs in the presence of leukocytes and bacteria in the urine, while the only presence of bacteria, if not symptomatic (asymptomatic bacteriuria) it does not usually require treatment, unless dealing with pregnant women or immunocompromised or transplanted people.

Patients who are periodically affected by cystitis may require further follow-up examinations, such as one ultrasound lower abdomen and bladder, a radiography abdomen, and, secondly, a cystography (urinary cysto-ureterography) which, through the infusion of contrast medium by ascending route, allows to evaluate the morphology and function of the lower urinary tract. It is also possible to carry out, in doubtful cases, one cystoscopy of the bladder using a fiber optic camera that allows you to directly view the urethral and bladder mucosa.

Cystitis cure

What are the main cures for cystitis? How to cure it? The therapy of cystitis depends on its etiology, that is, what it is caused. Normally, since cystitis is mainly of bacterial infectious origin, the drugs for cystitis consist primarily of adequate antibiotic therapy. The treatment for cystitis also provides symptomatic drugs and drug therapy useful to protect the body from infectious relapses, favoring their prevention. So let's see how to cure cystitis.

Antibiotic therapy

What to do when there is an annoying urinary infection with an inflamed bladder and bad symptoms? How is it treated? Bacterial cystitis must be appropriately treated with antibiotics.

Doctors may prescribe a 3-day or 7-10-day course of antibiotics, depending on the patient, their symptoms, and their medical history. Taking antibiotics should begin to relieve symptoms from the first day of therapy. If symptoms do not improve after taking antibiotics, the patient should return to the doctor.

The antibiotics commonly used for bacterial cystitis are

  • nitrofurantoin (Neofuradantin),
  • trimethoprim-sulfamethoxazole or cotrimoxazole (Bactrim),
  • amoxicillin (Zimox),
  • amoxicillin and clavulanic acid (Augmentin),
  • cephalosporins (Cefixoral, Ceporx, Giasion),
  • fuoro-quinolones such as ciprofloxacin (Ciproxin) and levofloxacin (Tavanic),
  • fosfomycin (Monuril)

In particular, the Monuril it is frequently prescribed by doctors for its good efficacy and ease of administration (one sachet once administered, in the most intense cystitis to be repeated also the next day). Older people and those with weak immune systems - for example due to diabetes - are at risk of the infection spreading to the kidneys and other complications. Therefore, the elderly, as well as people with poor health and pregnant women must be treated promptly.

Image of antibiotics for the treatment of cystitis

Antibiotic therapy is the key to treating bacterial cystitis.

Antifungal therapy

As for fungal cystitis, the therapy uses drugs antifungals such as fluconazole (Diflucan) or itraconazole (Sporanox), to be taken for a duration more or less similar to that of the antibiotic therapies described above, obviously always after medical prescription.

Remedies for cystitis

Are there any remedies for cystitis besides antibiotic therapy? The following immediate remedies is natural remedies they can help to calm and make the symptoms of cystitis more bearable (obviously drugs must always be taken after a doctor's prescription):

  • Anti-inflammatory and / or pain-relieving drugs, such as paracetamol (Tachipirina), ibuprofen (Moment, Brufen), ketoprofen (Oki) can relieve the discomfort associated with inflammation of the bladder
  • Drugs such as flavoxate and propiphenazone combination (Cistalgan) or oxybutynin (Ditropan) can reduce symptoms and discomfort when urinating.
  • Antispasmodic drugs such as scopolamine (Buscopan), phenazopyridine (Uricalm) or phloroglucine dihydrate (Spasmex) help to reduce the tone of the genitourinary tract muscles, relaxing them and reducing some symptoms such as cramps in the lower abdomen, the feeling of urgency having to urinate or pain when passing urine.
  • Water helps to clean up the urinary tract, and therefore also to fight bacteria: it is therefore useful to maintain proper hydration and therefore to drink adequately.
  • Alcohol should be absolutely avoided.
  • Cranberries have urine acidifying properties: the intake of cranberry juice or concentrate allows to reduce the possibility that bacteria adhere to the bladder wall and proliferate there.
  • Abstaining from sex reduces the chance of bacteria entering the urethra.

For some drugs such as cyclophosphamide and ifosfamide, responsible for chemical cystitis, there is a specific antidote, theuromitexanic acid which can be administered intravenously during chemotherapy, significantly reducing the incidence of mucositis and related symptoms.

Cystitis: what to eat?

What to eat if you have cystitis? Nutrition in the prevention of cystitis plays a fundamental role. There are some foods to avoid absolutely, others to be taken in moderation, many others finally recommended to avoid episodes of cystitis or to minimize its occurrence.
Among the foods not to eat in people who have suffered from cystitis there are actually foods that are in general to be avoided or in any case to be taken with caution, being unhealthy also from the point of view of the gastrointestinal mucosa and from the cardiovascular point of view. Here what not to eat or in any case what to take in moderation:

  • spirits and spirits
  • coffee, tea and xanthine derivatives in general
  • carbonated drinks, especially if they are high in sugar
  • pepper, chilli and hot spices, cause their ability to irritate the mucous membranes, including that of the bladder
  • cheeses and other spicy foods
  • sausages and salami
  • fatty foods such as fried, lard, butter, margarine, high-fat sauces such as cholesterol and triglycerides

Among the foods to be taken for people who suffer or have suffered from cystitis we remember:

  • fruit
  • vegetables
  • water and liquids in general
  • celery and parsley
  • garlic and onion
  • cereals
  • extra virgin olive oil
  • blueberry and other berries
  • skimmed milk and its derivatives such as yogurt

Prevention of cystitis

How to prevent cystitis? It is sometimes difficult to prevent cystitis, but the following measures can help reduce the possibility of our body being affected by this annoying urinary infection:

  • Practice good intimate hygiene after sexual intercourse.
  • Use neutral, unscented soaps for the genitals.
  • Completely empty your bladder when urinating.
  • Don't postpone urination.
  • Avoid tight underwear and pants.
  • Wear cotton underwear.
  • Using a lubricant during sexual activities.

The relationship between cystitis and sexual intercourse it is known and scientifically proven to cause a greater concentration of germs in the urinary tract of sexually active people. Also, men who have same-sex relationships with other men are more likely to have cystitis than others.
The development of cystitis after sexual intercourse is a not uncommon eventuality. The measures to prevent post-coital cystitis are very simple and involve adequate intimate hygiene after sexual intercourse, which is achieved by urinating after intercourse and performing a bidet with a normal intimate cleanser.
Patients using the catheter should ask a doctor or nurse to avoid bumps when changing the catheter.

Most women could experience cystitis in their lifetime.
All men and children should see a doctor if they have cystitis, in fact when cystitis affects men, it may be more serious than for women.

Male cystitis typically occurs due to another underlying condition, such as a prostate infection, cancer, obstruction, or an enlarged prostate.
In most cases of male cystitis, early treatment effectively solves the problem, but untreated bladder infections can lead to kidney or prostate infections or damage.

Recurrent cystitis

The onset of relapsing cystitis, also defined recurrent cystitis, it is an absolutely common fact, especially in the female population. As already mentioned, the presence of particular anatomical features puts the woman at greater risk of urinary infections and in particular of cystitis. The presence of relapses of this infectious pathology as well as of one persistent cystitis, or a "cystitis that does not pass", can therefore be linked to a particularly unfavorable body anatomy, but also to factors such as:

  • poor intimate hygiene
  • frequent sexual intercourse and not followed by proper igiane
  • incorrect use of antibiotics (skipping the intakes or shortening the treatment prescribed by the doctor)
  • always use the same antibiotic without carrying out urine cultures and an antibiogram (frequent in people who think they can manage the therapy alone without consulting a doctor)
  • presence of increased intestinal bacterial translocation with increased concentration of germs

The presence of recurrent cystitis and repeated involves the need to investigate with blood tests and, possibly, a urological visit to evaluate any anatomical-morphological problems in the urinary tract. Finally, there are gods prophylactic antibiotic treatments which, through the intake of antibiotics only a few days a week, allow to keep the urinary tract "disinfected", reducing the possibility of recurrence cystitis.

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