Cystitis is an inflammation or infection of the urinary bladder. When caused by germs, it’s called a urinary tract infection (UTI). UTIs can be painful and annoying. They can also become a serious health problem if they spread to infect your kidneys.
Your urinary system is composed of your kidneys, ureters, bladder and urethra. All play a role in removing waste from your body. Your kidneys, a pair of bean-shaped organs in your upper-posterior abdomen, filter waste from your blood. Tubes called ureters carry urine from your kidneys to the bladder, where it is stored until it exits your body through the urethra. A urinary tract infection can begin when bacteria enter the urinary tract through the urethra and then begin to multiply.
The usual treatment is with antibiotics. You can take a number of steps to help prevent a bladder infection.
Causes
The two main types of bladder infections are:
UTIs typically occur when bacteria enter the urinary tract from the outside, usually through the urethra, and begin to multiply. The urinary system is designed to keep out such microscopic invaders. The bladder secretes a protective coating that prevents bacteria from attaching to its wall. Urine also has antibacterial properties that inhibit the growth of bacteria. However, certain factors increase the chances that bacteria will take hold and multiply into a full-blown infection.
Sometimes cystitis is referred to as honeymoon cystitis, because this bladder infection commonly occurs in women as a result of sexual intercourse. During sexual activity, bacteria may be introduced into the bladder through the urethra. But even sexually inactive girls and women are susceptible to lower urinary tract infections because the anus, a constant source of bacteria, is so close to the female urethra.
Most cases of cystitis are caused by Escherichia coli (E. coli), a species of bacteria commonly found in the rectal area. A new strain of antibiotic-resistant E. coli may be the cause of increasingly hard-to-treat UTIs in women.
Although more rare, other causes of cystitis, or conditions that may mimic bacterial UTIs, include:
Some people are more likely than are others to develop bladder infections or recurrent urinary tract infections. Women are one such group. Up to 20 percent will develop a bladder infection over a lifetime. A key reason is anatomy. Women have a shorter urethra than men have, which cuts down on the distance bacteria must travel to reach the bladder.
Women who are sexually active tend to have more UTIs because sexual intercourse can result in bacteria being pushed into the urethra. Women who use diaphragms for birth control also may be at higher risk. Hormonal changes during pregnancy may increase the risk of a bladder infection as well.
Other risk factors in both men and women include anything that impedes the flow of urine, such as an enlarged prostate or a stone in the bladder. Changes in the immune system, which can occur with conditions such as diabetes, also can increase the risk of UTIs. So can the prolonged use of bladder catheters, which may be needed in people with chronic illnesses or in older adults.
Research funded by the National Institutes of Health suggests that a woman’s blood type may play a role in her risk of recurrent infections of the bladder and urinary tract. Bacteria may be able to attach to cells in the urinary tract more easily in those with certain blood factors. But more research is needed to determine whether an association exists and whether it could be useful in identifying people at risk of recurrent infection.
If you have any symptoms of a bladder infection, talk to your doctor as soon as possible. If your doctor suspects you have a bladder infection, he or she may ask for a urine sample to determine whether bacteria, blood or pus is in your urine.
Antibiotics are the first line of treatment for community-acquired bladder infections. Which drugs are used and for how long depend on your health condition and the bacteria found in your urine test, if such a test is performed. The drugs most commonly recommended for simple UTIs include amoxicillin (Amoxil, Trimox), ciprofloxacin (Cipro), nitrofurantoin (Macrodantin, Furadantin), sulfamethoxazole (Bactrim, Septra) and trimethoprim (Trimpex, Proloprim). Make sure your doctor is aware of any other drugs you’re taking or any allergies you might have.
Usually, symptoms clear up within a few days of treatment. However, you’ll likely need to stay on antibiotics for three days to a week, depending on the severity of your infection. No matter what the length of treatment, take the entire course of antibiotics recommended by your doctor to ensure that the infection is completely eradicated.
If you have recurrent UTIs, your doctor may recommend longer antibiotic treatment or refer you to a doctor who specializes in urinary disorders (urologist) or a doctor whose specialty is kidneys (nephrologist) for an evaluation to see if urologic abnormalities may be causing the infections. For some women, taking a single dose of antibiotic treatment after sexual intercourse may be helpful.
Hospital-acquired bladder infections can be a challenge to treat because bacteria found in hospitals are often resistant to the common types of antibiotics used to treat community-acquired bladder infections. For that reason, different types of antibiotics and different treatment approaches may be needed. Currently, researchers are testing whether using catheters pre-treated with antimicrobial products may help reduce the incidence of this type of bladder infection.
You can take steps to reduce the risk of bladder infections. Women, in particular, may benefit from the following:
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