Cystitis in Women

What is cystitis?

Cystitis means inflammation of the bladder. It is usually caused by a urine infection. Typical symptoms are pain when you pass urine, and passing urine frequently. You may also have pain in your lower abdomen, blood in your urine and fever (high temperature). Your urine may also become cloudy or smell offensive.

Most urine infections are due to bacteria (germs) that come from your own bowel. Some bacteria lie around your anus (back passage) after you pass a stool (faeces). These bacteria can sometimes travel to your urethra and into your bladder. Some bacteria thrive in urine and multiply quickly to cause infection.

Note: other causes of cystitis include radiotherapy and certain chemicals. This leaflet will only discuss cystitis caused by an infection.

Who develops cystitis?

Women are eight times more likely to have cystitis than men, as their urethra (the tube from the bladder that passes out urine) is shorter and opens nearer the anus.

About half of women have at least one bout of cystitis in their life.

Other risk factors for cystitis include having diabetes mellitus, being pregnant and being sexually active.

Can I be sure it is cystitis?

Some conditions cause symptoms that may be mistaken for cystitis. For example, thrush. Also, soaps, deodorants, bubble baths, etc, may irritate your genital area and cause mild pain when you pass urine.

Your doctor or nurse may do a simple 'dipstick' test on a urine sample to check for cystitis. This detects bacteria in urine. It is fairly reliable and usually no further test is needed. Occasionally, your urine sample is sent to the laboratory to find out which bacterium is causing the infection.

What is the treatment for cystitis?

For the majority of cases, cystitis is a self-limiting condition that improves without any complications.

• Not taking any treatment may be an option (if you are not pregnant). Your immune system can often clear the infection. Without antibiotics, cystitis, particularly mild cases, often resolves in a few days. However, symptoms can sometimes last for a week or so without treatment.
• Antibiotics. A three-day course is a common treatment. Symptoms usually improve within a day or so after starting treatment. See a doctor if your symptoms have not gone, or nearly gone, after three days of taking antibiotics. On average, taking antibiotics shortens the duration of symptoms by around one day. One option is that your doctor may offer you a delayed prescription for antibiotics. You then need only 'cash in' the prescription if your symptoms worsen, or do not improve, over the next few days.
• Have lots to drink. This is traditional advice to 'flush out the bladder'. However, there is no proof that this is helpful. Some doctors feel that it does not help and drinking lots may just cause more (painful) toilet trips. Therefore, it is difficult to give confident advice on whether to drink lots, or just to drink normally.
• Paracetamol or ibuprofen. These ease pain or discomfort and can also lower a high temperature.

There is no evidence that drinking cranberry juice or taking products that alkalise your urine (such as potassium citrate or bicarbonate) improve the symptoms of cystitis. These sort of products are sometimes sold as a treatment for cystitis.

If your symptoms worsen or you develop a high fever then you should see your doctor.

Note: if you are pregnant or have certain other medical conditions, you should always be treated with antibiotics to prevent any possible complications.

What is the outlook?

The vast majority of women improve within a few days of developing cystitis. However, if your symptoms do not improve despite taking antibiotics then you may need an alternative antibiotic. Some bacteria causing cystitis can be resistant to some types of antibiotic.

You should see a doctor if you have recurring bouts of cystitis to discuss ways of preventing it. See separate leaflet called 'Cystitis - Recurrent Infections in Women' for more information.

Further help and information

Cystitis and Overactive Bladder Foundation

Tel: 01908 569169 Web: www.cobfoundation.org
The Cystitis and Overactive Bladder Foundation gives support to people with interstitial cystitis, bacterial cystitis and overactive bladder.

References

• Urinary tract infection (lower) - women, Clinical Knowledge Summaries (October 2009)
• Santillo VM, Lowe FC; Cranberry juice for the prevention and treatment of urinary tract infections. Drugs Today (Barc). 2007 Jan;43(1):47-54. [abstract]
• Little P, Turner S, Rumsby K, et al; Dipsticks and diagnostic algorithms in urinary tract infection: development and Health Technol Assess. 2009 Mar;13(19):iii-iv, ix-xi, 1-73. [abstract]