Cystitis is an inflammation of the bladder lining and the urethra – the tube down which urine is excreted from the bladder. It is one of the most common complaints suffered by women, and estimates suggest that more than half the women in the UK contract cystitis at some time (though it occasionally afflicts men and children too). If you have had it, you will certainly wish to avoid a recurrence. Some women experience attacks several times a year and an unfortunate few are seldom free of the problem.
A woman’s anatomy makes her particularly prone to cystitis. Unlike a man’s, her urethra is very short and the normally harmless germs around the anus are easily able to track upwards to the bladder, whose natural defences may be unable to cope with them. Some people say they suffer more from cystitis when they are ‘run down’. It is likely that they feel run down because there is a niggling infection there which doesn’t cause local symptoms all the time, but causes the sufferer to feel under par – that is, run down. From time to time, however, the local symptoms will present themselves.
Inflammation then develops and often spreads to the urethra – a condition known as urethritis – which results in the typical burning pain as urine is passed. The urine is often dark brown and strong smelling; it may also contain traces of blood. The sufferer has a constant urge to ‘spend a penny’ even though there is little or nothing to pass. A slight temperature, nausea, a dragging feeling in the lower abdomen and tenderness over the bladder are also common, as is a general feeling of being unwell. However, cystitis is by no means always due to an infection. The delicate lining of the urethra and/or the bladder can, in those susceptible, react to irritants such as scented soaps, powders, vaginal deodorants, bath oils and the detergents used to wash clothes. Some people are sensitive to highly spiced foods, strong tea, coffee, alcohol and fruit juices. Friction or bruising during lovemaking can also inflame the tissues, as the urethra is just above the vaginal entrance – a lubricant jelly may then help by overcoming any dryness. Hormone replacement therapy or oestrogen cream may be more effective after the menopause.
Germs can also be inadvertently lielped’ into the urethra during intercourse. Inserting tampons can do this too, as can wiping yourself from back to front (instead of front to back) after a bowel movement. The main germ which causes trouble here and after sexual intercourse is one called Escherichia coliform, more commonly known as £. coli. It lives in the bowel, where it is harmless, but if it makes its way to the vagina or urethra it can cause problems.
Thrush infection, perhaps aggravated by wearing tight-fitting trousers, is another possible cause of symptoms. It is important, too, to pass urine as soon as you feel the need and to empty your bladder completely each time by squeezing out every last drop – a reservoir of urine can make a fertile breeding ground for germs.
So, if you are prone to cystitis, always wash around your vaginal area and ‘spend a penny’ both before and after making love. Having sex with a full bladder, or bowel for that matter, means bruising is more likely to occur, which can also encourage cystitis. Ask your partner to wash daily, too.
Try to drink at least three or four pints of water every day to flush out any germs and prevent them settling. It has been suggested that a glass or two of cranberry juice a day may also help to keep cystitis at bay. No one knows quite why, but some Americans swear by it.
If symptoms do develop, neutralising the acidity is a worthwhile first line of treatment, since as many as two out of three sufferers won’t actually have any infection and the symptoms should therefore settle in a day or so using this method aloneFULLSTOP
Start immediately symptoms appear by drinking a pint of water with a teaspoonful of bicarbonate of soda added – unless you suffer from high blood pressure, or heart or kidney trouble, in which case consult your doctor first. Drink a pint of this mixture every hour for three hours, interspersed with other soft drinks. This will change the urine from acid to alkaline and relieve the pain, but it is not something I would recommend too often, as an excess of bicarbonate of soda, especially in a sufferer whose kidneys are not working properly, could lead to side-effects such as a rise in blood pressure.
Alternatively you could take potassium citrate or a specially formulated, pleasant-tasting medicine from the chemist. These medicines mainly contain sodium citrate to make the urine less acid and are usually meant to be taken regularly for 48 hours. Such treatments can be very helpful, but if symptoms persist after the 48 hours are up, you should see your doctor – take a specimen of urine with you in a clean, screw-topped jar. If infection is found or suspected, antibiotics are usually effective but be sure to complete the course. You should not need to repeat treatments often, either.
If your symptoms come back regularly, see your doctor Just occasionally, if cystitis is a constant problem, there may be a rarer cause for which further investigations will be necessary.
Over-the-counter treatments for cystitis should not be taken by children except on medical advice, nor if you are pregnant or breast-feeding, if you have heart disease or high blood pressure, if you have had any kidney disease or if you are on a low salt diet.
Other helpful measures include rest in bed and a hot water bottle placed over your abdomen; your preferred painkiller will also make you feel better.
Cymalon, Cystoleve, Cystopurin