Cystitis

What Is Cystitis?

Cystitis is when your bladder is inflamed.  It lets you know about it with constant trips to the bathroom that often hurt and never quite give you relief.

A urinary tract infection (UTI) is the most common cause of cystitis.  When you have one, bacteria in your bladder cause it to swell and get irritated, which leads to symptoms like the urge to pee more often than normal.

Women tend to get cystitis much more than men do. Typically, it’s more annoying than it is serious, and if it is from a bacterial infection it can be treated with antibiotics. But bacteria can travel from the bladder to the kidneys and cause more severe problems, so it’s important to treat it right away.

Cystitis Causes

Usually, bacteria such asE. coli are to blame. They normally live on your skin and in your intestines, and they’re not a problem. But if they get into the urethra, which is the tube that carries pee out of your body, bacteria can end up in your bladder and cause issues.

It’s not as common, but you can also get cystitis from:

  • Chemicals in personal care products, such as bubble baths, soaps, and spermicides

  • Chemotherapy drugs

  • Damage from bladder surgery or a catheter -- a tube that helps empty pee from your bladder

  • Radiation to treat cancer around your pelvis

Some people have a condition called interstitial cystitis, where the bladder is constantly swollen but there’s no detectable infection. Doctors aren’t sure what causes it, and it’s much harder to treat than regular cystitis.

Cystitis Symptoms

Here are some things you might notice:

  • It burns, stings, or hurts when you pee.

  • The urge to pee is constant.

  • You feel sick (achy and tired, with a low fever).

  • You need to pee often, but only small amounts come out.

  • There’s pain or pressure in your lower belly.

  • Your pee is dark, cloudy, or has a strong smell.

  • It hurts when you have sex.

  • You have cramping in your back or belly.

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It also can affect your mental state. Some people dealing with cystitis may feel depressed or anxious.

In young children, wetting themselves during the day -- if they normally don’t -- can also be a sign. Bed-wetting at night isn’t usually related to cystitis.Children with cystitis may also feel weak and may have trouble keeping food down.

Signs of cystitis in young children and babies should be taken very seriously. It can be an indication of urinary reflux. That’s when urine comes back to the body instead of leaving it while peeing. 

Call your doctor if you have:

  • Blood in your urine

  • Signs and symptoms that last more than several hours

  • Symptoms that come back after your finish taking antibiotics

Get help right away if you have these signs of a kidney infection:

  • High fever

  • Pain in your side or back

  • Shaking and chills

  • Throwing up

  • Upset stomach

Cystitis Risk Factors

Some things can make a woman more likely to have cystitis:

  • Being sexually active

  • Being pregnant

  • Using tampons

  • Using diaphragms with spermicide in them

  • Being past menopause

These things can raise the chances of cystitis for both men and women:

  • A recent urinary tract infection (UTI)

  • Radiation or chemotherapy

  • Using a catheter

  • Having diabetes, kidney stones, or HIV

  • An injury to the spine

  • Something that affects the flow of pee

An enlarged prostate can raise the risk in men.

Cystitis Diagnosis

Your doctor will do a physical exam and ask about your symptoms. You may then get:

  • Urine analysis to check for bacteria, blood, or pus in your pee

  • Urine culture to find out which type bacteria you have

Often, the cause is a bladder infection and that’s all the testing you need. But if you belong to one of these groups, you may get more advanced tests to find the cause of cystitis:

  • Children

  • Men (Since they tend not to get cystitis, it could be a sign of something else.)

  • People who have kidney damage

  • Women who get three or more bladder infections in a year

Your doctor may use:

  • Cystoscopy. Your doctor inserts a cystoscope -- a thin tube with a camera -- into your urethra to look for problems or to get a tissue sample for more testing (biopsy).

  • Imaging.An ultrasound, CT scan, and MRI can show tumors, kidney stones, and other issues.

  • Intravenous urogram (IVU). It’s an X-ray that uses contrast dye to take images of the kidneys, ureters, and bladder.

  • Voiding cystourethrography. Your doctor puts a dye into your bladder to see if any urine flows backward from the bladder toward the kidneys.

  • Retrograde urethrography. This test uses contrast dye to find problems in the urethra.

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Cystitis Treatment

What you need will depend on the cause:

Bacteria.Your doctor will likely give you antibiotics. You usually start to feel better in a day or so, but be sure to take all the medicine as directed. How long you need to take them depends on your overall health, how often you get infections, and the type of bacteria.

If you’re a woman past menopause, your doctor may also suggest a vaginal cream that has estrogen in it.

Interstitial Cystitis

Because the cause isn’t known, your doctor may recommend a series of phases to see what  brings relief.  The first phase is lifestyle changes:

  • Avoid spicy foods and foods high in potassium.

  • Avoid smoking and drinking alcohol.

  • Work with your doctor on “ bladder training,” meaning you change your peeing habits so you don’t have to go as often.

The second phase includes medication and other treatments. Your doctor might suggest:

  • Medicine that relaxes your bladder and eases some symptoms.

  • Bladder stretching or hydrodistension. This is a procedure where your doctor fills your bladder with fluid. You’ll get medicine to numb the area during the procedure, but you may have some pain for up to 2 days afterward. You could notice improvement in your condition in about 2 weeks.

If these treatments don’t help your symptoms, your doctor may talk to you about other treatments, including surgery.

Other types of cystitis.If you have cystitis triggered by soaps, bubble baths, and the like, it’s best to avoid those products. If you���re getting chemo or radiation, your doctor can give you pain medicine and discuss how to take in more fluids to flush out your bladder. Cystitis brought on by chemicals and radiation can be hard to treat.  You’ll need to work with your doctor to come up with a treatment that works for you. 

Cystitis Home Remedies

You can do a few things to help ease the symptoms of cystitis, no matter what’s causing it:

  • Use heating pads or hot water bottles. Put these on your belly to ease bladder pain.

  • Take sitz baths. Put only enough water in the tub so that it comes up to your hips. 

  • Drink plenty of fluids. It’s important to stay hydrated. Stick to water and steer clear of alcohol, coffee, and other drinks with caffeine. Also watch out for spicy food as it can trigger an attack of cystitis in some people. 

  • Try over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDS). Pain-relievers like ibuprofen or naproxen sodium may help with pain.

  • Wear cotton underwear and loose-fitting clothes. Cotton doesn’t hold on to moisture when you sweat, which can cut down on the growth of bacteria. And looser clothes won’t put pressure on your belly. 

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Cystitis Complications

Cystitis can sometimes lead to other health issues, especially when bacteria get into your kidneys. This can cause a serious type of infection. 

Other conditions linked to cystitis include irritable bowel syndrome (IBS), vulvodynia, fibromyalgia, chronic fatigue syndrome, lupus, panic attacks, and pelvic floor dysfunction. It also can make blood show up in your pee.

Cystitis Prevention

There’s no sure way to prevent cystitis, but some doctors suggest that you:

  • Avoid bubble bath, soaps, and powders that have perfumes in them. And don’t use deodorants or sprays on your vagina.

  • Don’t hold it in. Pee when you feel the urge.

  • Drink plenty of liquids.

  • Pee after having sex.

  • Wipe your bottom front to back after you go to the bathroom.

WebMD Medical Reference Reviewed by Hansa D. Bhargava, MD on June 15, 2020

Sources

SOURCES:

National Health Service: “Cystitis.”

Mayo Clinic: “Cystitis,” “Urinary Tract Infection (UTI),” “Symptoms,” “Interstitial Cystitis,” “Oral Medications,” Lifestyle and Home Remedies,” “Bartholin’s Cyst.”

American Urological Association: “Diagnosis and Treatment Interstitial Cystitis/Bladder Pain Syndrome (2014).”

Victoria State Government: “Cystitis.”

KidsHealth: “Urinary Tract Infections.”

Merck Manual: “Bladder Infection (Cystitis),” “Interstitial Cystitis.”

NHS Inform: “Cystitis.”

National Institute of Diabetes and Digestive and Kidney Diseases: “Treatment of Interstitial Cystitis.”

Johns Hopkins Medicine: “Urinary Tract Infections.”

Interstitial Cystitis Association: “Associated Conditions.”

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