Cystitis overview
What is cystitis?
Cystitis is an infection or inflammation of the bladder. The bladder is a sac-shaped organ which stores urine produced by the kidneys. It has 2 tubes which run into it (the ureters) bringing urine from the kidneys, and one tube which takes the urine away (the urethra). The urethra may also be inflamed (urethritis) when you have cystitis.
What causes cystitis?
Cystitis is usually caused by bacteria which have made their way into the bladder, generally via the urethra. The most common bacterium involved is Escherichia coli, which is found in the rectal area, but other bacteria or infectious agents can also cause it.
Anatomically, women are more likely to get cystitis than men. Females have shorter urethras than males, making it easier for bacteria to enter the bladder. Also, in women the opening of the urethra is closer to the anus, where the bacteria are found.
Another cause of cystitis is inflammation of the urethra after having sex. This is caused by the continual rubbing of the urethral opening during sexual activity. Symptoms usually develop within 12 hours of having sex.
Symptoms of cystitis can also be caused by local irritants. Some people are allergic or will react to vaginal deodorants, perfumed soaps or talcum powders, even some types of toilet paper.
Occasionally children will get cystitis. In some cases this is caused by an anatomical abnormality which forces urine back up the ureters, disrupting the flow of urine through the urinary system. Any child who has symptoms of cystitis should see a doctor.
People who have difficulty moving, such as disabled people or older adults, can also be troubled with cystitis. This is because the bladder may not completely empty, or urine is not passed as frequently as it should be.
Children and adults who ‘hold-on’ too long after they get the urge to urinate may also be more prone to cystitis.
More rarely, cystitis may be caused by tumours, other medical conditions (such as pelvic inflammatory disorders, Crohn’s disease or lupus) or a reaction to certain medicines.
What are the symptoms of cystitis?
In adults, cystitis generally causes frequent and painful urination. The pain is often described as a burning sensation. The urine can be smelly, look cloudy or have blood in it. You may feel unwell and have persistent pain above the pelvic bone or in your back.
In older adults or young children the symptoms may not be so obvious. A generalised illness with a fever, tummy-ache or vomiting may be the only symptoms. In the older adult, a period of agitation or worsening confusion may be caused by cystitis.
Diagnosing cystitis
For an accurate diagnosis, your doctor will require a urine sample. This test is done to confirm the diagnosis and to find out what kind of bacteria are causing the infection (so the most appropriate antibiotic can be prescribed).
Giving a urine sample
Wash the end of the penis or the vaginal area with warm water (alternatively, you may be asked to wipe the area with a disinfectant). Women should wash from front to back. You should try to give a ‘mid-stream’ sample — pass a small amount of urine into the toilet, pause, then pass a small amount into the test pot (about 4 teaspoons), pause, then pass the rest into the toilet. Do not touch the inside of the test pot as it is sterile.
Self care when you have cystitis
- Drink plenty of fluids (particularly water). Reduce the amount of tea, coffee and alcohol consumed. These will irritate the bladder.
- Putting a warm pack, such as a hot water bottle or wheat bag, on your tummy or your back can give good relief.
- Take one teaspoon of bicarbonate of soda in a glass of water and repeat every hour for 3 hours. This makes the urine less acid and relieves the burning. There are powdered medications that are mixed in water available from the pharmacy that have the same effect.
- Visit your doctor if the symptoms have not gone after 24 hours. Take any prescribed medicine (usually antibiotics and pain relief) exactly as your doctor directs. Do not stop until the course of treatment is completed.
Preventing cystitis
- Urinate frequently (as soon as you feel the need to pass urine).
- Drink plenty of fluids (particularly water) every day.
- Shower or wash at least daily. Women should wipe from front to back after passing urine, reducing the chance that bacteria around the anus are wiped over the entrance to the urethra.
- Use cotton underpants in preference to nylon and avoid tight fitting trousers.
- Shower in preference to using a bath if cystitis is a recurring problem. Hand-held shower attachments or bidets make washing the area much easier.
- Pass urine after having sexual intercourse. This allows any bacteria introduced to the urethra to be flushed out before they can begin to multiply.
When to see the doctor
Occasionally, cystitis can cause more serious problems. See your doctor if:
- the symptoms last longer than a day (this is because infection can spread to the kidney);
- there is fever, back pain, or blood in the urine;
- these symptoms occur during pregnancy (pregnant women are more at risk of kidney infection);
- there are repeated attacks;
- attacks occur following a change of sexual partners; or
- the attack has occurred in a child or man.
When to see a urologist
If you have repeated urinary tract infections you may need to be referred to a specialist doctor (urologist). You may need tests to find out if your ureter and bladder are normal, and that your kidneys have not been damaged by the repeated infections. In rare cases, surgery may be needed.
Last Reviewed: 22 November 2009
- 1. Urinary tract infections [revised June 2006]. In: eTG complete [Internet]. Melbourne: Therapeutic Guidelines Limited; 2010 Mar (Accessed 2010 May 4.) http://www.tg.org.au/
2. Kidney Health Australia. All about urinary tract infections (UTIs) (updated 2010, Feb 3). Available at: http://www.kidney.org.au/ (accessed 2010, May 4)
3. Mayo Clinic [website]. Cystitis (updated 2010, Mar 6). Available at: http://www.mayoclinic.com/health/cystitis/DS00285 (accessed 2010, May 4)
4. Kidney Health Australia. Drink water instead (updated 2009, Jun 26). Available at: http://www.kidney.org.au/KidneyDisease/Drinkwaterinstead/tabid/703/Default.aspx (accessed 2010, May 4)
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