Acute cystitis
Acute cystitis, commonly referred to as a bladder infection, is an inflammation of the bladder usually caused by bacterial or yeast infections. It occurs when microorganisms from the lower gastrointestinal tract enter the urinary tract, often via the urethra, and travel to infect the bladder. Women are particularly susceptible due to anatomical proximity between the rectum and urethra, and factors such as sexual activity, menopause, and certain medical conditions can increase risk. Symptoms of acute cystitis can range from mild to severe and may include frequent urination, abdominal pain, burning during urination, and cloudy or blood-tinged urine. Diagnosis typically involves a urine test for bacteria, blood, and pus, while treatment generally includes antibiotics, with symptom relief often occurring within a few days. Prevention strategies focus on reducing bacterial entry into the urinary tract and include increased hydration, proper hygiene, and in some cases, the consumption of cranberry juice. Understanding these aspects of acute cystitis can empower individuals to seek appropriate care and adopt preventive measures.
Acute cystitis
- ANATOMY OR SYSTEM AFFECTED: Bladder, urinary system
- ALSO KNOWN AS: Bladder infection
Definition
The urinary tract normally contains no microorganisms. However, bacteria or yeast from the lower gastrointestinal tract or rectal area sometimes enter the urinary tract, usually through the urethra (the tube that allows urine to pass from the bladder). If bacteria or yeast cling to the urethra, they can multiply and infect the urethra. They then travel up and infect the bladder with a condition called acute cystitis.
Causes
Bacteria from the rectal area cause most cases of cystitis. In women, the rectum and urethra are fairly close to each other. This makes it relatively easy for bacteria to make their way into the urethra. Some women develop cystitis after a period of frequent sexual intercourse. This happens because bacteria enter the urethra during sex and cause infection.
Risk Factors
Risk factors for acute cystitis include being sexually active; using a diaphragm for birth control; condom use (this may also increase infection rates in women, especially when Nonoxynol-9-coated condoms are used); menopause; abnormalities of the urinary system, including vesicoureteral reflux or polycystic kidneys; paraplegia and other neurologic conditions; sickle-cell disease; history of kidney transplant; diabetes type 1 and type 2; kidney stones; enlarged prostate; weak immune system; bladder catheter in place or recent instrumentation of the urinary system; tight underwear and clothing; and chemicals in soaps, douches, and lubricants. Women are at higher risk for acute cystitis. Pregnancy may also increase the risk for acute cystitis due to hormonal changes and the pressure a growing fetus places on the bladder. Recent surgery to the urinary tract area and a history of chronic urinary tract infections may also increase risk. Individuals who do not drink enough water or are immobile may have an increased risk of acute cystitis. Finally, constipation can increase pressure on the bladder, leading to an increased risk of acute cystitis.
Symptoms
The symptoms of cystitis, which vary from person to person and can range from mild to severe, include frequent and urgent urination, passing only small amounts of urine, pain in the abdomen or pelvic area or in the lower back, a burning sensation during urination, leaking urine, an increased need to get up at night to urinate, cloudy, bad-smelling urine, blood in the urine, low-grade fever, and fatigue. Additional symptoms include nausea, vomiting, and confusion in older people.
Screening and Diagnosis
A healthcare provider will ask about symptoms and medical history, perform a physical exam, and test the urine for blood, pus, and bacteria. If bacteria are present in the urine, cystitis is likely to be diagnosed. Children and men who develop cystitis may require additional testing. In these cases, a cystoscope is used to check for structural abnormalities of the urinary system that predispose a person to infection.
Treatment and Therapy
Bacterial cystitis is treated with antibiotic drugs. Antibiotics (usually trimethoprim/sulfamethoxazole, nitrofurantoin, or fluoroquinolones) will be prescribed for at least two to three days and perhaps for as long as several weeks. The treatment length depends on the infection's severity and the patient’s personal history. Symptoms should subside in about one or two days. The healthcare provider will again test the patient’s urine to ensure the infection has disappeared.
Recurrent infections might be treated with stronger antibiotics or over more time. Low-dose antibiotics, which are prescribed as a preventive measure, might be prescribed either for daily use or for use after sexual intercourse. Patients with recurrent infections could be referred to a specialist.
Phenazopyridine (Pyridium) is a medicine that decreases pain and bladder spasms. Taking phenazopyridine turns urine and sometimes sweat orange. This medication is generally available without a prescription and can effectively relieve symptoms while the patient waits for medical treatment to work.
Occasionally, healthcare providers will choose alternative forms of treatment before resorting to antibiotics. These treatment options include increasing fluid intake, taking over-the-counter pain medications, and drinking cranberry juice or taking cranberry supplements.
Prevention and Outcomes
The chance of having cystitis can be lessened by preventing bacteria from entering the urinary tract. Of the following logical and commonly recommended steps, only cranberry juice has been clearly shown to be of value in reducing infection risk. One should drink large amounts of liquids; urinate when having the urge; empty the bladder and then drink a full glass of water after having sexual intercourse; wash the genital area daily; wipe from front to back (for women) after having a bowel movement; avoid using douches and feminine hygiene sprays; drink cranberry juice (which may help prevent and relieve cystitis); and avoid wearing tight underwear or clothing. Probiotics can help maintain a healthy balance of good bacteria in the urinary tract. Postmenopausal women may find relief from topical estrogen if vaginal dryness is a contributing factor to acute cystitis.
These prevention recommendations apply primarily to healthy young women at risk for bladder infections. Those with some unusual risk factors, or women for whom the preceding suggestions do not reduce recurrence, might find that other medically recommended prevention techniques help.
Bibliography
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