Do you have cystitis?

Here is the fourth article by Dr Isabelle Benard, a GP who practises at The Medical Chambers Kensington.

Cystitis is an infection of the bladder and lower urinary tract. It is a very common problem, particularly in women; and more than half of women will have at least one episode of cystitis in their lifetime. For a minority of them, cystitis can become a recurrent problem and a major nuisance.

Men and children are less affected by this problem, but need to be investigated for any underlying condition if they develop a urine infection.

Cystitis occurs when bacteria are spread from the perineum to the bladder. Once in the bladder, they thrive, damage the protective lining of the bladder, invade it and multiply, causing inflammation and irritation.

The symptoms are very unpleasant: painful urination, lower abdominal pains, wanting to pass urine very frequently, in small amounts. The urine can look cloudy or even bloody.

If left untreated, the infection may spread upwards to the kidneys, which is called pyelonephritis. This can cause pain in the lower back, malaise, fever and vomiting. Pyelonephritis is serious and requires prompt medical attention and sometimes hospital admission.

Very early symptoms of cystitis may disappear simply by drinking a lot of water: up to 2 or 3 litres per day, which helps to flush out the bacteria.

If the symptoms persist more than 2 days, it is important to see a doctor, who will prescribe a short course of antibiotics, to clear the infection.

Women with recurrent cystitis need to be assessed for any underlying problems (kidney stones, kidney abnormalities, etc).

Here are a few helpful tips to avoid getting cystitis:

• Drink plenty of water throughout the day, particularly on warm days. Aim for a minimum of 1.5 to 2 litres/day.
• Wearing cotton underwear seems preferable.
• Fight constipation by eating plenty of fibre-rich foods.
• Cranberry juice or cranberry extracts can be useful as a prevention for cystitis, as they appear to reduce the bacteria's ability to stick to the bladder. Unfortunately, once the infection has set in, cranberry does not help to clear it.
• Avoid washing the perineum with soap, as it might destroy the friendly natural flora which protect you from urine infections. Water is generally all you need to use.
• Probiotic drinks may also have a role in helping preventing cystitis, by replenishing the same protective flora.
• Last but not least, passing urine immediately after intercourse helps flush out any straying bacteria from the bladder.

Researchers are looking into a vaccine against E.Coli, the most common bacteria causing urine infections, which would be another weapon in our fight against cystitis.

Dr Isabelle Benard MD General Practitioner