Cystitis means inflammation of the bladder. Many people think that ‘itis’ on the end of the word means infection. Though infection is a frequent cause of inflammation (in the bladder or anywhere in the body), tissues can also become inflamed from allergy, auto-immune reactions and a variety of other chemical and physical irritations. Hay fever, common types of arthritis and sunburn are examples of inflammation caused otherwise than by infection. I mention this here because many women who have symptoms of cystitis presume that they have an infection, which isn’t always true.
Cystitis is a very common problem for women – ten times more common than in men. Few of us get through adult life without at least one attack of bladder symptoms. Many women are plagued by repeated attacks.
Symptoms of cystitis
The most common are frequency, urgency, and pain and burning on passing urine. You get an urgent desire to empty your bladder but when you get to the toilet you can only dribble out a spoonful, and it hurts! Within 10-20 minutes the urge strikes again. Sometimes there’s a constant urge to urinate, even when you can’t pass a drop.
With severe acute cystitis there’s also often pain behind the pubic bone, a burning or scalding feeling when the urine wets your genitals, chills and fever, and maybe blood in the urine, which may smell different and be cloudy. These symptoms usually mean cystitis resulting from infection. Loin pain and high fever may mean that the infection has spread to the kidneys.
With chronic cystitis there is more likely to be lower abdominal pain, frequency, urgency and sometimes urge incontinence. Fever, burning and blood-stained urine are less common.
Occasionally, especially in elderly women, there may be few or no symptoms of urinary infection. The onset of incontinence or delirium may be the first sign, without the burning and pain usually experienced by younger women.
The symptoms of cystitis are very distressing. Apart from the pain, activities are severely restricted by the need to stay within a short distance of a toilet. Frequent attacks can disrupt your home life and career, and lead to isolation, anxiety and depression. Because pain makes sex impossible during an attack and also because many sufferers fear that intercourse will trigger an attack, recurrent cystitis can lead to sexual problems.
Causes of cystitis
Most acute cystitis is due to infection. A multitude of germs can cause inflammation if they get into the urethra and bladder. Some sexually transmissible diseases – particularly gonorrhoea, chlamydia and trichomoniasis – can infect the urethra and cause urinary symptoms.
Infection, allergy, immune disorders, some drugs, bladder stones or tumours and any condition that prevents complete emptying of the bladder may lead to chronic or recurrent acute attacks of cystitis.
One type of chronic cystitis is interstitial cystitis. This means that the bladder lining remains inflamed in its deeper layers, causing symptoms after all possible infection has been eliminated by antibiotic treatment. Chronic interstitial cystitis can cause long-term bladder disability, with pain, urinary frequency and loss of control.
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