What should I feel if I have cystitis?
Cystitis symptoms are often uncomfortable, including pain, burning, or stinging when urinating, frequent urination urges, cloudy or strong-smelling urine and discomfort in the lower abdomen. Severe symptoms may include blood in your urine, indicating that the urinary tract, which carries urine from the bladder to be expelled from the body, is severely affected.
Types of Cystitis
- Bacterial Cystitis - bladder infection
The most common form is where urinary tract infections (UTIs), especially Escherichia coli, invade the bladder tissue, leading to inflammation. Untreated, the infection spreads to the kidneys, called pyelonephritis (kidney infection). Recurrent UTIs impact the quality of life negatively. - Interstitial Cystitis (Painful Bladder Syndrome)
A chronic condition causing bladder pressure and pain, with the main symptoms including recurring discomfort and a persistent urge to urinate. Painful bladder syndrome can be very debilitating. - Radiation Cystitis
This type can occur as a side effect of radiation treatment to kill cancer cells in the pelvic area, causing bladder inflammation and irritation. Radiation cystitis can be quite challenging to manage. - Chemical Cystitis
Exposure to chemicals in certain products like talcum powder can cause inflammation of the bladder, manifesting as symptoms worse than typical mild cystitis. - Foreign body cystitis
Foreign body cystitis is a form of cystitis or inflammation of the bladder that occurs due to a foreign body within the bladder. This can be a urinary catheter, a bladder stone, or any other foreign material or object that can introduce bacteria into the urinary tract, leading to bacterial infection and subsequent bladder inflammation.
Risk Factors and Causes
Cystitis frequently occurs in sexually active individuals and those with a weakened immune system, making them more susceptible to bacterial infections in the urinary system.
An enlarged prostate gland in males can obstruct urine flow, leading to bladder infections.
Females are more susceptible to recurrent urinary tract infections. This is due to their anatomy; however, lifestyle and medical factors play a role.
Additionally, drug-induced cystitis from certain chemotherapy drugs or radiation therapy can cause damage and irritation in the urinary tract, making one prone to developing cystitis.
Diagnosis and Tests
To diagnose cystitis, urine tests such as urine culture and urine sample analysis are vital. These urine tests detect the presence of bacteria, white blood cells, and red blood cells.
A further test, like a cystoscopy, may be needed if recurrent cystitis occurs.
Treatment and Management
Cystitis Treatment
The treatment may vary depending on whether the cystitis is bacterial or interstitial, and cystitis depends heavily on addressing the root cause.
Bacterial cystitis
Usually, it involves doctors prescribing antibiotic treatment to address the underlying bacterial infection in the acute event (painful urination, fever and other symptoms).
To manage symptoms of bacterial cystitis, patients are advised to drink plenty of fluids to flush bacteria from the urinary tract, avoid irritants, double void to ensure they empty their bladder during each urination and maintain proper hygiene during bowel movement to prevent bacterial transfer.
Alternative remedies like cranberry juice, probiotics, D mannose, and Hiprex are common. Some claim it can prevent bacteria from adhering to the urinary tract walls, although conclusive scientific evidence is still lacking.
Radiation cystitis
Regeneration of the inner lining of the bladder by hyaluronic bladder installations, using medications to relax the lower urinary tract system and alleviate cystitis symptoms. Hyperbaric treatment has been attempted. If these fail, one can consider the removal of the bladder.
Interstitial Cystitis (Painful Bladder Syndrome)
This is a very complex situation to address.
Controlling Symptoms
Several methods are available for controlling the symptoms of Interstitial Cystitis (IC), including diet modifications, healthy sleep habits, and effective stress management.
Dietary Approaches
Several dietary approaches can help manage IC, such as adhering to IC-friendly recipes, undergoing allergy testing, adopting gluten-free and alkaline diets, anti-yeast therapy, nutritional supplements, and following the IC Food List.
Physical Therapy
Hands-on Therapy & Tools
Physical therapy involves hands-on therapy and various tools. It’s crucial to understand how to locate a knowledgeable physical therapist and address the payment for the therapy.
Antidepressants
Understanding the role of various antidepressants is essential. These include tricyclics like amitriptyline (Elavil), SSRIs like Prozac and Paxil, SNRIs like Cymbalta, NRIs like Strattera, and bupropion (Wellbutrin).
Antihistamines
While hydroxyzine is the most widely used antihistamine, some IC patients find relief from Claritin, Benadryl, and Singulair.
Pentosan Polysulfate Sodium
Pentosan polysulfate sodium (Elmiron) is the singular oral medication approved by the FDA specifically for IC.
Bladder Instillations
Bladder instillations refer to combinations of medications introduced directly into the bladder. Some examples include DMSO, Sodium Hyaluronate, and Heparin, amongst others.
Immunosuppressants
It is pivotal to exploring the potential of immunosuppressants like Cyclosporine, Mycophenolate (CellCept), and Mycophenolate mofetil as they can be potential treatments for IC/BPS.
Surgical Procedures
For conditions like Hunner’s Ulcers, laser surgery proves helpful. Other procedures, like cystoscopy with hydrodistention, are typically seen as the last-resort treatments.
Neuromodulation
Electrical nerve stimulators or neuromodulators, such as UrgentPC, InterStim, Eon Mini, and IF3WAVE, have substantially benefited numerous IC/BPS patients.
Additional Medications
Numerous other medications play a role in IC/BPS treatment protocols. These include alpha blockers like Flomax, anti-seizure meds like Neurontin, histamine blockers like Tagamet, Zantac, and Pepcid, leukotriene inhibitors, prostaglandins like NSAIDs and ibuprofen, urinary antacids like potassium or sodium citrate and tricitrates, and urinary tract antispasmodics like Detrol, Toviaz, and VESIcare.
Reflection from a consultant urologist
Cystitis, whether it is bacterial cystitis or interstitial cystitis, is a condition that requires prompt attention and management. Recognising cystitis symptoms early to begin appropriate cystitis treatment and incorporating preventive measures.
