Cystitis is an inflammation of the mucous membrane of the bladder. It occurs frequently in women, and talking about it as calmly as about a runny nose is normal. There's no need for shame here: cystitis is a common infection, and in women it's more frequent due to the structure of the urinary tract.
When to see a doctor
Signs of a urinary tract infection require a doctor. Don't delay seeking help if:
- you are 65 years or older, or a child under 16 years old;
- you have diabetes, weakened immunity, pregnancy, or a urinary catheter;
- symptoms worsen rapidly or do not go away within 48 hours;
- there is blood in the urine, pain in the lower abdomen or lower back under the ribs, high fever or temperature below 36 °C;
- you are a man or a transgender or non-binary person assigned male at birth.
What is cystitis and why women get it more often
Most often, cystitis is caused by bacteria from feces that enter the urinary tract through the urethra — the channel through which urine exits. Among the pathogens are E. coli, staphylococci, and streptococci. The infection can ascend from the urethra or descend from the kidneys.
In women, the urethra is shorter than in men. Therefore, it's easier for bacteria to reach the bladder or kidneys.
Risk is increased by pregnancy, wiping from back to front after using the toilet, kidney stones and other conditions that obstruct the urinary tract, incomplete bladder emptying, constipation in children, a urinary catheter, weakened immunity — for example, poorly controlled diabetes or chemotherapy — menopause, spermicide in contraception, and insufficient fluid intake. The development of inflammation is also promoted by hypothermia, prolonged use of antibiotics and immunosuppressants, spicy and smoked foods, and alcohol.
By course, cystitis can be acute or chronic, including interstitial. By cause — infectious, medication-induced, chemical, thermal, radiation, traumatic. By spread of inflammation — diffuse, focal, cervical.
Symptoms
The main signs are pain or burning during urination, frequent urges, including at night, sudden strong urges, cloudy urine. Sometimes threads or flakes are visible in the urine, and at the end of urination — burning and a drop of blood. The lower abdomen hurts. Fever may be low-grade. Weakness, nausea, and vomiting may be added. In older adults and those using a catheter, the infection sometimes manifests differently: confusion, agitation, worsening urinary leakage, new shivering.
In children, a urinary tract infection can cause high fever, irritability, refusal to eat or drink, nighttime bedwetting, and vomiting.
When it's no longer cystitis
Cystitis is a bladder infection. A kidney infection, or pyelonephritis, is a different and more dangerous condition. Some of these signs — pain in the lower back under the ribs, high fever and chills, blood in the urine — may be manifestations of a kidney infection, which without treatment can lead to sepsis. With cystitis, the temperature is usually low-grade. There is a sign when you cannot wait.
Call 103 or 112 immediately if a person with signs of a urinary tract infection becomes confused, drowsy, or has difficulty speaking.
Diagnosis
The diagnosis is made based on complaints and test results. A urine test shows blood, white blood cells, and bacteria. A urine culture identifies which bacteria caused the inflammation. For a first episode, the clinical picture and a test are often sufficient, without further examination. If infections recur, additional tests are prescribed to rule out urinary tract pathology: ultrasound, computed tomography, cystoscopy. In men and young children, every episode is investigated.
Recurrences and prevention
Recurrences are defined as two infections in six months or three in twelve months. In such cases, a doctor is needed: they may change the approach or refer to a specialist for further examinations. There is also long-term cystitis: symptoms do not go away, short courses do not always help, and a urine test does not show infection. The cause is bacteria in the bladder mucosa. This condition is difficult to diagnose and significantly reduces quality of life.
This material is for reference and does not replace a doctor's consultation.
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This content is for reference and does not replace a doctor's consultation. Medical disclaimer