Table of Contents
Definition of Cystitis
Other pathogens, such as fungi (yeasts) and viruses, also can cause infectious cystitis.
Nonpathogenic causes of cystitis include irritation of the lining of the bladder, which may occur with excessive consumption of irritating substances such as CAFFEINE, high-acid foods, or certain medications.
Cigarette smoking is a significant bladder irritant. RADIATION THERAPY, CHEMOTHERAPY, and AUTOIMMUNE DISORDERS also may cause cystitis. Interstitial cystitis is a chronic condition the hallmark of which is inflammation of the bladder along with a constellation of symptoms for which there are no clearly identifiable causes.
Symptoms and Diagnostic Path
The symptoms of cystitis may include
- DYSURIA (burning or PAIN with URINATION)
- HEMATURIA (bloody URINE)
- URINARY URGENCY
- URINARY FREQUENCY, including NOCTURIA (the need to urinate at night)
- cloudy, foul-smelling, or discolored urine
- pain in the lower abdomen
- pain with SEXUAL INTERCOURSE
The diagnostic path begins with urinalysis, which often shows whether BACTERIA or other pathogens are present in the urine. Escherichia coli is the most commonly the culprit for infectious cystitis (UTI). Chlamydia and herpes simplex viruses (HSV-1 and HSV-2) are also common causes of UTIs.
The urologist may choose further diagnostic procedures such as CYSTOSCOPY or abdominal ULTRASOUND to rule out causes such as tumors or stones (UROLITHIASIS). Cystoscopy allows the urologist to assess bladder capacity, an important factor in determining a diagnosis of interstitial cystitis as reduced bladder capacity is a characteristic of this condition. The current standard of diagnosis for interstitial cystitis further requires the presence of key symptoms over a period of time as well as the exclusion of other causes for the symptoms.
Treatment Options and Outlook
UTIs require therapy with the appropriate medications, such as ANTIBIOTIC MEDICATIONS for bacterial infections or ANTIFUNGAL MEDICATIONS for yeastbased infections. The symptoms of infectious cystitis generally subside within a few days of beginning treatment, and the infection clears with the full course of medication. The oral medication phenazopyridine (Pyridium) acts as a topical anesthetic to block pain signals from the lining of the bladder, easing dysuria until the medication affects the infection.
It is essential to take prescribed medications as the doctor directs and to take medications to treat infections until the medication is gone (the full course of treatment) even after symptoms improve. Undertreated or untreated UTIs can migrate from the bladder to the KIDNEYS, where they can cause serious illness and sometimes permanent damage to the kidneys.
Treatment for autoimmune cystitis targets the IMMUNE SYSTEM with ANTIHISTAMINE MEDICATIONS, IMMUNOSUPPRESSIVE MEDICATIONS, and other approaches that aim to block the inflammatory response. Irritation cystitis often resolves with a combination of increased fluid consumption and ending the cause of the irritation, when possible. Common culprits include coffee, tea, carbonated beverages, citrus fruits and juices, tomatoes and tomato products, chocolate, ALCOHOL, and pickled or smoked foods.
Interstitial cystitis is difficult to treat. People respond differently to treatment regimens, and sometimes a successful treatment becomes ineffective. Urologists may prescribe various kinds of medications to relieve symptoms such as tricyclic ANTIDEPRESSANT MEDICATIONS (which appear to suppress certain pain response mechanisms), NONSTEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDS), and antihistamines.
The medication pentosan (Elmiron) is the only oral medication specifically for interstitial cystitis, though women who are pregnant cannot take it. Pentosan also takes up to six months to provide relief and may cause temporary HAIR loss. Other treatments include intravesical therapies in which the urologist instills medications directly into the bladder via urethral catheterization. Bladder distention under ANESTHESIA (via cystoscopy) provides long-term though temporary relief for some people.
|FOODS AND DRINKS THAT CAN IRRITATE THE BLADDER|
|chocolate||chocolate-covered espresso beans|
|cranberries and cranberry juice||lemons and lemonade|
|mixed ALCOHOLIC drinks||onions|
|oranges and orange juice||peanuts and peanut butter|
|peppers (sweet or hot)||pineapple|
|tea (hot or iced)||tomatoes and tomato juice|
|vinegar and dressings with vinegar||wine (white or red)|
Risk Factors and Preventive Measures
Women are more likely to develop infectious cystitis and interstitial cystitis, primarily because a woman’s shorter URETHRA allows easier access for pathogens. Diligent personal hygiene, including urination soon after sexual intercourse and wiping toilet tissue from front to back, helps reduce exposure to bacteria. Doctors are unsure why interstitial cystitis occurs more often in women. However, doctors do not know what causes interstitial cystitis, either. Finding the cause will likely shed light on all dimensions of this chronic and disruptive condition.
See also BLADDER CATHETERIZATION; NEPHRITIS.