December 16th, 2015
Cystitis refers to inflammation of the urinary bladder – the muscular organ that is responsible for collecting and storing urine. Under normal circumstances, urinary bladder is a sterile organ (which means no microorganisms are present in the cavity). Most common cause of cystitis is ascending infection from other parts of the urinary tract.
According to the latest statistics reported by Association of Reproductive Health Professionals (1), investigators suggested that the annual prevalence of cystitis is 60 per 100,000 adults. More than 80,000 males and 1.2 million females are currently living with interstitial cystitis or painful bladder syndrome in United States.
Cystitis patients usually presents with symptoms like:
Symptomatology in the cystitis patients vary and changes with time. In women, symptoms worsen during periods. Poorly managed cystitis greatly compromises the capacity of individuals to perform day-to-day activities; such as occupational and social responsibilities, sexual relationships etc.
Most cases of mild cystitis are asymptomatic and are diagnosed incidentally on urological investigations for other causes. Certain risk factors that may increase the risk of cystitis are:
Other risk factors include:
The pathophysiology of Cystitis is usually multifactorial. Most notable causes include:
Classic causes include:
Other less common causes include:
The diagnosis is usually clinical or via routine urological and serum tests to assess the signs of infection. Healthcare providers also carry out different tests to identify the source of primary infection such as:
Most reliable diagnostic tools that are employed to identify primary source of inflammation in the urinary bladder are:
Cystitis treatment options are usually decided after identifying the primary source of infection. If the cause of cystitis is bacterial colonization, antibiotics are usually preferred. For chronic and inflammatory varieties of cystitis, more comprehensive treatment regimen is usually advised.
Some modalities include:
Following remedies and interventions can help in reducing the intensity of symptoms and shorten the duration of ailments.
Some OTCs (such as antipyretics) help in relieving symptoms; such as pain and fever; until inflammation subsides.
Other medicines include:
Medicine is filled into bladder for multiple time periods and then emptied. Treatment cycle is about 6-8 weeks.
If cystitis is due to nerve dysfunction or improper voiding of urine from the bladder (due to disorders of nerves); specialized treatments can be considered such as Electrical Nerve Stimulation.
If cystitis is due to an organic cause, it is highly recommended to address the primary cause. However, surgical intervention should only be considered if all other options fail.
It is believed that certain foods and beverages may worsen the symptoms of cystitis. Therefore it is highly recommended to limit the intake of following foods during active cystitis:
It is highly recommended to maintain high intake of Vitamin C rich beverages (especially cranberry juice) and water to alleviate the symptoms and to boost natural immunity.
References:
2. Gupta, K., Hooton, T. M., Naber, K. G., Wullt, B., Colgan, R., Miller, L. G., … & Soper, D. E. (2011). International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: a 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clinical infectious diseases, 52(5), e103-e120.
3. O’Brien, V. P., Hannan, T. J., Schaeffer, A. J., & Hultgren, S. J. (2015). Are you experienced? Understanding bladder innate immunity in the context of recurrent urinary tract infection. Current opinion in infectious diseases, 28(1), 97-105.
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