Cystitis is inflammation of the urinary bladder. It causes increased frequency of urination, along with an   urgent need to pass urine. This is associated with painful urination. One also experiences low backache, pain in lower abdomen, nausea, vomiting, e.t.c, symptoms in various combinations.  

In severe cases, urine may pass out involuntarily which is very embarrassing for the individual. Chronic or recurrent cystitis leads to thickening of the bladder wall, thus augmenting the problem of chronic frequency and urgency of urination. 

Women are more prone to cystitis due to multiple reasons. They have a shorter urethra (tube connecting bladder to the exterior). This facilitates easy entry   of the bacteria in the bladder.  Due to this, they can acquire cystitis even while using common public toilets or unclean toilets at home. Menstrual bleeding is yet another cause for cystitis in women. Blood passed during menses provides a rich medium for bacteria to grow, making women prone to cystitis.  Poor personal hygiene during menstruation, damp sanitary pads, also contribute    to the infection. Women can acquire infection from the sexual partner during intercourse as infecting germs can easily reach the urinary bladder resulting in cystitis.  Trauma to the birth canal during child birth is yet another   risk factor which can result in infection of the genital parts as well as cystitis. Women, who develop prolapsed uterus due to multiple child births or other factors, also suffer from chronic cystitis. This happens because   the prolapsed uterus compresses the adjoining bladder and prevents complete evacuation of urine.  Residual urine remaining in the bladder facilitates growth of bacteria leading to cystitis.

Young men mostly acquire cystitis due to sexually acquired infections, gonococcal infection being the most common one.  Germs reach the urinary bladder through genital parts due to the close proximity. Elderly men can have this problem due to an enlarged prostate.   Stones in the urinary tract also lead to cystitis. Parasitic infections like schistosomiasis can affect the urinary bladder leading to its inflammation.

An indwelling catheter can cause infection and inflammation of the urinary bladder in any individual. If untreated, cystitis can lead to infection of the kidneys which poses a crucial threat to a person’s health, Chronic and or recurrent kidney infection can lead to chronic kidney failure over time. It can also cause   sepsis, i.e. spread of infection to the entire body, via blood stream.

The germs commonly implicated in cystitis are gram negative germs like E-coli, proteus mirabilis, e.t.c. 

If suspected, cystitis can be diagnosed by simple microscopic examination of a urine sample. This sample should be of the urine passed first thing in morning, after waking up.  Infecting germs tend to concentrate in bladder overnight when one does not pass urine for several hours. The first few drops should be discarded as they could be contaminated by microbes present on outer surface of genital parts, thus giving false results. A culture of the urine sample helps to identify the causative microbe and a suitable antibiotic, which given can help cure the infection.

 Drinking large quantities of water (8 to 10 glasses daily), is a good measure to prevent cystitis. This ensures passing adequate amount of urine thus washing out microbes also from the body.  Good menstrual hygiene helps prevent cystitis in women. It is advisable to wash perineum after sexual intercourse to prevent settling of microbes over genitals.  This prevents sexually acquired infection as well as cystitis.  

The writer is a specialist, internal medicine

E-mail rachna212002@yahoo.co.uk