Infections of the bladder mucosa: cystitis

By Cristiano Antonino On Jan 15, 2023

Cystitis is an inflammation of the bladder mucosa, acute or chronic, which affects many people, particularly women

This condition is characterised by the sensation of having to urinate often and a feeling of discomfort in the intimate area.

Women in particular suffer from cystitis and there are many risk factors for the development of this inflammation

This pathology can be very unpleasant for the patient and the symptoms are different depending on the level of severity and vary from person to person.

Certainly, cystitis can worsen a person’s quality of life, but it is not usually a life-threatening condition.

In more extreme cases, when the condition is not treated properly, there may be complications, such as spread to the kidneys or systemically, but if recognised and treated promptly, the picture quickly moves towards an uncomplicated resolution.

It is a good idea to inform the doctor if discomfort appears that can be traced back to cystitis, to prevent it from worsening.

Cystitis tends to heal within a few days with antibiotic treatment.

Forms of cystitis

Cystitis is usually not a dangerous condition but can be very annoying.

It is possible to classify cystitis into two categories: simple or complex (the latter also known as ‘complicated’).

Simple cystitis is the most common form and also the best known, characterised by the more traditional symptoms, such as the need to urinate often, burning and pain in the lower abdomen.

Complicated cystitis, on the other hand, is the most severe form, presenting additional symptoms in addition to the traditional ones, such as the presence of blood in the urine, increased body temperature (fever) and infections of other structures of the urinary tract.

If such cystitis is suspected, it is necessary to be examined by a specialist so that the most suitable treatment can be found quickly.

In men, cystitis can lead to difficulty in emptying the bladder and consequently to urine stagnation, which predisposes to further infectious processes in the urinary tract.

Cystitis can also be divided into infectious and non-infectious

Infectious cystitis is the most common and accounts for 90% of all forms of cystitis. An example of these cystitis are bacterial infections with Escherichia coli.

Non-infectious cystitis are those caused by a reaction to a non-infectious insult.

The most common are radioinduced (or actinic) cystitis, caused by damage induced to the bladder by ionising radiation usually used in radiotherapy to treat tumours of neighbouring structures or of the bladder itself.

What are the causes of cystitis

The causes of cystitis are different and often combined.

Although the bladder is particularly resistant to infection, thanks to the disinfecting properties of urine, certain conditions can lead to a reduction in the body’s defence mechanisms in the face of a bacterial attack.

There are several factors that can cause cystitis

Among the most common are:

the use of antibiotics, which can promote the growth of resistant bacteria,
excessive stress load,
irregular and incorrect diet,
intimate hygiene issues, such as excessive or poor hygiene,
the use of tampons,
use of products such as a diaphragm or spermicidal creams that alter vaginal acidity and decrease its ability to defend itself,
unprotected sexual intercourse,
the catheter,
stones or tumours,
prostatic hypertrophy,
diverticula,
the presence of glucose in the urine, which can cause significant bacterial growth (diabetes can also be considered a risk factor for cystitis).

Diagnosing cystitis

The easiest way to diagnose cystitis is to talk to your doctor, informing him or her of the various symptoms.

The characteristics of cystitis make it easy to suspect, as the symptoms are often present simultaneously and are specific to this condition.

Even when it is clear that it is cystitis, the doctor may require specific tests in order to confirm the suspected diagnosis.

In order to diagnose cystitis, a urine culture, i.e. the analysis of bacteria in the urine from a sample provided by the patient, may be required.

Crucial for the success of this test is the use of a sterile container, which is provided at the hospital or pharmacy

In the laboratory, the presence of various elements in the collected biological sample such as proteins, blood, glucose and ketones is also checked.

In order to understand the patient’s state of health, the reactions of these components with certain chemicals are analysed.

A physical-chemical test of the urine can also be useful, as it allows an evaluation of important characteristics such as colour and density.

Should these tests prove negative or particularly altered values occur, further tests may be required.

Cures for cystitis

There is no single, universal cure for cystitis.

Usually, if the cause is bacterial, empirical antibiotic therapy is administered to resolve the problem.

Thanks to the use of these antibiotics, it is possible to cure this inflammation.

It is good to remember that a first episode of cystitis is a risk factor for the development of a new episode later in life.

With correct antibiotic therapy, the symptoms disappear.

Correct antibiotic therapy rebalances the bladder bacterial flora, reducing the risk of developing new episodes.

Those suffering from recurrent cystitis should take prophylactic antibiotic therapy to prevent relapses.

For this therapy to work, however, it must be targeted so that it acts on the bacterium causing the infection.

For this reason, it is important to first identify the type of bacterium responsible by performing an antibiogram, in order to understand which antibiotic may be most effective, as they are not all the same.

Sometimes the antibiotic can be accompanied by a supplement that makes it more effective, helping to remove the bacteria from the bladder walls.

One example is D-Mannose, which can be given in combination with the antibiotic for the removal of E. coli.

When suffering from cystitis, it is advisable to hydrate the body by drinking at least two litres of water per day.

In this way, the body can expel the bacteria more easily.

Proper hydration makes healing faster and treatment more effective

There is a type of cystitis, known as coital cystitis, which occurs after sexual intercourse and, in this case, abstinence from sexual intercourse may be indispensable in order not to further irritate the vaginal mucous membrane, a frequent entry route for pathogens.

Cystitis in pregnancy

Cystitis can be related to pregnancy because of the constant changes in a woman’s body at this delicate time.

During pregnancy, a woman undergoes many physiological changes including hormonal changes that can make the bladder more susceptible to developing infections.

In particular, increased progesterone can lead to decreased urethral tone and altered urinary flow.

This results in an increased likelihood of reflux, which predisposes to the development of infection.

The compression exerted by the growing uterus can also hinder the complete emptying of the bladder.

In the case of cystitis in pregnancy, it is advisable to follow an antibiotic treatment that ensures the lowest possible risk for the mother and the foetus, thus curing the infection and preventing complications, such as kidney infections, which can lead to premature birth.

In any case, it is advisable to consult one’s general practitioner and gynaecologist in order to obtain appropriate treatment.

Preventing cystitis

To prevent cystitis, it is essential to adopt a healthy lifestyle, paying particular attention to nutrition.

It can be helpful to maintain a healthy intestinal flora to prevent bladder disease, for example by taking yoghurt and miso-based foods, which are rich in probiotics.

Foods to prevent cystitis are also those rich in fibre such as whole grains, which prevent imbalances in the bacterial flora.

Fruits and vegetables should be eaten in season and fresh, so as to avoid additives used in agriculture. In this way, the intestine is strengthened and properly hydrated.

Several studies have shown the effectiveness of fruit, especially red fruits such as blueberries and blackberries, in preventing cystitis episodes.

Foods to avoid are those that can increase inflammation, such as those that are spicy, spicy or high in sugar. Excessively spicy or spicy foods may cause inflammation of the urinary tract, which may predispose to colonisation by pathogenic bacteria.

High sugar consumption could lead to a proliferation of bacteria in the bladder that would make them difficult to eliminate.

Finally, one way to prevent cystitis is certainly to consume the recommended amount of water per day, which, in adults, corresponds to at least 2 litres per day.

If one practises sport, this amount may increase, as the body may need additional hydration

Hydration promotes the elimination of bladder bacteria, making it difficult for them to proliferate.

It is important to recognise the symptoms of cystitis at an early stage and to seek a consultation with your doctor, so that you can get further information on how to treat the disorder and prevent new episodes. In this way, you can get professional advice on which solution is best suited to your needs.

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