Cystitis: Risk Factors and Treatment

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"I woke up one morning and every time I had to urinate it became more and more painful," says Amy, a 28-year-old publicist. The pain worsened throughout the day until she noticed she was "peeing pink."

"I thought it was because I was drinking so much cranberry juice," she says. It turned out the discoloration was due to blood in her urine, caused by a bladder infection (cystitis).

Such infections occur when bacteria (usually E. coli, normally found in the colon) enter the bladder. Cystitis is the most common type of urinary tract infection (UTI), a prevalent disorder that leads to about 9.6 million doctor visits annually, according to the National Institute of Diabetes and Digestive and Kidney Diseases. Women are especially at risk, with one in five developing a UTI during her lifetime.

It's important to seek treatment for a bladder infection because it can lead to a kidney infection -- a more serious and potentially life-threatening disorder -- if not treated.

Women's Risk

While researchers still aren't clear why bladder infections are so common in women, it's thought to be because a woman's urethra (the tube that carries urine from the bladder out of the body) is short, and its opening is close to the anus, making it easy for bacteria to travel from the colon to the bladder.

Certain risk factors increase likelihood of a bladder infection. They include:

• sexual activity, which can introduce bacteria into the urinary tract;
• use of diaphragms and spermicides, which alter the bacteria in a woman's urethra;
• pregnancy, because of changes in anatomy and physiology (a UTI can put the unborn child at risk and a doctor should be consulted immediately);
• increased age;
• poor hygiene;
• diabetes;
• medical conditions that suppress the immune system or make emptying the bladder difficult. Once a woman has a UTI, her chances of developing another one increase substantially.

Diagnosis and Treatment

If you have signs of a bladder infection, consult a doctor as soon as possible, before the problem becomes more serious. Other conditions with similar symptoms include urethritis (inflammation of the urethra), interstitial cystitis (a bladder infection with unknown cause), urinary stones and bladder tumors. Your doctor will ask questions about your medical and sexual history and take a urine sample to see whether it contains bacteria and, if so, what type.

Bladder infections are treated with a wide variety of antibiotics. Symptoms usually clear up within a few days in uncomplicated cases, though the medication needs to be taken for the entire prescribed course to cure the infection. Other medications may be given to treat symptoms until the antibiotics kick in.

Dr. James Lewis, chief of obstetrics and gynecology at Kaiser Permanente Golden Gate Hospital in San Francisco, recommends a urological evaluation for anyone who gets recurrent infections (more than two or three a year), to see whether another medical problem or a congenital malformation is causing them.

Prevention and Self-Care

"The main way to prevent a UTI is to keep the urine diluted and drink lots of fluids," says Lewis. The same is true of caring for yourself when you have one. Traditionally, people recommend drinking cranberry juice, and evidence shows that a substance in the juice and in vitamin C supplements may suppress growth of bacteria.

To prevent and care for infections, you should also:

• wipe from front to back after going to the bathroom so bacteria is not dragged from the anus to the urethra;
• keep the genital area clean;
• urinate often;
• urinate immediately after intercourse and drink two glasses of fluid before and after to flush the bladder;
• avoid douching, which can make the vulva less able to fend off infection;
• avoid baths and take showers instead;
• be sure to empty the bladder completely when urinating. In addition, when you have an infection, avoid alcohol, caffeine, spicy foods and citrus juices, which irritate the bladder.

Symptoms of Urinary Tract Infection

In rare instances, no symptoms may be apparent, but in most cases one or more of the following will be present:

• pain, burning or discomfort during urination;
• frequent need to urinate, though only small amounts of urine may come out;
• nighttime urination;
• pain in the lower back or abdomen;
• strong or foul-smelling urine cloudy urine;
• blood in the urine. Other possible symptoms include fever, vomiting, chills, painful intercourse and fatigue.

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