Cystitis is the medical term for inflammation of the bladder. Most of the time, the inflammation is caused by a bacterial infection, in which case it may be referred to as a urinary tract infection (UTI). A bladder infection can be painful and annoying, and can become a serious health problem if the infection spreads to your kidneys.
Less commonly, cystitis may occur as a reaction to certain drugs, radiation therapy or potential irritants, such as feminine hygiene spray, spermicidal jellies or long-term use of a catheter. Cystitis may also occur as a complication of another illness.
The usual treatment for bacterial cystitis is antibiotics. Other treatments are used for other types of cystitis.
Symptoms
Cystitis symptoms often include:
* A strong, persistent urge to urinate
* A burning sensation when urinating
* Passing frequent, small amounts of urine
* Blood in the urine (hematuria)
* Passing cloudy or strong-smelling urine
* Discomfort in the pelvic area
* A feeling of pressure in the lower abdomen
* Low-grade fever
In young children, new episodes of bed-wetting (enuresis) also may be a sign of a UTI.
Causes
Your urinary system is composed of the kidneys, ureters, bladder and urethra. All play a role in removing waste from your body. Your kidneys — a pair of bean-shaped organs located toward the back of your upper abdomen — filter waste from your blood and adjust the body composition of many substances. Tubes called ureters carry urine from your kidneys to the bladder, where it's stored until it exits your body through the urethra.
Bacterial cystitis
UTIs typically occur when bacteria enter the urinary tract through the urethra and begin to multiply. The urinary system is designed to keep out such microscopic invaders. The bladder secretes a protective coating that prevents bacteria from attaching to its wall. Urine also has antibacterial properties that inhibit the growth of bacteria. However, certain factors increase the chances that bacteria will take hold and multiply into a full-blown infection.
Bacterial bladder infections may occur in women as a result of sexual intercourse. During sexual activity, bacteria may be introduced into the bladder through the urethra. But even sexually inactive girls and women are susceptible to lower urinary tract infections because the female genital area often harbors bacteria that can cause cystitis.
Most cases of cystitis are caused by Escherichia coli (E. coli), a species of bacteria commonly found in the genital area. A new strain of antibiotic-resistant E. coli may be the cause of increasingly hard-to-treat UTIs in women.
Main types of infections
The two main types of bacterial bladder infections are:
* Community-acquired bladder infections. These infections occur when people who aren't in a medical care facility, such as a hospital or nursing home, develop a bladder infection. This condition is common in women between the ages of 30 and 50, but it is rare in men of the same age. However, men older than 50 may be at risk of this type of infection because of prostate enlargement, a common condition that can block urine flow in older men.
* Hospital-acquired, or nosocomial (nos-o-KO-me-ul), bladder infections. These infections occur in people in a medical care facility, such as a hospital or nursing home. Most often they occur in those who have had a urinary catheter placed through the urethra and into the bladder to collect urine, a common practice before some surgical procedures, for some diagnostic tests, or as a means of urinary drainage for elderly people or people confined to bed.
Noninfectious cystitis
Although bacterial infections are the most common cause of cystitis, a number of other noninfectious factors may cause the bladder to become inflamed. Some examples:
* Interstitial cystitis. The cause of this chronic bladder inflammation, also called painful bladder syndrome, is unclear. Most cases are diagnosed in women. The condition can be difficult to diagnose and treat.
* Drug-induced cystitis. Certain medications, particularly the chemotherapy drugs cyclophosphamide and ifosfamide, can cause inflammation of your bladder as the broken-down substances of the drugs exit your body.
* Radiation cystitis. Radiation treatment of the pelvic area can cause inflammatory changes in bladder tissue.
* Foreign-body cystitis. Long-term use of a catheter can predispose you to bacterial infections and to tissue damage, both of which can cause inflammation.
* Chemical cystitis. Some people may be hypersensitive to chemicals contained in certain products, such as bubble bath, feminine hygiene sprays or spermicidal jellies, and may develop an allergic-type reaction within the bladder, causing inflammation.
* Cystitis associated with other conditions. Cystitis may sometimes occur as a complication of other disorders, such as gynecologic cancers, pelvic inflammatory disorders, endometriosis, Crohn's disease, diverticulitis, lupus and tuberculosis.
Your urinary tract is made up of your kidneys, ureters, bladder and urethra. Because of anatomy, women are more likely to have a bladder infection than men are. Women have a shorter urethra than men have, which cuts down on the distance bacteria must travel to reach the bladder.
Your urinary tract is made up of your kidneys, ureters, bladder and urethra. Although cystitis is more common in women, men can contract cystitis as well. In men, the most common cause of bladder infection is enlarged prostate (benign prostatic hyperplasia, or BPH), which occurs when the prostate gland grows and impairs the flow of urine from the bladder. Because the bladder doesn't empty completely, it is more susceptible to bacteria growth and infection. There are other causes as well.
Risk factors
Some people are more likely than are others to develop bladder infections or recurrent urinary tract infections. Women are one such group. A key reason is anatomy. Women have a shorter urethra than men have, which cuts down on the distance bacteria must travel to reach the bladder.
Women who are sexually active tend to have more UTIs, because sexual intercourse can result in bacteria being pushed into the urethra. Women who use diaphragms for birth control also may be at higher risk. Hormonal changes during pregnancy may increase the risk of a bladder infection as well.
Other risk factors in both men and women include:
* Interference with the flow of urine. This can occur in conditions such as an enlarged prostate or a stone in the bladder.
* Changes in the immune system. This can occur with conditions such as diabetes, HIV infection and cancer treatment. A lowered immune system increases the risk of bacterial and, in some cases, viral bladder infections.
* Prolonged use of bladder catheters. These tubes may be needed in people with chronic illnesses or in older adults. Prolonged use can result in increased vulnerability to bacterial infections as well as bladder tissue damage.
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