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Cystitis – Causes, Symptoms and Treatment

Cystitis is a bacterial infection of the bladder causing pain during urination and frequent urges to urinate. It is most common in women and is usually easily treated.

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Things worth knowing about "Urinary Tract Infection (Cystitis)"

Cystitis is a bacterial infection of the bladder causing pain during urination and frequent urges to urinate. It is most common in women and is usually easily treated.

What is Cystitis?

Cystitis is an inflammation of the urinary bladder, most commonly caused by a bacterial infection. It is one of the most frequent types of urinary tract infection (UTI) and primarily affects women due to their shorter urethra. Men can also develop cystitis, although this is less common.

Causes

The most common cause of cystitis is the bacterium Escherichia coli (E. coli), which normally lives in the intestine and can enter the bladder through the urethra. Other possible pathogens include:

Staphylococci
Klebsiella species
Proteus mirabilis
Rarely: fungi or viruses

Contributing risk factors include:

Insufficient fluid intake
Poor genital hygiene
Sexual activity
Hormonal changes (e.g., during pregnancy or menopause)
Urinary tract abnormalities or urinary retention
Weakened immune system
Diabetes mellitus

Symptoms

The typical signs and symptoms of cystitis include:

Pain or burning sensation during urination (dysuria)
Frequent urge to urinate, even when little urine is produced (pollakiuria)
Cloudy, foul-smelling, or blood-tinged urine
Pressure or pain in the lower abdomen
Occasionally a mild fever

If fever exceeds 38.5 °C, chills, or flank pain occur, the infection may have spread to the kidneys (pyelonephritis), requiring immediate medical attention.

Diagnosis

Diagnosis is typically established through:

Urinalysis: Detection of bacteria, white blood cells, and possibly blood in the urine
Urine culture: Identification of the causative organism and antibiotic sensitivity testing
For recurrent infections: ultrasound of the urinary tract or further urological evaluation

Treatment

Antibiotics

Uncomplicated cystitis is usually treated with antibiotics. Commonly used agents include fosfomycin, nitrofurantoin, and trimethoprim. Treatment duration ranges from 1 to 7 days depending on the medication. Antibiotic selection should ideally be guided by sensitivity testing to prevent antibiotic resistance.

General Measures

Drink plenty of fluids (at least 1.5–2 litres per day) to flush bacteria from the bladder
Apply warmth (e.g., a heating pad to the lower abdomen) to relieve discomfort
Pain relievers such as ibuprofen or paracetamol for significant pain

Herbal and Complementary Remedies

Certain herbal preparations (e.g., bearberry leaf extracts, cranberry products) are traditionally used as supportive measures. However, scientific evidence for their effectiveness is limited. They may help relieve mild symptoms but do not replace antibiotic therapy when a bacterial infection is confirmed.

Prevention

Stay well hydrated
Wipe from front to back after using the toilet
Urinate before and after sexual intercourse
Avoid tight-fitting synthetic underwear
Avoid getting cold in the pelvic region
For recurrent infections: consult a doctor regarding long-term preventive strategies

References

European Association of Urology (EAU) – Guidelines on Urological Infections, 2023.
Hooton, T.M. – Uncomplicated Urinary Tract Infection. New England Journal of Medicine, 366(11), 1028–1037, 2012.
World Health Organization (WHO) – Global Antimicrobial Resistance and Use Surveillance System (GLASS) Report, 2022. Available at: www.who.int

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