Cystitis can make life a misery. Instead of visiting the toilet three or lour times a day, to empty your bladder, it’s more like three or four times an hour – and each time it may be a painful and uncomfortable experience. A very high proportion of women have cystitis at some point in their lives (about one in lour all told).

A onc-offattack. Whether mild or severe, can usually be cleared up very quickly witli the help of your doctor, if necessary, though home treatments may prove very effective, But lor some women, cystitis is a long-term problem returning again and again over the years, perhaps only lor a few hours at a time, but often for months on end. Nobody is clear why some women seem to be so much more vulnerable, bui for them preventative measures which may ward off attacks are crucial.

Identifying cystitis

Just because you feel a frequent urge to empty your bladder, doesn’t mean that you’ve got cystitis. It’s well known that people who are anxious about something -whether they’re awaiting a job interview or going through a difficult time- suffer from ‘frequency. And, of course, if you drink more liquid than you need, you will have to go to the toifel more often. But what distinguishes cystitis is the discomfort involved.

Usually when you empty vour bladder, it’s cmite painless; you feel full and afterwards a pleasant sense of relief. But with cystitis, you have thai full feeling much more often, though you may find that only a lew drops pass when you try to ‘go’. When you do empty your bladder, it’s very uncomfortable, ranging from a mild scalding sensation to agonizing pain which may well reduce you to tears.

The constant dash to the toilet doesn’t stop at night (unlike the sort of urge that’s the result of emotional excitement or upheaval), and if you do not respond to the promptings ofyour bladder, there is a danger or incontinence (bed-wetting).

In severe attacks (and these seem to happen especially in women who are long-term sufferers) the combination of lack of sleep and the infection can affect general health, making them look drawn and haggard.

The more severe the attack, the worse the pain, and it may be constant, affecting the lower stomach and back as well as the sexual organs. You may notice changes in the urine as well; often there’s a little blood and other debris in it I turning it pink and cloudy) which may make it smell rather unpleasant. Occasionally the last few drops are fairly heavily bloodstained.

Common causes of cystitis

Essentially, cystitis means an inflammation of the bladder, which stores the urine. Being clastic, it can stretch to hold a whole day’s output from the kidnevs, but il the lining becomes inflamed, the bladder loses its elasticity – hence- the need to empty it more often.

The inflammation makes you feel full, even when you aren’t, and of course, makes ii painful to go to the toilet. Especially if the urethra, the passage down which the urine passes, is also involved.

Bacterial infection

A common cause of cystitis is germs finding their way into die- urine where they multiply, irritating die bladder and inflaming it. Normally, mine in the body is quite sterile, but if bacteria find their wayin from outside, they can takehold in the bladder, despite the body’s efforts to get rid of them.

The germs usually responsible are- die bacteria which live in and around the- rectum. Normally they cause no trouble, unless they find their way from the back passage up the urinary tract.

In women, the opening of the urethra is much closer to the anus than in men, so it’s much easier for the bacteria to move across, especially if ‘helped’ on their way r-vvith toilet paper. ) If you have an attack of cystitis, the best L thing you can do is drink plenty of water to try and ‘flush’ the bacteria out.

The bacteria thrive in an acid environment, so taking an alkaline substance like baking powder (sodium bicarbonate) will help .

You should avoid drinks and foods which contain acid or produce acid in the body; coffee, tea, lemon drinks, carbonated soft drinks, oranges, grapefruits, highly spiced dishes, etc, are all potential trouble-makers. Another good reason for avoiding stimulants (tobacco, alcohol, coffee etc.) is that they tend to stimulate the muscles in the wall of the bladder, so that it contracts making you feel the to ‘spend a penny even more.

Smoking tends to ‘concentrate’ the urine and therefore stopping the habit will increase the flow and help to clear the system.

In severe cases, some sufferers find passing water becomes less painful if a towel-wrapped hot-water bottle is held close to the sexual organs for a while before urinating; others find it easier to pass water while sitting in a warm bath.

Consulting your doctor

If the attack lasts for more than just a few davs, or if you are in pain and passing a little blood in the urine, you should see vour doctor. He will not only be able to prescribe tablets to relieve the discomfort, but will also be able to check that it is indeed cystitis and that there are no other problems .

When you make an appointment, he may ask you to bring along a sample of vour urine in a small, clean, screwtop jar, since’ lie will need this for testing.

Your doctor will question and examine you to rule out other possible causes. He will feel the lower part of your tummy and around the areas where the kidneys are located to check lor tenderness. He may also take vour temperature and feel j- your pulse.

If the symptoms are mild, you may be ‘L given tablets to reduce the acid in the urine, thus killing off the bacteria.

But in severe cases, your doctor may prescribe a course of suitable antibiotics (remember to tell him if you have been allergic to any antibiotic in the past). The course will usually last from 10 to 14 days and Even if vour symptoms soon disappear, the infection may flare up again. Taking your tablets or capsules at mealtimes will reduce any tendency for them to upset you.

Recurrent cystitis

There are several theories as to why some women seem to suffer from repeated attacks of cystitis. It may be that the bacteria remain dormant, even after antibiotic treatment, and flare up again at the slightest provocation. Or the acidic content of the urine may be much higher in • – • – certain women, and this may be aggravated by eating acid-producing foods, and by worry or stress.

Other doctors believe that the recurrent cystitis might not be caused by an infection at all. They suggest that the problem is a sensitive urethra and bladder, that the bladder itself is not inflamed but is responding to pain nearby; for example after a woman has had a baby, when the area around the genitals may be quite sore.

Some doctors are more sympathetic than others when it comes to recurrent cystitis. You may find women doctors are more helpful, as many will have had some experience of cystitis themselves.

Cystitis and sex

Many girls seem to get cystitis when they first make love, and this can be for a combination of reasons. It’s possible that an influx of’new’ germs may provoke the problem, or it could be that the friction and chafing during love-making sets it off. This may irritate the opening to the urethra itself, but any rubbing – even from clothing like close-fitting underwear or trousers – will irritate the skin, making a little fluid seep through from the blood. And this fluid is a very rich environment p. for bacteria to grow in. (Apart from the usual treatment, a brief respite from love-making will allow the inflammation and soreness to die down. Using a water-based lubricant, obtainable from any chemist, will also help to prevent dryness during intercourse and the risk of chafing in the future.

Cystitis and kidney infection

In some cases, the germs which start an infection mavget in from above, reaching the bladder from the bloodstream or the kidneys, if there is an infection there.

For this, as (or other forms of cystitis, antibiotics should c|uickly clear up the infection at its source.

Cystitis in children

The most common cause of cystitis in young children is through a kidney infection, and can result when one (or both) kidneys are not properly formed.

It can be a difficult thing to spot because children tend to show signs of general illness – Fever, vomiting, fretfulness – rather than obvious bladder pain and a frequent need to go to the toilet.

But many small girls suffei from cystitis, due to a simple bladder infection transmitted from the lower bowel – often because the child has not been taught always to wipe her bottom from the front rto the back.

Alwavs seek a doctor’s advice il a child ° shows frequency or pain on passing water; neglected cases can go on to become kidney infections. Many adults today who suffer from kidney disease do so because their childhood infections were ignored.

Your doctor may well want to tackle the cystitis with acid-reducing tablets first before resorting to antibiotics if nccessarv.

Cystitis and pregnancy

During pregnancy and afterbirth, women often find that emptying the bladder becomes more difficult, because the changing shape of the womb has affected the other organs in the abdomen. If you are pregnant and suspect you have cystitis see your doctor, as early treatment is especially important in pregnancy.

Tips on prevention • Avoid anything acidic and highiv spiced (coffee, tea, carbonated soft drinks, citrus fruits, curries) • Restrict intake of other stimulants (tobacco or alcohol) • Give up smoking (it concentrates the urine) • After a bowel movement, alwavs wipe from front to back • Wash the area around the vagina with a plain soap (not perfumed or medicated) • Drink plenty of water • When making love, use a lubricant • Choose open-crotch tights and cotton underpants rather than nylon • Avoid tight jeans and trousers which could chafe Home treatment.

Try drinking the following mixture every two hours during the dav for a couple of days: Add one or two heaped teaspoonsful of baking powder (sodium bicarbonate) to a glass of preferably warm water, sweetened with a teaspoonful of honey.

If simple home treatment fails to bring relief, consult your doctor as soon as possible.