Cystitis: What You Should Know

Cystitis is the inflammation and irritation of the bladder. Cystitis can occur for several reasons, including from a bacterial infection.

When an infection occurs in the bladder, it's called a urinary tract infection (UTI). Women are more likely than men to get a UTI. Although cystitis from a UTI is treated with antibiotics, other types of cystitis are treated differently.

This article will review types of cystitis along with symptoms, diagnosis, and treatment of the condition.

What Is Cystitis?

When the bladder lining becomes inflamed, it is called cystitis. The most common cause of cystitis is a UTI, which is also the most commonly treated outpatient infection. At least 50% of women will experience a UTI in their lifetime.

If untreated, a UTI can result in a kidney infection called pyelonephritis. There are several noninfectious conditions that also cause cystitis.

Symptoms

Common symptoms of cystitis include:

• Burning or pain with urination
• Urge to urinate often
• Passing small amounts of urine
• Cloudy urine
• Bloody urine (hematuria)
• Pelvic pressure
• Low-grade fever
• Foul-smelling urine
• Fatigue

See your healthcare provider if you experience any of these symptoms.

Causes

Cystitis is divided into two groups: infectious and noninfectious.

Infectious cystitis happens when bacteria travel up the urethra to the bladder. The bacteria colonize (reproduce and grow), resulting in the irritation and swelling of the bladder lining.

Noninfectious cystitis occurs when certain chemicals or medications inflame the bladder lining. In addition, people who require catheterization can experience noninfectious cystitis.

Types of Cystitis

Although bacterial infections are the most common type of cystitis, other types include chemical, medication, foreign body, and radiation. If left untreated, cystitis can result in bladder damage or other medical issues. Cystitis can occur suddenly (acute cystitis) or can be chronic (interstitial cystitis).

Bacterial Cystitis

Once bacteria have migrated to the bladder and begin to grow, the symptoms of cystitis can worsen. The most common bacterium responsible for infectious cystitis is Escherichia coli (E. coli), contributing to 75%–90% of all UTIs. Other types of bacteria that cause infectious cystitis are:

• Proteus mirabilis
• Klebsiella pneumoniae
• Staphylococcus saprophyticus
• Group B Streptococcus
• Lactobacillus
• Enterococci

Chemical Cystitis

Much of what is ingested is filtered through the kidneys and excreted from the bladder. Therefore, chemicals used in chemotherapy medicines can result in cystitis. Other chemicals that cause cystitis include spermicide, soaps, bubble baths, and dyes.

Drug-Induced Cystitis

In addition to chemotherapy, other medications can cause noninfectious cystitis. Chronic ketamine use, for example, can cause ulcerative cystitis resulting in hematuria (bloody urine).

In addition, some types of bladder cancer are treated by putting chemotherapy drugs directly into the bladder; although this kills cancer cells, it can also lead to cystitis.

Foreign Body Cystitis

Repeated or chronic use of urinary catheters or stents (tubes placed in the body to drain and collect urine from the bladder) can introduce bacteria into the bladder, causing recurrent UTIs. What's more, 75% of hospital-acquired infections are UTIs from urinary catheter use.

Unfortunately, the longer a catheter stays in, the risk for infectious cystitis rises. As a result, healthcare organizations continually evaluate and implement processes to decrease UTI rates. 

Interstitial Cystitis

Approximately 4 million to 12 million Americans suffer from interstitial cystitis (IC) yearly. Although the exact cause is unknown, researchers speculate that IC is due to trauma or injury to the bladder. IC can have a negative impact on the quality of life.

Radiation Cystitis

The most common urological complication leading to hospital admission is hemorrhagic cystitis due to radiation to the pelvic area. Radiation is used to destroy and shrink cancer tumors. Unfortunately, it also affects the body’s healthy cells. Radiation to the colon, uterus, rectum, and prostate can result in radiation cystitis.

Risk Factors

The following can put you at higher risk for developing cystitis:

• Being sexually active
• Pregnancy
• Use of diaphragms and spermicides
• Altered hormone levels
• Low immune system response
• Use of urinary catheters
• Urinary retention (not being able to empty your bladder completely)
• Having diabetes

Diagnosis

Tests that help diagnose infectious and noninfectious cystitis are:

• Urine culture: A urine sample is evaluated for a bacterial infection. The type of bacteria causing the UTI is identified, which helps your healthcare provider prescribe the correct antibiotic.
• Ultrasound: Ultrasound evaluates how well your kidneys, ureters, and bladder are functioning.
• Cystoscopy: This allows the urologist (kidney/bladder doctor) to visualize the bladder lining. However, this is not done during an active urinary tract infection.

Ways to Treat Cystitis at Home

Infectious cystitis will likely need to be treated with an antibiotic. Home remedies, however, can be used to alleviate symptoms of both infectious and noninfectious cystitis. In addition, some over-the-counter (OTC) medications may help relieve cystitis as well.

Home Remedies

Perhaps the best-known home remedy for cystitis is drinking cranberry juice. Cranberries contain proanthocyanidins, a substance that may prevent bacteria from sticking to the bladder wall. Although often used, there is no definitive evidence that cranberry juice improves cystitis.

According to one study, other home remedies include:

• Vitamins A and C
• Probiotics
• Herbs
• Cinnamon
• Eating bladder-friendly foods

Over-the-Counter Medications

Nonprescription medications that help prevent or alleviate cystitis are:

• Nonsteroidal anti-inflammatory drugs (NSAIDs, such as Advil ibuprofen and Aleve naproxen sodium)
• Tylenol (acetaminophen)
• Azo (phenazopyridine hydrochloride)
• Cystex (methenamine and sodium salicylate) 

When to See a Healthcare Provider

It's important to be evaluated by your healthcare provider should you have symptoms of cystitis, especially if accompanied by fever, shaking chills, back pain, bloody urine, or the inability to urinate.

Prevention

Since infectious cystitis contributes to about 15% of all antibiotic prescriptions, prevention is key to avoiding cystitis. Here are some ways to prevent cystitis:

• Complete the full course of antibiotics if prescribed.
• Wipe from front to back.
• Urinate after intercourse.
• Urinate often throughout the day.
• Use neutral soaps and vaginal products.
• Stay well hydrated.
• Wear cotton underwear.

Summary

Cystitis is inflammation of the bladder. Infectious cystitis is common and happens when bacteria travel to the bladder, causing a bacterial infection. Noninfectious cystitis can occur from chemicals, medications, catheters, or pelvic radiation. Although antibiotics may be required to cure cystitis there are home remedies and OTC medications that can alleviate the symptoms.

A Word From Verywell

Women are at higher risk for infectious cystitis compared to men. Pregnancy, hormone changes, and being sexually active increase your chances of getting cystitis. Staying well hydrated, using gentle vaginal products, and urinating after sex can help prevent cystitis. Call your healthcare provider if you have foul-smelling urine, pain with urination, urgency, or fever.