Cystitis: Symptoms, Causes & Treatment

Cystitis is an infection and inflammation of the bladder that often leads to a frequent urge to urinate. Many people notice they pass only small amounts of urine and feel burning or stinging when they pee.

It is most often caused by Escherichia coli, a bacteria naturally found in the intestines and sometimes in the urinary tract. In some cases, it can multiply and travel up to the bladder.

If symptoms suggest cystitis, it is important to see your primary care provider, a urologist or, for women, a gynecologist. Treatment is prescribed based on symptoms and may include antibiotics and pain relievers.

Common symptoms

The main symptoms of cystitis are:

• Pain in the lower abdomen or back;

• Frequent urges to urinate but passing only a small amount of urine;

• Pain or burning when urinating (dysuria);

• A feeling of heaviness in the lower abdomen;

• Pain during sexual intercourse (dyspareunia);

• Urine with a strong smell, dark urine, or blood in the urine;

• Low-grade fever.

Lower back pain can also indicate that the infection has reached the kidneys and is causing pyelonephritis. In this case, other symptoms may also appear, such as feeling unwell, vomiting, chills, and excessive sweating.

Confirming a diagnosis

To confirm the diagnosis, it is important to see your primary care provider, a urologist or, for women, a gynecologist to review symptoms and health history.

Based on the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), lab testing for a suspected bladder infection typically includes a urinalysis and a urine culture, which can help identify bacteria and guide antibiotic selection.

Different types

The main types of this infection are acute cystitis and interstitial cystitis

1. Acute cystitis

Acute cystitis is an infection and inflammation of the bladder that starts suddenly and can worsen quickly. With this type of infection, a person may have pain when urinating and frequent urges to urinate but pass only a small amount of urine.

2. Interstitial cystitis

This type of cystitis is an inflammation of the bladder wall that causes thickening and reduces the bladder’s ability to store urine, leading to pain during sexual intercourse, painful ejaculation in men, and pain during menstruation in women.

Possible causes

Possible causes of cystitis include:

• Unprotected sex (sex without condoms);

• Switching between anal sex and vaginal sex, as this can promote the transfer of bacteria from the intestines to the vagina;

• Poor intimate hygiene, wiping from back to front after using the bathroom;

• Low water intake, which increases urine concentration;

• Use of certain medications that affect immunity and can favor the growth of microorganisms;

• Irritation caused by products such as soaps and perfumes in the genital area;

• Health conditions such as diabetes, kidney failure, and kidney stones;

• Enlarged prostate in men;

• Vesicovaginal fistula, which is an abnormal connection between the bladder and the vagina.

According to the CDC, urinary tract infections happen when bacteria, often from the skin or rectum, enter the urethra and infect the urinary tract, which helps explain why cystitis is more common in women than in men.

Cystitis during pregnancy

Cystitis is more common during pregnancy because hormonal changes and a naturally weaker immune system make it easier for bacteria to grow and cause urinary tract infections.

It produces the same symptoms as other UTIs, and treatment must be overseen by an OB/GYN or midwife.

Honeymoon cystitis

Honeymoon cystitis is an infection and inflammation of the bladder caused by frequent friction during sexual intercourse, mainly affecting women.

This can make it easier for bacteria to enter the urethra and reach the bladder and, in more severe cases when not treated appropriately, can reach the kidneys and cause pyelonephritis.

Treatment options

Cystitis treatment should be prescribed by a doctor based on the type of bacteria and the symptoms a person has. A urinary antiseptic/pain-relief product such as Cystex may be recommended, as well as antibiotics such as ciprofloxacin or amoxicillin, and they should be used exactly as prescribed.

In addition to medications, it is also important to drink at least 2 liters of water per day and include diuretic foods such as watermelon, coconut water, pears, and cucumber, for example.

Treatment for cystitis may also be complemented with home remedies such as a sitz bath with vinegar, dandelion tea, and hibiscus tea.

Possible complications

When cystitis is not treated properly, bacteria can travel from the bladder to the kidneys, causing pyelonephritis. Treatment for pyelonephritis should be started quickly to prevent bacteria from entering the bloodstream and causing sepsis, which is a serious infection that can be fatal.

Other possible complications of cystitis include thrombosis of the renal vessels, acute kidney failure, and prostatitis, which is inflammation of the prostate, causing symptoms such as pain, burning when urinating, and fever.