Cystitis is the inflammation of the bladder caused by a microbial infection in any part of the urinary system (the kidneys, bladder and urethra). It is usually caused by bacteria that reach the bladder through the urethra due to poor hygiene or sexual intercourse. This disease affects at least 60% of women and it is very rare in men, specifically for two reasons: the female urinary tract is shorter, so the path that the bacterium must travel is faster and second, the opening of the urethra in women is closer to the anus than in men, facilitating the infection.

Cystitis causes more complications when the urinary tract is ‘not normal’, some examples of it is when the kidneys don’t work properly or there are underlying conditions such as diabetes. The most common cause of this illness is the bacteria that come from the intestinal flora (Escherichia coli). This bacteria ascends through the urethra to the bladder, generating the infection. E. coli is responsible for at least 80% of the cases. There are also situations where this condition is caused by viruses, fungi or even parasites. The most frequent ones are:

  • Candida albicans: is a fungus that causes yeast infections, usually on the skin or mucous membranes such as the vagina or intestinal tract. It is very common in people with a poor immune system.

  • Polyoma virus and adenoviruses: these viruses can trigger hemorrhagic cystitis (HC).

  • Verminosis: is a parasitic illness that gives rise to a chronic disease called granulomatous cystitis characterized by recurrent bacterial infections.

Some of the risk factors of cystitis are: foreign elements in the urethra, bladder stones, prostate dilatation, certain drugs, long term use of a catheter, congenital malformations, tumors in the lower urinary tract and/or pregnancy, among others. Cystitis is classified in different ways according to the trigger, clinical evolution, symptoms and factors that predispose to the disease. Based on these classifications we find the following types of cystitis:

  • Bacterial or nonbacterial, depending on whether bacteria are the cause or not.

  • Chronic: if it occurs at least four to six times a year. There are 3 subtypes: recurrent (it is always caused by the same bacteria), reinfection (when a new bacterium originates it) and superinfections (if new bacteria are added to the existing bacteria)

  • Symptomatic or asymptomatic

  • Simple or complex: the simple ones are not associated with other pathologies, anomalies or alterations, whereas the complex ones are.

The most common symptoms of this infection are: frequent and urgent desire to urinate, a burning or painful sensation during urination and during sexual intercourse, abnormal color in the urine, a strong urinary odor, fever with chills, pain in the pelvic area, vomiting and nausea, irritability, itching in the vagina and redness of the vulva.

Some recommended tips to follow to avoid this condition are:

  • Drink plenty of water during the day

  • Urinate any time you feel the need, do not hold or delay going to the bathroom

  • Keep a proper hygiene

  • Avoid the use of feminine products that can irritate the urethra and/or bladder

  • Try your bladder soon after having sex

  • Avoid spicy foods

  • Reduce stress

  • Wear cotton underwear

The type of clinical tests that are ordered to make the diagnosis depends on the area where the infection is suspected. Commonly, several exams are requested by a specialist, some of them are:

  • Medical exploration. Palpitation of the abdominal or pelvic area to detect pain and redness.

  • Urine analysis, to detect if there is an infectious agent.

  • Urine culture, urethral fluid or vaginal fluid; allows to determine the exact type of bacteria that caused the infection, thus, the best antibiotic can be prescribed.

  • Cystoscopy: the introduction of a tube with lenses and light to observe the urinary tract directly.

  • A urography, which is basically a radiography of the kidney

  • An abdominal ultrasound to visualize the urinary tract.

The vast majority of cystitis cases can be overcome in a period of 24 – 48 hours. When there is a kidney infection, the treatment could take a week or more. If there are other associated pathologies or some additional complications, it is possible that a longer intervention is necessary until a cure has been established. If you present any of the symptoms mentioned above, it is recommended to visit your doctor or specialist.

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