Cystitis

Cystitis means bladder inflammation. Bladder stores urine before we empty it via urethra, the urinary passage. Inflamed bladder (like a cold) is irritable, making you pass urine very frequently and with pain in lower part of the tummy. There is severe burning when you pass urine. You have to rush to pass urine, (urgency). There may be some blood in urine in severe infections, especially at the end.

Commonest cause is bacterial infection. Not uncommon cause is tuberculosis in our country or schistosomiasis in countries like Egypt. Some times stones or other local problems may cause infection. In some young women, sexual intercourse seems to trigger it (Honeymoon cystitis).

As long as the stone is not blocking the flow of urine, you are fine, but since the tube draining each kidney ( the ureter ) is very small (inner diameter 2-3 mm at some points ) once it gets ’jammed’ , it causes urine to dam up in the kidney, leading to severe back pain. The ureter tries valiantly to clear the block by squeezing its muscles, and this leads to severe pain, called ‘colic’.

Generally, first infection, in a woman, is symptomatically treated with a short course of antibiotic. It is necessary to do urine (R+M) Routine examination for sugar, albumin and microscopy for pus cells and Red cells-RBCs- as well as culture sensitivity test (urine C/S) to identify the type of bacteria causing the infection. If infections are frequent and severe, it becomes necessary to try and identify any underlying factors. Apart from Blood Sugar to rule out Diabetes, Ultrasound scan KUB region (Kidney, Ureters , Bladder) is one important test which is painless, and can provide information about ‘left over urine’, stones, dilatation, and other anomalies. Urine culture test for TB (Tuberculosis), specialized X-ray test like MCU (Micturating-Cysto-Urethrogram) and finally, examination of the bladder (cystoscopy) may be required in certain cases to find underlying problems.

Some people are more prone to getting cystitis than others. Certain precautions help :

Plenty of liquids help to ‘wash out’ the bacteria. Water is the best liquid, as long as it is clean and potable. Soft or hard (i.e.     Bore-well water) does not matter.

Avoid Constipation. Take green vegetables, salads and fruits (if not diabetic), in plenty.

Regular physical exercise improves circulation and general immunity. Take help of qualified physical instructors if in doubt.

Empty the bladder regularly, once in 3-4 hours is recommended. Especially, getting up in the middle of night, passing urine and     drinking a glass of water before going back to bed, is a must if you keep getting lot of infections.

‘Front to back’ action for ablution, after passing motion, rather than using ‘back to front’ action which is more instinctive and     easy. The logic is, since most of infections come from our own body and anal region is prime source, the action should be from     relatively cleaner area, to dirtier region and not vice versa.

Pass urine immediately after sex. This is to flush out the germs which might attack when there is some lowering of normal     defence.

Do not use Tampoons. Pads are preferable if one is prone to infections

No douche/ ‘cleaning’ the vagina using antiseptics/lotions like V wash etc. to be used. Natural fluid secretions of vagina has     inherent antibacterial action.

Yes, provided approved earlier by the urologist. Even then, before taking antibiotic, collect a Clean Catch Mid Stream Urine sample for R+M and C/S tests -in a sterile container (obtained earlier from The lab with cellophane wrapper intact) and submit to the lab, if lab is open or store in the fridge(Not Freezer)in a plastic bag overnight and submit next working morning. Insist on test being done on that overnight specimen, collected before antibiotic and stored at 4˚C, rather than giving a ‘fresh’ sample, which will be post antibiotic, and hence of not much use.

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