Cystitis in women

Every year, 1 –3 women out of 10 have an attack of cystitis
At any time, about 1 in 20 healthy women has bacteria in her bladder, without any symptoms. Only 10% of these progress to cystitis symptoms
In the USA, over 11 million women each year receive antibiotics for cystitis, costing over $1.6 billion (£1100 million)
In the UK, doctors write 5.5 million prescriptions for cystitis each year

Cystitis is inflammation of the bladder. There are two main types. The only sure way to tell the difference is by a urine test.

Bacterial cystitis is caused by bacteria (germs). These bacteria, mainly Escherichia coli (E. coli for short), normally live in and around the anus (back passage). In men, the urethra goes along the length of the penis and is about 24 –30 cm long but, in women, it is only about 6 cm long. So in women bacteria on the skin can easily get into the bladder by using the short urethra as a ladder. This probably explains why cystitis is much more common in women than in men.

Interstitial cystitis (also called painful bladder syndrome, non-bacterial cystitis, urgency and frequency syndrome) is inflammation of the bladder without any bacteria being present. Most sufferers (90%) are women. It can occur at any age, but is most common in women in their early 40s.

Interstitial cystitis is a bit of a mystery – no one really knows what causes it.

One theory is that a substance called glycosaminoglycan is deficient in the bladder. This substance is part of the slimy layer that covers and protects the lining of the bladder.
Another theory is that it is a type of allergy, because cells common in allergy (mast cells) are present in the bladder wall in interstitial cystitis.

a burning, stinging or aching pain when you pass urine
a need to pass water very frequently, often only a small amount each time
bloody or cloudy urine (severe cystitis).

if you have soreness or itching around the opening of the urethra (pee hole) you might have a herpes infection, thrush or a chlamydia infection
if your only problem is having to pass urine frequently, you might have diabetes (especially if you are thirsty all the time), so see your doctor
if your main problem is having to rush to the toilet, you may have a continence problem.

Bacterial cystitis. With bacterial cystitis , you usually experience only the burning pain and frequent urination. However, it is possible for the infection to travels upwards to the kidney. Fortunately, this is unusual. Infection in the kidney needs proper medical treatment, so see your doctor straight away if you also have:

blood (or a smoky appearance) in the urine
backache or stomach ache
fever and weakness.

Interstitial cystitis. With interstitial cystitis the symptoms are diverse. You have to pass urine frequently, and maybe urgently, and passing the urine may be uncomfortable. You may notice discomfort in the lower abdomen when the bladder is filling (pelvic pain), which is relieved by passing small amounts of urine. Sex may be painful. Often, symptoms are worse in the week before a period.

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