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Cystitis in women: what you can do

Cystitis can come on very suddenly, and the last thing you want to do is go to the shops. So make sure you have paracetamol, long-life cranberry juice, potassium citrate cystitis remedy (available from pharmacists) and two hot water bottles available.

It is not necessary to see your doctor for every attack of cystitis – 60% of attacks of bacterial cystitis cure themselves within 4 days without antibiotics. The following measures will relieve the discomfort, and help you to get through the attack.

• Take painkillers such as paracetamol if you need them.
• Decide whether you need to see your doctor, for example, if this is your first attack (see below).
• Drink plenty of water. As soon as you feel an attack coming on, drink 300 mL (that is a ½ pint or a mugful) of water straight away. Then continue to drink 300 mL of water or very weak tea every hour for 3 hours. Avoid coffee and alcohol because these can irritate the bladder.
• Make sure you empty your bladder completely each time, pushing out every last drop.
• Drink about 300 mL of cranberry juice twice a day, because it may help to shorten the attack.
• Use a potassium citrate cystitis remedy according to the instructions on the packet. This neutralizes acidity in urine. It will not get rid of bacteria, but it can relieve symptoms.
• If you do not have potassium citrate, mix a teaspoonful of bicarbonate of soda with some water – this will do a similar job. Repeat it three more times, 1 hour apart. (But do not use bicarbonate of soda if you are on a low salt diet for blood pressure.)
• Use hot water bottles, in a cover or wrapped in a towel, and put one on your back, and one between your legs, close to the opening of the urethra (pee hole).
• If you think you might have painful bladder syndrome, try avoiding acidic fruits and juices (grapefruit, lemon, orange, pineapple), and caffeine, alcohol and fizzy drinks (British Medical Journal 2009;339:b2707). You may also find that avoiding some foods helps your symptoms. Lists of these foods are available on several websites (see Useful contacts). Avoid the foods for about 2 weeks, then reinclude them in your diet one by one, to see whether particular foods are making your symptoms worse. Be careful not to avoid more foods than necessary, as we all need to eat a wide range of foods to keep healthy.

Cranberry juice and blueberries

There is some evidence that cranberry juice is useful for preventing cystitis and possibly also for treating an attack.

• Cranberry juice seems to be most useful for women who experience repeated attacks of cystitis (Cochrane Database of Systematic Reviews 2008, Issue 1: CD001321).
• Some studies have shown that cranberry juice will shorten an attack of cystitis, while other studies have shown no effect.
• Cranberry juice contains proanthocyanidin chemicals, which prevent Escherichia coli bacteria from sticking to the wall of the bladder and urethra. Therefore the bacteria can be flushed out before establishing an infection.
• The effect of cranberry juice lasts only about 10 hours, so it should be taken twice a day.
• Researchers have now found that blueberries also contain proanthocyanidins. Apart from their benefits in cystitis, blueberries and cranberry juice are good sources of vitamin C and antioxidants.

 

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