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Cystitis - acute

Definition

Acute cystitis is an infection of the bladder or lower urinary tract. Acute means that the infection begins suddenly.

Alternative Names

Uncomplicated urinary tract infection; UTI - acute; Acute bladder infection; Acute bacterial cystitis

Causes

Cystitis is caused by germs, most often bacteria. These organisms enter the urethra and then the bladder and can cause an infection. The infection commonly develops in the bladder. It can also spread to the kidneys.

Most of the time, your body can get rid of these bacteria when you urinate. But, the bacteria can stick to the wall of the urethra or bladder, or grow so fast that some stay in the bladder.

Women tend to get infections more often than men. This happens because their urethra is shorter and closer to the anus. Women are more likely to get an infection after sexual intercourse or when using a diaphragm for birth control. Menopause also increases the risk for a urinary tract infection.

The following also increase your chances of having cystitis:

  • A tube called a urinary catheter inserted in your bladder
  • Blockage of the bladder or urethra
  • Diabetes
  • Enlarged prostate, narrowed urethra, or anything that blocks the flow of urine
  • Loss of bowel control (bowel incontinence)
  • Older age (especially in people who live in nursing homes)
  • Pregnancy
  • Problems fully emptying your bladder (urinary retention)
  • Procedures that involve the urinary tract
  • Staying still (immobile) for a long period of time (for example, when you are recovering from a hip fracture)

Most cases are caused by Escherichia coli (E. coli), a type of bacteria found in the intestines.

Symptoms

The symptoms of a bladder infection include:

  • Cloudy or bloody urine
  • Strong or foul smelling urine
  • Low fever (not everyone will have a fever)
  • Pain or burning with urination
  • Pressure or cramping in the lower middle abdomen or back
  • Strong need to urinate often, even right after the bladder has been emptied

Often in an elderly person, mental changes or confusion are the only signs of a possible urinary tract infection.

Exams and Tests

In most cases, a urine sample is collected to do the following tests:

  • Urinalysis. This test is done to look for white blood cells, red blood cells, bacteria, and to check for certain chemicals, such as nitrites in the urine. Most of the time, your health care provider can diagnose an infection using a urinalysis.
  • Urine culture. A clean catch urine sample may be needed to identify the bacteria in the urine and decide on the correct antibiotic.

Treatment

Antibiotics taken by mouth are most often given to prevent the infection from spreading to the kidneys.

  • For a simple bladder infection, you will take antibiotics for 3 days (women) or 7 - 14 days (men). For a bladder infection with complications such as pregnancy or diabetes, or a mild kidney infection, you will most often take antibiotics for 7 - 14 days.
  • It is important that you finish all the antibiotics prescribed, even if you feel better before the end of your treatment. People who do not finish their antibiotics may develop an infection that is harder to treat.
  • Your health care provider will also want to know if you are pregnant.

Your health care provider may prescribe medicines to ease discomfort. Phenazopyridine hydrochloride (Pyridium) is the most common of this type of drug. You will still need to take antibiotics.

Everyone with a bladder infection should drink plenty of water.

Some women have repeat bladder infections. Your health care provider may suggest treatments such as:

  • Taking a single dose of an antibiotic after sexual contact may prevent these infections if they occur after sexual activity.
  • Keeping a 3-day course of antibiotics at home to use for infections, based on their symptoms.
  • Taking a single, daily dose of an antibiotic to prevent infections.

Over-the-counter products that increase acid in the urine, such as ascorbic acid or cranberry juice, may be recommended. These medicines lower the concentration of bacteria in the urine.

Follow-up may include urine cultures to make sure the bacterial infection is gone.

Lifestyle changes may help prevent some urinary tract infections.

Outlook (Prognosis)

Most cases of cystitis are uncomfortable, but go away without complications after treatment.

When to Contact a Medical Professional

Call your health care provider if:

  • You have symptoms of cystitis
  • You have already been diagnosed and symptoms get worse
  • You develop new symptoms such as fever, back pain, stomach pain, or vomiting.

References

American College of Obstetricians and Gynecologists (ACOG). Treatment of urinary tract infections in nonpregnant women. Obstet Gynecol. 2008;111(3):785-794.

Gupta K, Hooton TM, Naber KG, et al. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: A 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis. 2011; Mar;52(5):e103-20.

Society of Obstetricians and Gynaecologists of Canada (SOGC). Recurrent urinary tract infection. J Obstet Gynaecol Can. 2010;32(11):1082-1090.

Review Date:8/17/2014
Reviewed By:Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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