Bladder Infection (Cystitis)

What is a bladder infection?

A bladder infection, also called cystitis, is a type of urinary tract infection. The inner lining of the bladder becomes inflamed (red and swollen) and the urine is full of bacteria.

How does it occur?

Bacteria are the usual cause of infection. Rarely a virus may cause it. Normally there should be no bacteria in the urinary tract. A bladder infection occurs when bacteria travel up the urethra and into the bladder.

Women are more likely to have bladder infections than men because their urethra is shorter. The short urethra makes it easier for bacteria from the anus or genital area to reach the bladder. This can happen during such activities as wiping after using the toilet or sexual intercourse. Most infections of the urinary tract are caused this way.

Bladder infections often occur in young women who have just become sexually active.

Bacteria may grow in the urine if the flow of urine is blocked. For example, in women the pressure from a baby during pregnancy can cause this problem. In men, an enlarged prostate may cause such a blockage.

What are the symptoms?

Possible symptoms of a bladder infection include:

• urinating more often
• feeling an urgent need to urinate
• a burning, stinging, or pressure sensation during urination
• a crampy pain or discomfort in the lower abdomen just above the pubic bone or sometimes in the lower back
• a need to urinate more often in the night
• cloudy urine that smells bad
• blood in the urine
• leaking of urine
• fever and occasionally chills.

How is it diagnosed?

Your health care provider will examine you and may ask for a urine sample. You may also have blood tests. More tests may be done if you have had several infections.

Also, when men have a bladder infection usually more tests are done because cystitis is less common in men. The tests will check for possible causes of the infection.

How is it treated?

Bladder infection is a common problem that is usually easily treated. Your health care provider will prescribe an antibiotic to kill bacteria and prevent the spread of infection to your kidneys.

If your case is more serious with fever, pain, or vomiting, you may have to spend a day or two in the hospital and take your antibiotics by vein (IV).

Your health care provider may also prescribe Pyridium, a medicine that helps reduce the pain and spasm of the bladder during the first couple of days. Pyridium will turn your urine orange and may stain your clothing.

In some cases your health care provider may ask you to have a follow-up visit after you have taken all of the antibiotic so another sample of your urine can be tested. This is to make sure the infection is gone.

How long will the effects last?

Prompt treatment of a bladder infection with antibiotics usually relieves the symptoms in 24 to 48 hours. If your case is more serious, you may take several days to feel better.

How can I take care of myself?

• Take all of the antibiotic that your health care provider prescribes, even when you feel better. Do not take medicine left over from previous prescriptions.
• If your provider prescribed Pyridium, use it to feel better while you are waiting for the antibiotic to work.
• Drink more fluids, especially water, to help flush the bacteria from your system.
• Follow your health care provider's directions for a follow-up urine test. Your provider may want to test your urine soon after you finish taking the antibiotic.
• Follow your health care provider's recommendation for regular urine testing to check for recurrence, if necessary.

If you have a fever:

• Rest in bed if your temperature is over 100°F (38°C).
• Ask your health care provider if you should take aspirin or acetaminophen to control your fever. Anyone under the age of 21 with a fever should not take aspirin because of an increased risk of Reye's syndrome.
• Keep a record of your daily temperature.

Call your health care provider if you are not getting better after you have taken the antibiotic for 48 hours. Call sooner if you are getting worse.

What can I do to help prevent bladder infection?

To help prevent a bladder infection from recurring, urinate often during the day and empty your bladder completely each time.

In addition, women who tend to have bladder infections often should follow these guidelines:

• Talk to your health care provider. You may need extra tests to find out why you often have bladder infections. Your provider may prescribe medicine that helps prevent infections.
• Drink plenty of water.
• Do not delay urinating when you feel the need to urinate.
• Keep the vaginal area clean. Wipe from front to back after a bowel movement. Be sure to gently wash the genital area each time you bathe or shower. However, use soap only on the outside of your vagina. The chemicals in soap may cause additional irritation.
• Urinate after intercourse. Never combine anal and vaginal intercourse.
• Wear cotton underwear, which allows better air circulation than nylon. Wear pantyhose with cotton crotches.
• Avoid tight clothes in the genital area, such as control-top pantyhose and tight jeans. Do not wear a wet bathing suit for long periods of time.
• During pregnancy, tell your health care provider if you have a history of urinary tract problems. Your provider may order tests for bacteria in your urine before you have symptoms of infection.

If you have stopped having your periods because of menopause and are not taking estrogen, your provider might suggest a vaginal cream. Sometimes this cream helps prevent bladder infections after menopause.

Men should always wash the penis during baths or showers. If you are not circumcised, gently pull back the foreskin and wash the tip of the penis when you bathe.