Cystitis and what to do about it! Outpatient Department Tel: 01473 703124
Contents Page 2 Page 3 Page 4 Page 6 Page 7 Page 9 Cystitis And What To Do About It! How To Recognise Cystitis What Causes It? What To Do When You Are Having An Attack Of Cystitis When To See The Doctor What Your Doctor Can Do What A Clinic Can Do How To Prevent Further Attacks Further Information Page 1
Cystitis And What To Do About It! Cystitis is an inflammation inside the bladder. Over half the women in this country suffer from it at some time during their lives, often repeatedly. Although cystitis is sometimes very distressing, it is usually more of a nuisance than a danger to your health. This booklet gives you information about how to treat cystitis yourself, when to go to the doctor and how to prevent further attacks. How To Recognise Cystitis In a typical attack of cystitis you will usually feel one or more of the following: A burning, stinging or sharp pain in the urethra (water passage) when you pass urine. A need to pass urine more often than usual. Although you may feel there is an urgency to go to the toilet, there may be hardly any urine to pass. An urgent need to pass urine for fear of losing control. You may also suffer from fever (feel hot/sweating), an ache in the lower abdomen or back, cloudy urine or blood in the urine. If you are taking prescribed medicines, or have any other illness, you should consult your doctor before following the advice in this booklet. Page 2
What Causes It? There are several things which can cause an inflammation of the bladder including germs, allergic reactions and friction. Germs Bacterial germs Cystitis can be caused by bacterial germs which normally live in and around the bowel opening. Sometimes the bacteria get into the urethra and bladder, which are normally germ-free. Once inside the bladder the bacteria multiply and irritate its lining, causing inflammation. In a woman the entrances to the urethra, vagina and anus are all very close together so bacteria can travel very easily from one area to another. This is why more women suffer from cystitis than men. The bacteria can be pushed into the urethra and bladder by sexual intercourse, by inserting tampons, by wiping your bottom from back to front, or even wearing tight trousers. Non-bacterial germs Common non-bacterial vaginal infections like thrush can cause an attack of cystitis symptoms. Also the germs which cause sexually transmitted diseases like herpes or trichomonas are sometimes responsible. Other causes Allergies. Some people find they are allergic to toiletries such as vaginal deodorants, perfumed soap or talcum powder. Friction of the urethra. The urethra is close to the vagina so this can happen during sexual intercourse. Irritable bladder. A particularly sensitive bladder. Anxiety, stress or depression. These may bring on an attack of cystitis or may make symptoms worse. Uterus Bladder Urethra (water passage) Vagina Anus Page 3
What To Do When You Are Having An Attack Of Cystitis There s a lot you can do to relieve an attack of cystitis. Of course, anyone who has had cystitis before may have found their own ways to relieve the pain and discomfort of an attack. Here are a few tips on self-treatment which may be useful. Do something about it straight away Even if it starts at night, it is best not to turn over and try to get back to sleep. The sooner you do something about cystitis the more chance you have of clearing it up quickly by yourself. 1. Immediately drink a pint of water This is the first of many you ll have to drink. Drinking a lot of fluid will help to flush out the germs in the bladder. Water is best, but if you can t manage so much plain water, you may prefer milk, orange squash, weak tea or any other bland fluid. Keep a supply close at hand so that you can keep drinking it. 2. Get some hot water bottles ready. If you are in pain, hot water bottles can be very comforting. It is best to get two ready if possible so that you can put one in your lower back and the other between your thighs. Wrap them in towels so that you can put them next to your skin without burning. 3. Take some bicarbonate of soda Mix a teaspoon of bicarbonate of soda with some water or other weak liquid and drink it down. Repeat this every hour for the next three hours. Bicarbonate of soda makes the urine less acidic and this stops the bacteria multiplying. It also soothes the urethra and relieves the burning. It may taste horrible but a lot of women find it helps. (Note: Anyone with high blood pressure or heart trouble should consult their doctor before taking bicarbonate of soda.) Page 4
4. Take pain relief If you are in pain, take one or two mild pain relief tablets. 5. Drink another half pint of liquid As soon as you can, drink another half pint of fluid (or more if you can manage it). Repeat this every 20 minutes, or more often if you can. This should make you want to go to the toilet frequently. Although it may sting the first few times you go, this usually gets better the more urine you pass. It is essential to keep emptying the bladder if you are to flush out germs. You may find that drinking a cup of strong coffee every hour helps you to pass more urine. But if coffee makes your cystitis worse it s obviously best not to drink it. 6. Lie down or put your feet up If you can, take your hot water bottles, jug of water and glass and make yourself comfortable in bed or in an armchair. Keep drinking as much fluid as you can about half a pint every 20 minutes for at least three hours. 7. Relax Three hours is a long time to put up with the pain and discomfort of cystitis. Try to rest your mind as well as your body. Take comfort from the fact that by following your self-help routine you re giving yourself a good chance of clearing up the cystitis quickly. Once you re in a routine keep yourself occupied read a book, do a crossword, anything that will keep your mind off your discomfort and anxiety. Many women find that after three hours of this routine the cystitis will begin to wear off. Page 5
When To See The Doctor If you are taking prescribed medicines you should check with your doctor for advice about what to do when cystitis occurs. It s impossible to give strict guidelines on how long you should wait before you go to your doctor. You will probably be able to tell whether or not selftreatment is clearing up your cystitis. But in general, you should always see a doctor: If an attack of cystitis continues for longer than a day or two despite your self-treatment, or if you have repeated attacks. This is because it is possible for the infection to spread to the kidneys. An attack of cystitis in men and children is uncommon and should always be referred to a doctor. What Your Doctor Can Do Your doctor will probably ask you for a urine sample to find out whether your cystitis is caused by germs. If it is, you will probably be given a course of antibiotics this will be dependent on whether you have a bacterial or nonbacterial infection. If your cystitis is not caused by germs, you may only need further advice on self-treatment and prevention. If you also have a vaginal discharge or itch, your doctor may take a swab from your vagina to find out whether there are any germs there which need treatment. If your cystitis doesn t clear up after treatment from your own doctor you may be referred to a hospital. This is usually only necessary after repeated and persistent attacks of cystitis. If you are pregnant. Pregnant women are particularly at risk of kidney infection. If you notice blood in your urine. Page 6
What A Clinic Can Do If you think your cystitis could be caused by a sexually transmitted disease you can go directly to a sexual health clinic, especially if you have recently changed sexual partner and they complain of similar symptoms to yours. It is often possible to telephone the clinic in advance to make an appointment. You can find the local number on page 9 of this booklet or in the telephone directory under Venereal Diseases. If you are given a course of drugs by your own doctor or at the clinic, it s a good idea to check whether your partner should be treated as well. Your partner will not necessarily have any symptoms but might have an infection which is causing your cystitis. How To Prevent Further Attacks Drink at least three or four pints of fluid every day. This may seem a lot but it will help flush out any germs before they cause a problem. The most common drinks to avoid are beer, alcohol, carbonated beverages, drinks containing artificial sweeteners, and caffeine drinks. Try sticking to water, squash and decaffeinated drinks and see if things improve. Drink cranberry juice (one glass each morning) or take cranberry tablets. Eat one carton of live bio-yogurt daily. Pass urine whenever you feel the need. Try not to hang on; this can encourage an attack of cystitis. Count to twenty after passing water then strain again to push out the last drops. Page 7
If you find you get cystitis after sexual intercourse, try washing before and after intercourse and get your partner to do the same. It might also help to pass urine before and after. Some people find it helps to use a lubricant to prevent soreness and bruising. You can get this from chemists without prescription. Avoid wearing tight trousers, and try to wear cotton pants and tights with a cotton gusset. Man-made fibres don t allow your skin to breathe so easily and may irritate. You may prefer to wear stockings rather than tights. Always wipe your bottom from front to back. This helps stop germs spreading from the anus. Keep the genital area clean by washing yourself morning and night. Don t use antiseptics, talcum powder, perfumed soap or deodorants in the genital area. Instead of perfumed soap, try unperfumed. And don t use shampoo or bath oils in the bath if you find they irritate. Page 8
Further Information Clinics Sexual Health Clinic Tel: 01473 711011 Internet http://www.interstitialcystitis.co.uk Books Overcoming Bladder Disorders Rebecca Chalker and Kristene Whitmore MD (can order 8.95) You don t have to live with Cystitis Larrian Gillespie (can order 9.99) The Pain Relief Handbook Chris Wells and Graham Nown Painful Sex Michelle Goldsmith Coping with Thrush Carolyn Clayton (can order 6.99) Try for Dry Mary Medill Available to order from: Waterstone s Booksellers Ltd. 15 Buttermarket, Ipswich Tel: 01473 289044 Page 9
Produced by: Outpatient Department The Ipswich Hospital NHS Trust Heath Road, Ipswich, Suffolk IP4 5PD Direct tel: 01473 703124 Hospital switchboard: 01473 712233 www.ipswichhospital.nhs.uk Published: April 2003 2003 The Ipswich Hospital NHS Trust DMI ref: 3874-02.indd(PING)