What Is Cystitis?

Cystitis is an inflammation of the bladder, sometimes involving the tube that drains urine from the bladder, called the urethra.

Urinary system

Cystitis is the most common form of urinary tract infection and occurs mainly in women. But men and children also can experience cystitis.

Elderly men and women are especially at high risk for cystitis. Nearly one-third experiences the condition.

Bacterial infection causes most bouts of cystitis. Although the urinary tract is normally sterile, germs sometimes may enter the body through the urethra and grow inside the bladder.

This bacterial growth causes the inside walls of the bladder to become inflamed. That inflammation leads to the common symptoms of cystitis.

Cystitis does not:

  • Cause cancer
  • Lead to more serious kidney disease in otherwise healthy individuals

Occasionally, no cause can be found for a bladder inflammation.

Understanding How the Bladder Works


The bladder is a balloon-like sac that sits in the lower part of the abdomen in front of the bowel. It stores the urine that the kidneys produce as they filter out waste products from the bloodstream.


  • As urine forms in the kidneys, it travels down the ureterswhich are the tubes that connect the kidneys to the bladder.
  • The urine is stored in the bladder until the person feels the urge to urinate.
  • Going to the bathroom to urinate causes the bladder to contract.
  • This releases the urine, which passes down a tube called the urethra.
  • The urethra connects the bladder to the outside of the body.

Urinating allows the body to continually remove certain waste products from its system.

Facts About Cystitis

  • Cystitis occurs in 2 out of every 100 people.
  • In most cases, bacteria cause the condition. Usually the infection is brief and acute, with only the surface of the bladder infected.
  • Women are much more prone to cystitis than men.
  • Up to 20% of women will experience cystitis in their lifetime.
  • Women are 30 times more likely to have cystitis than men are.
  • Cystitis occurs most often in sexually active women ages 20 to 50. It also may occur in women or teenagers who are not sexually active, or in young girls.
  • Cystitis rarely occurs in men with normal urinary tracts.
  • In men, an enlarged prostate gland can cause bladder infections.
  • Infection limited solely to the urethra, known as urethritis, is a common sexually transmitted disease in men.


What Causes An Attack Of Cystitis?

Cystitis is almost always caused by bacterial infection. Nearly all episodes of cystitis (90%) are caused by bowel bacteria known as E. coli.

The bowel is full of bacteria from the intestines. E. Coli are common there. Many bacteria are harmless and live normally on the skin of the perineum.

Urine in the bladder normally is considered sterile and contains few bacteria. Urinating usually washes away germs that may enter the bladder. The body’s immune system and its natural germ-fighting substances in the bladder’s lining also eliminate many organisms.

Infection results when bacteria enter the urinary tract system and multiply faster than either urinating or the body’s natural defenses can remove them.

Women are especially prone to cystitis because the bowel opening is near the urethra. If the urethra becomes contaminated with bowel germs, the bacteria can travel up the urethra and into the bladder, causing inflammation.

Some everyday activities can cause bowel germs to enter the urethra. Those include:

  • For women, wiping incorrectly from back to front after a bowel movement. Always wipe from front to back.
  • Sexual intercourse or other activities that push germs into the bladder, such as rough foreplay.
  • Insertion of instruments into the urinary tract, such as a catheter or cystoscope.

Why Do Women Get Attacks More Easily Than Men?

What Increases the Risk of Cystitis?

Why Do Older People Get Cystitis so Often?

Why Doesn’t Everyone Get Attacks?

Why Do Women Get Attacks More Easily Than Men?

A woman’s urethral opening is much closer to the anus than a man’s is. That makes it easier for germs to get from the bowel area to the urethral opening.

A woman’s urethra also is much shorter than a man’s, so bacteria travel a shorter distance to reach the bladder:

  • A woman’s urethra is about 1 and 1/2 inches long.
  • A man’s urethra is about 8 inches long.

What Increases the Risk for Cystitis?

Some things you do or conditions you have can increase your risk for cystitis. These include:

  • Infrequent urination in both men and women. “Holding it in” causes urine to stagnate, which helps bacteria flourish and grow.
  • Skin allergies. Some women are allergic to ingredients in vaginal creams, soaps, bath products, or other products used in the perineal area.
  • Lowered resistance. The body’s natural defenses can be lowered from colds, flu, stress, or other causes.
  • Incomplete emptying of the bladder. Many conditions can block urine flow and prevent the bladder from emptying completely, such as kidney stones.
  • Changes in normal acidity of vaginal fluid, such as after a douche. Women should not douche unless directed to do so by a doctor.
  • Pregnancy.
  • Diabetes.

Occasionally, no bacterial cause can be found for a bladder inflammation. These episodes may result from:

  • Irritation of the urethra
  • Vaginal infections
  • Interstitial cystitis
  • Sexually transmitted diseases

Why Do Older People Get Cystitis So Often?

Elderly people are at increased risk for cystitis primarily because they often cannot empty their bladders completely. This inability is associated with conditions such as:

  • Enlargedprostate gland, a common condition as men age. An enlarged prostate can slow the flow of urine, which fosters bacterial growth.
  • Inflammation of the prostate gland in men, a condition called prostatitis.
  • Narrowing of the urethral opening, a common occurrence in people who are older.
  • Inability to control the bowels.
  • Decreased mobility or total immobility.
  • Poor nutrition. Older people often eat and drink less than they should. Poor eating can increase risk of infection. Drinking too little can cause urine to become concentrated and to foster bacterial growth.

Nice To Know:

Q. My mother is in a nursing home. She just had a catheter put in, and I’m worried that she’ll get a bladder infection on top of everything else she’s gone through. Anything I can do?

A. You are right to be concerned. People who have urinary catheters for any length of time can develop large numbers of bacteria in their urine. People who can’t move well are also at higher risk for infection. Catheters should be used only when necessary and removed as soon as possible.

Talk it over with the doctor. Does she really need one? Or is it simply a convenience for the nursing home staff?

If your mother must have a catheter, make sure it is replaced every two weeks to help reduce the risk of infection. Make sure the nursing staff irrigates the bladder with antibiotics between replacements. The drainage bag should never be on the floor.

Every day and after each bowel movement, both the catheter and the area around the urethra should be cleaned with soap and water. Check to see that the bag is kept securely in place against her leg.

Encourage your mother to drink lots of fluids and assist her if she needs help. If she can tolerate cranberry or blueberry juice, see that she gets three glasses a day.

Q. Since going through menopause my mother hasn’t had a bladder infection, yet she used to get them a lot. She says her secret is hormones. How so?

A. Women who use a vaginal cream containing estrogen seem to avoid many bladder infections. Some experts believe that estrogen may resist infection by increasing the number of a certain kind of “good” bacteria, called lactobacilli. These bacteria fight infection by changing the character of the vaginal discharge and preventing E. coli-the most common cause of cystitis-from adhering to vaginal cells.

Oral estrogen may not have the same benefit. Some studies show that women who take oral estrogen actually have more urinary tract infections.

Why Doesn’t Everyone Get Attacks?

The healthy human body normally harbors a wide variety of bacteria and other organisms. But the body’s natural defenses usually keep them in check.

These natural defenses also kick in when the body is exposed to potentially disease-causing germs from outside.

If the body’s natural defenses become overwhelmed, bacteria and other germs can multiply in force and cause infection.

How Do I Know If I have Cystitis?

Common Symptoms Of Cystitis

These include:

  • Painful or burning urination
  • A sense of urgency to urinate
  • Continually feeling the urge to urinate, but almost nothing comes out when you try
  • Trying to urinate hurts
  • A feeling of heaviness in your lower pelvic area
  • Urine may look cloudy, smell bad, or be pink or red with blood

Other symptoms may include:

  • Painful sex
  • Penis pain
  • Extreme fatigue
  • Your sides, lower back, and belly may hurt
  • Fever with chills
  • Vomiting
  • Slower thinking, or feeling confused. In older people, this may be their only symptom.

Many times, cystitis will clear up on its own within a day or two with self-care. If symptoms persist, contact a doctor or health clinic.

How Will the Doctor Diagnose Cystitis?

Your doctor will conduct a physical examination and will ask about your medical history.

  • In women, the doctor will perform a pelvic examination.
  • In men, the doctor will insert a gloved finger into the rectum to check for prostate enlargement. The doctor also will examine a man’s penis and testicles for infection.

For both women and men, the doctor will check the abdomen and kidney areas for any swelling and tenderness. You will be asked to give a urine sample.

In diagnosing cystitis, the doctor must make sure that other conditions are not causing the bladder infection. Some of these other conditions include:

  • Sexually transmitted diseases, such as chlamydiagonorrhea, and urethritis
  • Infection of the upper urinary tract, called pyelonephritis
  • Vaginal infection

In people with severe, recurring bladder infections, the doctor will rule out such things as:

  • Diabetes, which increases risk for cystitis
  • Kidney stones, which may block urine flow anywhere along the urinary tract. This can cause urine to pool in the bladder.
  • Body abnormalities of the lower urinary tract.

Nice To Know:

Urine is Key

Normal urine is clear and has little odor. If infection is present, urine is often cloudy or thick-looking, and may have a foul odor.

Examining a sample of urine allows the doctor to see if some other condition is causing the bladder infection.

Large numbers of bacteria in a urine sample indicate infection. A urine sample also allows the doctor to determine the bacteria that is causing cystitis, which is essential for choosing the right treatment.

Knowing which type of bacteria helps the doctor pinpoint the most effective antibiotic to use for treatment.

How To Information:

Giving a urine sample

The urine sample needs to be free from any other bacteria on the skin or vaginal area. This kind of urine sample is called a “clean catch.”

Here’s how a woman can get a clean catch:

  • The staff will give you a kit with a sterile container and moistened, antiseptic wipes for cleaning the outer vaginal area.
  • Wash your hands before opening the kit.
  • Open the container, but do not touch the inside of the lid or container.
  • Sit down on the toilet. Some women find it helpful to sit backward on the toilet and use the toilet lid as a shelf.
  • Once you’re seated, use one hand to spread vaginal lips apart.
  • Using the moistened wipes, wipe front to back once only with each wipe, dropping each wipe in the toilet when done.
  • Begin urinating and let a little urine go into the toilet-then put the container under the stream. You don’t need to fill the container with urine completely.
  • Put the lid on the container, but don’t touch the inside of the lid.
  • Wash your hands thoroughly.
  • Moisten a paper towel and wipe the outside of the container.
  • Give the container to the appropriate staff person.

Make sure that both inner and outer vaginal folds are open before cleaning the area front to back with antiseptic wipes.

How Is A Urine Sample Studied?

A few ounces of urine can reveal many things. The lab will run a series of tests:

  • Dipstick test. A laboratory technician dips a stick containing chemicals into the urine sample. The stick will change color if it finds large numbers of bacteria, abnormal proteins, blood, or pus cells. Normal urine contains none of these.
  • Spinning out sediments. A small laboratory machine called a centrifuge works like the spin cycle of a washing machine-only much faster. Spinning a bit of urine allows particles to collect, which are then examined under a microscope.
  • Microscopic examination. Looking at the urine under a microscope can reveal pus and blood cells, as well as skin cells from the lining of the bladder or urethra. It can also reveal large numbers of bacteria.

Additional tests may be needed, such as a urine culture. The doctor may request a urine culture if:

  • Basic tests are negative but severe symptoms continue.
  • Bladder infection happens repeatedly.
  • The doctor suspects that there may be other complications.

Culturing is a laboratory procedure that involves growing germs in a dish of special jelly-like material.

  • Different types of bacteria grow in different ways, so culturing urine can help identify which specific type of germ is present.
  • Sometimes, pus shows up in the urine but not bacteria. This may indicate the presence of certain other organisms, such aschlamydia.

Nice To Know:

Q. A friend says she tests her own urine at home whenever a bladder infection starts up. How can she do that?

A. In the U.S., home dipstick urine tests are now available without prescription and are easy to use. The dipstick turns color if the urine shows large amounts of bacteria. Some experts say that these tests detect almost all common bladder infections. The tests are especially useful for women who have recurring attacks.

Other Procedures That May Be Needed

Other procedures that may be necessary for diagnosis include:

  1. Obtaining a catheter specimen of urine
  2. Obtaining a direct urine sample from the bladder
  3. Ultrasound Scan
  4. Intravenous pyelogram (IVP)
  5. Voiding cystourethrogram (VCUG)
  6. Cystoscopy
  1. catheter specimen of urine may be requested. This procedure is performed by passing a thin, flexible tube into the bladder through the urethral opening. Catheterization involves:
    • Positioning the knees up and spread apart
    • Cleaning the area around the urethral opening with an antiseptic solution
    • Passing the catheter into the bladder

    Deep breathing in and out through the mouth while the catheter is inserted helps the muscles relax and makes insertion easier and more comfortable.

  2. Sometimes it is useful to take a urine sample directly from the bladder, especially in babies, small children, and certain adults. A long, thin needle is passed directly through the skin of the lower abdomen into the bladder.
  3. An Ultrasound scan is an easy test to take because nothing is inserted, injected, or placed inside the body. It uses sound waves that produce pictures of the urinary tract, which can show if anything inside is blocking urine flow. It also can reveal kidney stones or kidney abscesses.

    Ultrasound is useful for all people with urinary tract infections because:

    • In men, it can detect any enlargements or abscesses.
    • In children, it can observe defects that can occur in the tubes that go from the kidneys to the bladder.
  4. The intravenous pyelogram (IVP) test involves injecting a special dye into the bloodstream.
    • The dye circulates throughout the body and enters the kidneys, ureters, and bladder.
    • A series of x-rays are taken as the dye moves through the urinary tract.
    • The dye later leaves the body through urination.

    IVP tests help detect:

    • Kidney stones .
    • Small pockets of tissue containing urine that may be bulging out of the bladder or urethra. These pockets are called diverticula.
    • Narrowing of urinary tract tubes.
    • Whether the bladder has dropped down into the vagina. This common condition, called a cystocele, occurs when the body’s support structures that normally hold the bladder in place weaken. Childbirth and aging are common causes.
  5. In a voiding cystourethrogram, a chemical is put into the bladder via catheter. X-rays are taken as the person urinates. VCUG detects any back up of urine that may be causing infection.
  6. Cystoscopy is a procedure that lets the doctor actually see inside the bladder. For this procedure, light anesthetic is given and the bladder is filled with water. The doctor inserts a flexible, tube-like instrument called a cystoscope into the bladder.

    The doctor can then directly examine the inside of the bladder and its related organs. Cystoscopy can help detect:

    • Structural abnormalities
    • Masses that do not show up on x-ray
    • Interstitial cystitis

What Are The Symptoms of Cystitis?

Older people, pregnant women, and people with diabetes should seek medical care as soon as symptoms of cystitis appear.

For others, simple bouts of cystitis often disappear on their own within a day or two, especially if they take certain steps to take care of themselves.

What you need to do

When Should I Seek Medical Help?

How To Information:

What you need to do

Increase fluids

Going often to the bathroom helps wash bacteria out of the infected bladder. To keep the bladder full, drink plenty of water or other kinds of fluid. Avoid alcohol and coffee, which can irritate the bladder.

Here’s more about fluids:

  • Drink 10 ounces of fluid every half-hour until the burning goes away.
  • Drink cranberry or blueberry juice. Studies show that drinking these juices helps rid the bladder of infection more quickly. Both juices also help prevent attacks of cystitis.
  • Increase vitamin C intake. Oranges, pineapples, tomatoes, and leafy green vegetables are good sources.
  • If the acidity of the above juices and fruits can’t be tolerated, add baking soda (one teaspoon) to 10 ounces of fluid. Drink this two or three times a day.
  • After burning disappears, continue drinking 10 ounces of fluid every hour for two to three more days.

Try pain relievers

If pain is severe and continues after trying these steps, painkillers may help relieve symptoms. One kind, called phenazopyridine, is often used specifically to relieve painful urination. It requires a prescription.

Urinate frequently

Wash the bacteria out of your bladder by going to the bathroom every hour or so:

  • Relax and let your bladder empty completely.
  • In women, always wipe from front to back to avoid bringing new germs from the bowel area up to the opening of the urethra.

Clean carefully after a bowel movement

After having a bowel movement, women should wash the entire area carefully with warm soap and water. Be careful not to drag germs from the bowel area to the urethral opening.

  • Use one set of clean cloths for the anal area and another set for cleaning around the urethral opening and vagina.
  • Wash, rinse, and pat the anal area dry with the first clean set. Put these cloths into the laundry.
  • Use the second clean set to wash, rinse, and pat dry the area from your urethral opening back to the vaginal opening. Put these cloths into the laundry.

To launder the cloths:

  • Set the washer at its hottest setting and wash both sets of dirty cloths together.
  • Add the recommended amount of detergent.
  • Add the recommended amount of bleach.
  • Dry the cloths on the dryer’s hottest setting.

Following these steps essentially kills all germs on any dirty or contaminated cloth or clothing.

When Should I Seek Medical Help?

In general, if symptoms get worse despite self-care or do not improve within a day or two, contact your doctor or clinic.

Seek immediate medical care if you have the following conditions:

  • Diabetes. Diabetes puts people with cystitis at risk for serious kidney infection.
  • Pregnancy.

Also seek medical care if you have:

  • Fever over 101 degrees
  • Nausea and vomiting
  • Severe lower back pain right below the rib cage
  • Blood or pus in the urine
  • Uncommon vaginal discharge

Any of the following conditions also indicate a need to obtain medical care:

  • History of heart or lung problems
  • History of kidney stones, kidney infections, or urologic surgery
  • The last bladder infection was within the last two months
  • More than three bladder infections have occurred during the past year
  • Menopause has ended

How Can I Prevent Further Attacks of Cystitis?

Almost all people who have recurring cystitis have nothing seriously wrong. People with more than three bouts a year may need to see a urologist.

Many people who suffer recurring bouts may simply do common things that make them more susceptible. Here are some steps you can take to help prevent cystitis:

  • Urinate frequently. This is the single best prevention.
  • Drink lots of fluids.
  • Women should always wipe front to back.
  • Keep the perineal area clean to avoid spreading bacteria from the anal area to the urethra.
  • Wear underwear made of cotton only-not silk, nylon, or other fabrics.

Don’t use:

  • Harsh soaps
  • Bubble baths
  • Feminine hygiene sprays
  • Deodorized tampons
  • Douches
  • Hot tubs that may not be kept clean

Don’t wear:

  • Anything tight-fitting for long periods of time. This includes tummy control panties, girdles, stretch pants, or shorts.
  • Underwear made with polyester, nylon, or stretch materials.

It’s important to urinate when you feel the need, instead of waiting. Many people hold their urine in, but this is a bad habit. If work interferes with the ability to take a bathroom break, make some adjustments. For example:

  • Teachers who cannot leave the classroom.

    Solution: Ask a neighboring teacher to watch your classroom for a few minutes.

  • Workaholics so absorbed in a project that they forget to go.

    Solution: Keep bottled water by your desk and drink often. Set an alarm to go off every hour or two. Then stop working and go!

Nice To Know:

How the congressmen did it

Filibustering members of Congress solved the “can’t go to the bathroom now” problem years ago by rigging up a funnel and tube that connected the urethral opening to a container strapped onto their leg. The whole setup stayed hidden beneath their clothing.

How To Information:

Cystitis and Sexual Intercourse

Nearly all women with recurrent cystitis notice the onset of infection within 24 hours after intercourse. This happens because:

  • Sex can irritate the urethra, allowing bacteria to get inside and move up into the bladder.
  • Many women hold in their urge to urinate after intercourse.


To help avoid an attack while enjoying your sexual relationship:

  • Urinate right before and right after having intercourse. Urinating after sex helps wash out bacteria from the urethra.
  • If you use a diaphragm for birth control, be sure to clean it after each use and have your doctor check the fit routinely. The size may need to be changed if you gain or lose weight or if you have a baby. If it is too large, it can push against the neck of the bladder, making it hard to empty the bladder completely. Urinate right before diaphragm insertion and right after its removal.
  • If you use a lubricant when you have intercourse, use one that washes away with water (such as K-Y Jelly, H-R Lubricating Jelly, Surgilube).

Other causes of repeated attacks of cystitis include:

  • Obstruction or blockage. Anything that obstructs or blocks the urinary tract, such as a kidney stone, can lead to repeated attacks of cystitis. Certain tests can detect these conditions. Treating the underlying cause may solve the problem.
  • Injuries. Any damage to the lower back area can affect the nerves connecting to the bladder and make it impossible to empty it completely.

How Is Cystitis Treated?

Cystitis is almost always treated with medication.

These medications include:

  • Oral antibiotics
  • Painkillers
  • Antispasmodics

Surgery is rarely used to treat cystitis. It can occasionally be useful for treating people with interstitial cystitis.

Surgery also can be useful for correcting an underlying structural blockage or abnormality that is causing recurring cystitis.

Oral Antibiotics

Oral antibiotics are the most common medications used to treat cystitis. They kill the bacteria that are causing the infection.

  • Symptoms usually disappear within a few days, and further tests probably will be unnecessary.
  • If symptoms continue beyond that time or increase in severity, check with the doctor.
  • Some experts say that any woman with persistent symptoms of cystitis should receive antibiotics, even if the urine shows low-to-normal bacteria counts.

Nice To Know:

Tips on taking antibiotics:

  • Take exactly as directed.
  • Be sure to finish taking all of the antibiotic prescribed. Not completing the course of treatment can let the bacteria regrow and become resistant to the drug.
  • If you are pregnant or suspect you are, make sure your health care provider knows.
  • Take the drug at bedtime to help it work the most effectively.

Many experts worry that widespread use of antibiotics causes them eventually to become ineffective. That happens when bacteria that certain antibiotics used to kill quickly become resistant to these medications.

Penicillin and sulfa drugs were once common treatments for cystitis. Today, about a third of bacterial strains causingurinary tract infections have become resistant to these medications.

Because bacterial resistance is increasing for other antibiotics, as well, your health care professional may change the usual antibiotic treatment regimen.

Antibiotics often used to treat cystitis include:

  • Amoxicillin
  • Sulfa drugs (sulfonamides)
  • Cephalosporins
  • Nitrofurantoin
  • Doxycycline
  • Trimethoprim-sulfamethoxazole

People with serious recurring or chronic cystitis need thorough treatment because of risk for kidney infection.

  • Your doctor may recommend long-term antibiotic therapy and request a urine culture.
  • Sometimes stronger-than-normal antibiotics may prove useful.
  • Combinations of drugs also may work.


Pain-relieving drugs help treat symptoms of burning and urgency. They may be available over-the-counter (often called OTC drugs) or by prescription only.

Painkillers do not cure the infection causing cystitis.

  1. Phenazopyridine is a prescription drug in the United States used specifically to relieve painful urination. U.S. brands include Azo-Standard, Eridium, Geridium, Pyridium, and Urogesic. In Canada, it is available without a prescription, and brands include Phenazo and Pyridium.

    Phenazopyridine turns urine red to bright orange, which can stain clothing. Urine returns to normal color when the drug is stopped.

    Nice To Know:

    To use phenazopyridine:

    • Take with food to reduce chances of stomach upset.
    • Discard any leftover drug. Do not use for future attacks.
    • Do not store in damp places. Heat or moisture can break down the medicine.
    • Check with the doctor if symptoms worsen.
    • Do not take phenazopyridine if you wear soft contact lenses. The drug can permanently discolor or stain the lenses.
    • If you are diabetic, be aware that phenazopyridine may cause false urine test results, both for urine sugar and urine ketone. Check with the doctor before taking this drug.
  2. Aspirin (OTC). Aspirin often can relieve the pain and discomfort of cystitis.

    Need To Know:

    Caution: Never give aspirin to children or teenagers, unless directed by a doctor. Aspirin is associated with a condition calledReye’s syndrome, which can be fatal.

  3. Acetaminophen (OTC). Although acetaminophen does not relieve inflammation, it is relatively free of the side effects that sometimes occur with some other painkillers. Brands include Tylenol, Panadol, and Tempra.
  4. Ibuprofen (OTC). Brands include Advil and Motrin.
  5. Naproxen sodium (OTC). Brands include Aleve and many store-name brands.

How To Information:

Which Pain Reliever is Best for You?

With so many over-the-counter pain relievers in the stores, it is hard to know which one is best. Facts to keep in mind:

  • Almost all OTC pain relievers contain one of five common ingredients: aspirin, acetaminophen, ibuprofen, naproxen sodium, and ketoprofen.
  • Few differences exist among them.
  • All relieve minor pain and reduce fever.
  • Some also reduce inflammation (aspirin, ibuprofen, naproxen sodium).
  • Some of these products (aspirin, ibuprofen, naproxen sodium and ketoprofen) are called NSAIDs. You should be aware of side effects, particularly erosions or ulcers that can occur in the stomach and cause significant bleeding. This side effect can be minimized by taking the medication with meals or soon thereafter. The new Cox 2 inhibitors (Celebrex andVioxx) are less likely to cause these side effects but they are much more expensive.
  • Take painkillers with milk and food to help prevent stomach upset.

Nice To Know:

General precautions:

  • If you take other medicines, discuss which painkiller is best for you with your doctor or pharmacist.
  • Never take more than what the package label or your doctor recommends.
  • Don’t drink alcohol. Drinking while taking NSAIDs can increase chances of stomach upset and bleeding. Drinking and taking too much acetaminophen can seriously damage your liver.


These prescription-only medicines help decrease the muscle spasms that cause urgency to urinate. Some of the most commonly used are:

  • Tolterodine (brand name Detrol)
  • Flavoxate (brand name Urispas)
  • Oxybutynin (brand name Ditropan)

Nice To Know:

Best ways to use antispasmotics:

  • Take exactly as directed.
  • Make sure the doctor knows if you are pregnant or nursing.
  • Make sure the doctor knows if you are diabetic.
  • Discuss all medical conditions with your doctor before taking.
  • Inform the doctor of all other medications you are taking (including all OTC and prescription drugs).


Is Cystitis Serious?

Most cystitis infections are not serious and can be easily treated with antibiotics. But untreated, recurring bouts can result in kidney damage.

If symptoms persist or get worse regardless of what you do, seek medical treatment.

Diabetes can complicate things. Anyone with diabetes should immediately seek medical care at the very first symptom of a cystitis attack.

The good news is that research offers hope to people who suffer from cystitis and other urinary tract infections. Vaccines against the bacteria that cause these infections are currently in development.

What Is Interstitial Cystitis?

Interstitial cystitis (IC) is an inflammation of the tissues of the bladder wall. It causes the same symptoms as cystitis, but no obvious cause can be found.

The condition is difficult to diagnose, and many people are unaware of the problem. On average, a period of four years may pass between the first symptom and when the condition is diagnosed.

About 50,000 cases are diagnosed every year in the United States. Some experts estimate that up to a half million people have interstitial cystitis.

Doctors often fail to consider the possibility of interstitial cystitis and may diagnose this condition as a psychological problem.


  • Unknown

Diagnosis and tests:

  • Ruling out other conditions is the first step.
  • Finding little spots of bleeding in the bladder lining during cystoscopy is characteristic of interstitial cystitis.


  • Sometimes a biopsy of the bladder lining helps confirm the diagnosis.


Although many therapies have been tried, no standardized or completely effective treatments exist. Results vary, depending on the person.

Some treatments that may be useful:

  • Medication to relieve the symptoms. Pentosan (brand name Elmiron) is one drug used specifically to reduce the inflammation of interstitial cystitis. It is available by prescription only.
  • Antidepressants to relieve depression that often accompanies this condition. Antidepressants can help relieve pain, as well.
  • Medication to relax the muscles of the bladder wall. These are called antispasmodics.
  • Antibiotics to kill bacteria when a bladder infection also is present.
  • Following a low-acid diet.

Other treatment options include surgery or participating in clinical trials.

Long-term outlook

Treatment results differ from person to person. Simple treatments work for some, while others may need extensive treatment. Surgery rarely is required to relieve symptoms.

For more information:

Frequently Asked Questions: Cystitis

Here are some frequently asked questions related to cystitis.

Q: I just returned from my honeymoon with a miserable bladder infection. I’ve never had one before. Why now?

A: Your condition is sometimes called “honeymoon cystitis.” This happens when the urethra is irritated during sexual intercourse. Sexual activity can push bacteria into the urethral opening and the germs migrate up to the bladder. Emptying your bladder both before and after intercourse helps wash bacteria out of the urethra.

Q: My husband says that only women get bladder infections. Is that true?

A: Men also get bladder infections, although not as frequently as women. Symptoms for both men and women are about the same. As men age, the prostate gland often enlarges and can push onto and narrow the urethra. That makes it difficult for a man to empty his bladder completely. The pooled urine can breed bacteria and cause an attack of cystitis. If the prostate becomes inflamed, a condition called prostatitis, may occur. The symptoms are the same as for a bladder infection. Sometimes, just the urethra becomes inflamed. Any man with painful urination should see the doctor.

Q: A friend says she tests her own urine at home whenever a bladder infection starts up. How can she do that?

A: In the U.S., home dipstick urine tests are now available without prescription and are easy to use. The dipstick turns color if the urine shows large amounts of bacteria. Some experts say that these tests detect almost all common bladder infections. The tests are especially useful for women who have recurring attacks.

Q: I’m expecting my first baby and just got over a bladder infection. I’ve never had one before. Why now?

A: Pregnant women have more attacks of urinary tract infection than other women do. Early in pregnancy, frequent urination may happen because the uterus gets bigger and presses on the bladder. Later on in pregnancy, many women have bacteria in the urine even though they have no symptoms of infection. All pregnant women should be tested for urinary tract infection as part of routine prenatal care.

Q: My doctor just prescribed an antibiotic for my bladder infection. I’ve been reading about the problem of growing resistant to these drugs. What can I do to avoid that?

A: First, always finish all of your medication. Don’t stop taking it just because you’re feeling better. Stopping early allows the toughest bacteria to survive and multiply. That’s how a resistant strain of bacteria develops. Second, take your antibiotic exactly as prescribed. Skipping a dose can encourage growth of resistant bacteria. Third, don’t take antibiotics for cold or flu, or to prevent disease. Taking antibiotics routinely also increases the chances for developing resistant infections.

Q: I just read that generic painkillers are cheaper than brand name drugs. Should I pay more for the brand names to make sure I get the best relief?

A: Save some health care dollars and buy generic drugs. Generic painkillers are almost always cheaper than brand name drugs and are just as effective.

Q: My mother is in a nursing home. She just had a catheter put in, and I’m worried that she’ll get a bladder infection on top of everything else she’s gone through. Anything I can do?

A: You are right to be concerned. People who have urinary catheters for any length of time can develop large numbers of bacteria in their urine. People who can’t move well are also at higher risk for infection. Catheters should be used only when necessary and removed as soon as possible. Talk it over with the doctor. Does she really need one? Or is it simply a convenience for the nursing home staff? If your mother must have a catheter, make sure it is replaced every two weeks to help reduce the risk of infection. Make sure the nursing staff irrigates the bladder with antibiotics between replacements. The drainage bag should never be on the floor.Every day and after each bowel movement, both the catheter and the area around the urethra should be cleaned with soap and water. Check to see that the bag is kept securely in place against her leg.Encourage your mother to drink lots of fluids and assist her if she needs help. If she can tolerate cranberry or blueberry juice, see that she gets three glasses a day.

Q: Since going through menopause my mother hasn’t had a bladder infection, yet she used to get them a lot. She says her secret is hormones. How so?

A: Women who use a vaginal cream containing estrogen seem to avoid many bladder infections. Some experts believe that estrogen may resist infection by increasing the number of a certain kind of “good” bacteria, called lactobacilli. These bacteria fight infection by changing the character of the vaginal discharge and preventing E. coli-the most common cause of cystitis-from adhering to vaginal cells.Oral estrogen may not have the same benefit. Some studies show that women who take oral estrogen actually have more urinary tract infections.

Q: Vitamin C is supposed to help you get over a cystitis attack. How so?

A: Vitamin C, also called ascorbic acid, helps decrease the concentration of bacteria in the urine. Oranges, pineapples, tomatoes, and leafy green vegetables are all good sources of vitamin C.

Q: High-acid foods like oranges and pineapples upset my stomach. What else can I do to get over this attack?

A: For one day, add one teaspoon of baking soda to 10 ounces of fluid. Drink that mixture two or three times during that period. Baking soda makes the bladder less friendly to bacterial growth.

Q: I drink lots of orange juice, but the clinic nurse says that cranberry or blueberry juice is better. Are they?

A: Cranberry and blueberry juice both prevent the E. coli bacteria from sticking to the lining of the bladder. Studies show that drinking either of them helps rid the bladder of infection more quickly than if they are not used. Both juices also help prevent bladder infections.

Q: At my wedding shower, I got some lovely silk underwear. But since getting married, I’ve had several bladder infections and my doctor says to wear only cotton. Why so? Can I ever wear my silk lingerie?

A: Cotton “breathes” better than silk or other fabrics. Because germs thrive in moist, dark, warm places, that pretty underwear will hold in the moisture. Wear cotton underwear for everyday use, and enjoy silky wear on special occasions. Make sure all your underwear fits loosely. Tight-fitting clothing also holds moisture in.

Putting It All Together: Cystitis

Here is a summary of the important facts and information related to cystitis.

  • Cystitis is an inflammation of the bladder, usually caused by bacterial infection.
  • Drink lots of fluids and urinate frequently to help wash bacteria away.
  • Antibiotics usually eliminate infections that last more than a few days.
  • Urinate before and after sexual intercourse to help prevent cystitis.
  • Wipe only from front to back.
  • Contact the doctor if your symptoms get worse or do not improve within two days.
  • If you are pregnant or diabetic, see your doctor at the first sign of a bladder infection.

Glossary: Cystitis

Here are definitions of medical terms related to cystitis.

Antibiotics: Medicines that kill bacteria or prevent them from growing.

Bacteria: Microscopic germs that can cause infection.

Bacterial infection: Infection caused by bacteria.

Biopsy: Removal of a small piece of tissue from the body to study under the microscope for any abnormality.

Bladder: The muscle-like sac that stores urine produced by the kidneys.

Catheter: A small flexible tube used to drain urine from the bladder.

Chlamydia: A sexually transmitted disease caused by certain types of germs.

Clean catch: A urine sample collected in the middle of urinating to avoid contaminating the sample with other body germs.

Congenital: A condition present at birth.

Cystocele: Hernia of the bladder in which the tissue weakens and causes the bladder to fall into the vagina.

Cystoscope: An instrument used to look inside the bladder.

Dipstick: A stick containing chemicals that, when dipped in urine, change color to indicate infection or the presence of other abnormalities.

Diverticula: Abnormal pouches inside a hollow organ such as the bladder.

E. coli: The strain of bacteria that usually causes cystitis.

Gonorrhea: A sexually transmitted disease.

Interstitial cystitis: A long-term, recurring bladder infection for which no cause can be found.

Intravenous pyelogram: An x-ray test that tracks the movement of a chemical substance as it collects in the kidneys and exits through the bladder. Also called an IVP test.

Kidneys: A pair of organs that rid the body of waste materials from the bloodstream.

Kidney stones: Rock-like substances that form in the kidneys of some people. They can cause blockage of the urinary tract, which in turn can cause cystitis.

Organisms: Microscopic forms of life, including bacteria, viruses, and fungi.

Perineal area: The tissue area surrounding the opening of the bladder, vagina (in women) and rectum.

Perineum: See perineal area.

Prophylactic: An action that works to prevent disease recurrence, such as taking antibiotics before a cystitis attack.

Prostate: A muscular-like gland at the base of a man’s urethra.

Prostatitis: Inflammation of the prostate gland.

Pyelonephritis: Inflammation of the kidneys caused by bacterial infection.

Reye’s Syndrome: a serious complication in children following treatment with aspirin, usually after a viral infection. It may progress to coma and death.

Sterile: Free of germs.

Ultrasound: A test that uses sound waves to produce two-dimensional images of internal body organs and structures.

Ureters: Body tubes that carry urine from the kidneys to the bladder.

Urethra: Body tube that connects the bladder to the outside of the body. The tube acts like a drainpipe, allowing urine to run from the bladder to the outside of the body.

Urethritis: Inflammation of the urethra.

Urinary tract infections: Infections involving all or part of the kidneys, ureters, bladder and urethra. Often called UTIs.

Urologist: A doctor who specializes in diseases of the urinary tract.

Vagina: A woman’s birth canal.

Voiding cystourethrogram: An x-ray test taken as a person urinates. It tracks a chemical put into the bladder and can detect back-up of urine. Often called a VCUG test.

Additional Sources Of Information: Cystitis

Here are some reliable sources that can provide more information on cystitis.

Interstitial Cystitis Association 
Phone: 1-800-HELPICA
Phone: 1-212-979-6057


National Institute of Diabetes and Digestive and Kidney Diseases Office of Communications and Public Liaison National Institutes of Health 


For online clinical trials information: or

Books of interest

Barbara Doherty King, Judy Harke, “Coping With Bowel and Bladder Problems,”(Coping With Aging Series), Singular Pub Group, December 1994.

The authors are geriatric nurse practitioners and offer practical information for aging adults and their families.

Beverley Laumann, “Taste of the Good Life: A Cookbook for an Interstitial Cystitis Diet,” Freeman Family Trust Publications, July 1998.

An easy-to-read cookbook that eliminates the confusion about what to eat and how food can trigger attacks. The information is backed up by research and offers nutritional guidance to people who must live with the condition.

Catherine M. Simone, “To Wake in Tears: Understanding Interstitial Cystitis,” IC Hope Ltd., November 1998.

One woman’s account of living with the condition, which discusses her wide-ranging journey in search of relief. The author talks about her experiences with Western medicine and alternative approaches. She reveals what made her life easier and how she stayed in control of her condition.

Jerry G. Blaivas, “Conquering Bladder and Prostate Problems: The Authoritative Guide for Men and Women,” Perseus Books, May 1998.

An easy-to-understand book that explains how the urinary tract works, things that can go wrong and what symptoms mean. Some chapters discuss particular conditions and treatment choices. To illustrate points, the author includes imaginary conversations between patients affected by these disorders and their doctors.

Larrian Gillespie, Sandra Blakeslee, “You Don’t Have to Live With Cystitis,” Avon Books, December 1996.

Gillespie, a physician and an authority on treating cystitis, offers ways for women to break out of the cycle of recurring bladder infections. She also discusses treatment options and research.

Rebecca Chalker, Kristene E. Whitmore, Suzann Gage, Kristine E. Whitmore, “Overcoming Bladder Disorders: Compassionate, Authoritative Medical and Self- Help Solutions for Incontinence, Cystitis, Interstitial Cystitis, Prostatitis,” HarperCollins, June 1991.

A woman urologist offers wide-ranging information on major bladder problems that affect both women and men. The book gives both medical information and guidance on how to work effectively with medical practitioners. It includes self-assessment charts, a comprehensive survey of medical treatments and products, and a number of coping strategies.

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