Cystitis explained

It’s one of the most common, and most irritating, conditions in women but natural approaches to prevention and treatment can help you beat the burn.

If you have ever suffered a bout of cystitis, no doubt you will cringe when recalling the pain and burning that you experienced.

If you were unfortunate enough to have been hit with symptoms of fever or vomiting, understandably you never want to suffer through it again.

Unfortunately, cystitis is very common, occurs across all age groups and often hits more than once. Fortunately, the news is not all doom and gloom. There is a range of practical naturopathic and common sense ways in which to attack this awful infection before it attacks first! While there are several types of Urinary Tract Infection (UTIs), this article focuses specifically on the causes, treatment and prevention of acute, uncomplicated cystitis.

The urinary tract

It’s useful to start by understanding the physiology of the urinary system. The urinary tract is a usually exceptionally efficient system of organs that produce, store, and remove urine. These include the kidneys, the ureters, the bladder, and the urethra. The kidneys filter the blood and remove waste products. The waste products become part of the urine, which flows from the kidneys through a pair of tubes called ureters, which connect to the bladder. Urine collects and is held in the bladder until you are ready to urinate via
the urethra.

In men, the urethra passes through the penis; in women, the urethra is much shorter and opens just in front of the vagina. A normal urinary tract is sterile and strongly resistant to infection, yet cystitis continues to be a common problem.

Understanding cystitis

Cystitis is an inflammation of the bladder, usually caused by a bacterial infection. The offending bacteria move up through the urethra into the bladder where they get trapped. The bacteria thrive in the wet and warm environment. In more serious cases, the infection can continue into the kidneys. E. coli is the most common bacteria responsible for cystitis. Although E. coli is normally present in a healthy system, in cystitis, it grows out of control and causes an infection. Cystitis is not sexually transmitted.

The typical experience

The onset is usually sudden with a constant urge to urinate that is associated with pain. Despite urinary frequency, only small amounts of urine are able to pass, and this is with severe discomfort. Pain often involves the entire lower abdominal area and sometimes the lower back. The painful sensations are described as aching, stabbing or burning and can be severe.

The pain is a result of the bacteria attacking the lining of the bladder, which causes some erosion of the bladder wall. When this sensitive tissue comes into contact with urine, the result is very painful. Urine may appear dark or cloudy and will often smell different. It may have a pink tinge, which indicates blood. In some cases, nausea, vomiting and fever can add to an already unpleasant experience.

A cystitis infection is confirmed when a urine sample has tested positive for several factors, including blood, pus and bacteria. Cystitis, particularly in young women, is very common and often self-diagnosed. Identification of an infection and appropriate monitoring by a qualified health professional is essential for the
following reasons:

• A common cystitis infection can progress to the kidneys, which is a serious condition requiring medical intervention.
• The symptoms of cystitis can be mistaken for another ailment, which may differ in severity and call for other avenues of treatment. Such ailments could be a sexually transmissible infection, thrush or a kidney condition.
• There may be considerable numbers of bacteria with few or no symptoms or very severe symptoms with little or no bacteria present.
• Complications are rare if cystitis is treated promptly. However, if left untreated, an acute or chronic kidney infection (pyelonephritis) may develop and could lead to permanent kidney damage.

Who suffers cystitis and why?

Cystitis is the most common infection of the urinary tract among women. Women are more likely to suffer from cystitis for the following reasons:

• Compared to the male counterpart, the female urethra is short, allowing for bacteria to find an easy pathway into the bladder. This can happen during intercourse as the bacteria are easily pushed towards the urethra.
• The female urethra is located close to the anus where bacteria from faecal matter can easily be transferred to the urethra. This risk can be minimised by always wiping from front to back.
• Hormones affect the vaginal secretions, which can make the environment more favourable to bacteria during certain times. Cystitis is common following menopause. The tissues of the vagina, urethra and base of the bladder are thinner and more fragile due to a loss of oestrogen. A woman may find that she is more susceptible to infections during certain times of the menstrual cycle.
• The risk of cystitis is increased during pregnancy. This may be a result of a decreased immunity from compromised nutrition, possibly as a result of inadequate diet and supplementation. A decrease in tone of the pelvic region due to the pressure exerted by a growing baby may also be a factor.
• A decrease in bladder tone predisposes elderly women to cystitis. Faecal incontinence also predisposes elderly women to infection, as the bacteria come into close contact with the urethra.
• In men, cystitis is more common later in life and often stems from an infection of the urethra or prostate. Difficulty urinating may be associated with a prostate disorder, rather than cystitis.
• Cystitis also occurs in children and must always be investigated. The signs and symptoms in children may vary from the adult presentation and may be overlooked or mistaken. Cystitis in children may be due to an abnormality of the urinary system.

Medical treatment

Antibiotics are generally prescribed by for cystitis. They are so effective in clearing bacteria because they annihilate any bugs that dare get in their way. Unfortunately, the useful, healthy bacteria are also destroyed alongside their overgrown, malevolent counterparts. Without adequate levels of healthy bacteria in the body, the immune system is weakened and a susceptible person is prone to recurrent episodes. When antibiotics are used as the only form of treatment in recurrent cystitis, an unfortunate cycle of repeated infection and antibiotic administration can result. This can be an ineffectual and very frustrating experience for
many people.

The naturopathic opinion

For illness to manifest there has to be a pre existing situation, or ‘root cause’ of the illness. When one organ or system is weakened through overwork, other areas are invariably affected. A naturopath
will work on:

• Why the infection happened in the first place
• How to eliminate possible causes
• Addressing unpleasant symptoms
• Supporting the urinary and immune systems, as well as any other body system seemingly involved
• Implementing prevention strategies for the future. Prevention may involve dietary or lifestyle modifications, perhaps longer-term support of the urinary, digestive or immune systems, maybe a combination of all of the above.

What can I do?

Even if you don’t have access to a naturopath, the following measures can be implemented to assist in the recovery from cystitis and help prevent future infections:

• Increase fluid intake: Drinking two to three litres of water per day during an infection helps to manually flush out the bladder and encourage bacteria to move out. It is important to avoid liquids that dehydrate the body and that can further irritate the bladder such as tea, coffee and alcohol. Herbal teas are an excellent option as an alternative to caffeinated drinks. Besides increasing fluid intake, they work topically through the kidneys and bladder. Try meadowsweet (Filipendula ulmaria,) as a soothing anti-inflammatory, nettle (Urtica dioica folia,) as an internal cleanser and diuretic and echinacea (Echinacea spp.) as an immune stimulant. A naturopath, herbalist or health store with bulk herbal teas should be able to mix these up for you.
• Take probiotics: A broad spectrum probiotic that contains varied strains of bacteria is excellent for restoring the balance of healthy flora. Bacteria exist in the body as part of a delicate balance of health. In an optimally healthy individual, the bacteria go about their work, causing no problems. In the person who, for any number of reasons, has a compromised immune, digestive or urinary system, the balance is thrown off and an infection such as cystitis has the opportunity to proliferate. A poor balance of bacteria can be caused by a long list of factors, including: poor diet, over consumption of alcohol, stress, illness and medications. Our bodies can often stave off these problems for a time, but this causes stress to the immune system. When the immune system is over worked, it can weaken over time and contribute to recurrent infections. Probiotics are available in capsule, powder or liquid form. Be aware when buying liquid probiotics that there may be a high sugar content.
• Limit sugar intake: Excess sugar disrupts the balance of flora in our systems. Bacteria feed on sugar and can proliferate out of control when excess sugar is consumed. Be aware of where sugar may be hidden, always read food packaging.
• Drink cranberry juice: It has been found that the cranberry contains compounds called proanthocyanidins (also found in blueberries) which prevent the offending bacteria from adhering to the mucous membranes of the urethra and bladder, hence lessening the duration of an infection. Also found in cranberries is a simple sugar called d-mannose, which attaches to the bacteria and transports it out with urination. Remember that bacteria thrive on sugar.. Cranberry and d-mannose extracts are also available in capsule or powder form.
• Look after your immune system: General immune nutrients such as vitamins A, C, E and zinc are a great way to help build immunity. It is a good idea to examine why the immunity may be low. Some reasons for weakened immunity include stress, lack of sleep and poor diet.
• Wear breathable,
  cotton underwear.
• Do not hold urine in if there is the urge to use the toilet. Empty the bladder before and
  after intercourse.

Herbal medicine

Ethical Nutrients Urinary Tract Support is a unique herbal formula which may reduce the symptoms of urinary tract infections such as cystitis. It promotes urinary tract health and may relieve the pain and burning sensation .

Prevention is key

While cystitis is decidedly uncomfortable, it is encouraging to know that armed with some awareness of your body and by making a few changes, you can bring about dramatic results. The fundamental belief in natural medicine is that each person is an individual, both in health and in illness. It is important to assess the ways in which your lifestyle can affect your health. Addressing the underlying causes of cystitis is the most effective way to begin healing and prevent future problems. This may mean taking measures to avoid stress, improve your diet or address hygiene issues. With the help of some of these natural approaches, positive steps can be made to begin a cystitis free future!