The condition frequently affects sexually active women ages 20 to 50 but may also occur in those who are not sexually active or in young girls. Older adults are also at high risk for developing cystitis, with the incidence in the elderly being much higher than in younger people.
Cystitis is rare in males. Females are more prone to the development of cystitis because of their relatively shorter urethra—bacteria do not have to travel as far to enter the bladder—and because of the relatively short distance between the opening of the urethra and the anus. However it is not an exclusively female disease.
More than 85% of cases of cystitis are caused by escherichia coli ("E. coli"), a bacterium found in the lower gastrointestinal tract. Sexual intercourse may increase the risk of cystitis because bacteria can be introduced into the bladder through the urethra during sexual activity. Once bacteria enter the bladder, they are normally removed through urination. When bacteria multiply faster than they are removed by urination, infection results.
Risks for cystitis include obstruction of the bladder or urethra with resultant stagnation of urine, insertion of instruments into the urinary tract (such as catheterization or cystoscopy), pregnancy, diabetes, and a history of analgesic nephropathy or reflux nephropathy.
The elderly of both sexes are at increased risk for developing cystitis due to incomplete emptying of the bladder associated with such conditions as benign prostatic hyperplasia (BPH), prostatitis and urethral strictures. Also, lack of adequate fluids, bowel incontinence, immobility or decreased mobility and placement in a nursing home are situations which put people at increased risk for cystitis.
Commonly used antibiotics include:
The choice of antibiotic should preferably be guided by the result of urine culture.
Chronic or recurrent UTI should be treated thoroughly because of the chance of kidney infection (pyelonephritis). Antibiotics control the bacterial infection. They may be required for long periods of time. Prophylactic low-dose antibiotics are sometimes recommended after acute symptoms have subsided.
Pyridium may be used to reduce the burning and urgency associated with cystitis.
There is some evidence that making the urine either more acidic (e.g. with ascorbic acid) or more alkaline may calm the pain of cystitis. Cranberry juice also contains condensed tannins and proanthocyanidins which have been found to inhibit the activity of E. coli by preventing the bacteria from sticking to mucosal surfaces lining the bladder and gut, helping to clear bacteria from the urinary tract
An effective, but old fashioned treatment (that seems to have been forgotten) is a salt water douche. Dissolve plenty of salt in warm water and bathe the affected region until symptoms subside.
Increasing the intake of fluids may allow frequent urination to flush the bacteria from the bladder. Urinating immediately after sexual intercourse may help eliminate any bacteria that may have been introduced during intercourse. Refraining from urinating for long periods of time may allow bacteria time to multiply, so frequent urinating may reduce risk of cystitis in those who are prone to urinary tract infections.
Drinking cranberry juice prevents certain types of bacteria from attaching to the wall of the bladder and may lessen the chance of infection. Cranberry extract tablets have also been found to be effective in preventing cystitis and avoiding the taste of cranberry juice (which some find unpleasant).