Signs and symptoms

Cystitis causes a frequent urge to urinate accompanied by intense pain, burning sensations and strong odour. Sufferers may also experience a mild fever and chills, abdominal pain or blood in the urine. If untreated, symptoms worsen and infection can spread to the kidneys.

Non-bacterial cystitis (interstitial cystitis) may be due to a spread of candida (a fungal organism) triggered by antibiotics, oral contraceptives, food intolerances, stress and poor diet. Dehydration and exposure to cold or chemical irritants are also factors.
Orthodox treatments

Doctors will request a urine test to confirm bacterial infection. If positive, they’ll prescribe antibiotics but these also kill healthy bacteria, which may lead to thrush. If the test is negative, alkalising agents are used.
Complementary approaches

* Herbal medicine – cranberry contains an ingredient that prevents bacteria adhering to the lining of the bladder, thereby preventing the spread of infection. Uva ursi, golden seal, marshmallow root, buchu and juniper are all used to treat cystitis, as are various Chinese herbal formulas.

* Acupuncture – can help treat and prevent cystitis. Acupressure is also useful.

* Homeopathy – helpful remedies include: sarsaparilla (burning pain after urination and thirst), cantharis (acute pain and frequent urge to urinate),staphysagria (triggered by sex and relieved by urination) and mercurius corrosivus (extreme pain and blood in urine). In the case of recurrent cystitis, see a practitioner for professional advice on the best remedy.

* Dietary change – nutritionists recommend decreasing junk foods, sugar, refined carbohydrate, alcohol and coffee and increasing vegetables (especially leafy greens), wholegrains, live yoghurt, garlic and good quality water (six to eight glasses a day). If candida infection is suspected, yeast, sugar and fermented foods should be avoided. Naturopaths may recommend a cleansing diet combined with hydrotherapy.

* Nutritional therapy – supplements of vitamin C and bioflavonoids can boost immune function and help prevent infection, while vitamin E has an anti-inflammatory effect. Yeast free B-complex plus biotin and probiotics(healthy bacteria such as Lactobacillus acidophilus) help to reduce candida infection.

* Aromatherapy and massage – essential oils of lavender, juniper, sandalwoodand chamomile are all indicated for cystitis. They may be added to a carrier oil, such as almond (ten to 15 drops to 25ml carrier oil) and massaged into the abdomen, lower back and feet to bring relief and prevent recurrence.

* Osteopathy – is sometimes used to relieve pelvic congestion in recurrent sufferers.

* Counselling and cognitive therapies – can help relieve anxieties and stress that contribute to a lowered immune system.

Self-help tips

To prevent cystitis:

* Always urinate before sex and as soon as possible afterwards.
* Never delay going to the toilet and always empty the bladder fully.
* Wipe from front to back after going to the toilet.
* Gently wash the perineal area or penis regularly using warm water but no soap, and avoid all perfumed soaps and vaginal deodorants.
* Wash before intercourse (both partners).
* Ensure good lubrication during intercourse.
* Women should use sanitary towels rather than tampons.
* Drink plenty of water every day to avoid dehydration and limit intake of sugar and avoid coffee, tea and alcohol.
* If candida is suspected, avoid all yeast products (including bread and beers), fermented products (such as vinegar and soy sauce), mushrooms and sugar.
* Take a cranberry supplement (cranberry juice is also good, but beware added sugar).
* Wear cotton underwear and avoid tight-fitting jeans or trousers.

To treat an attack:

* Take immediate action at the first sign of discomfort.
* Drink a mug of black coffee (this is the only time you should drink coffee if you’re a cystitis sufferer) to help expel urine followed by two large glasses of water to flush out infection. Continue to drink at least one full tumbler of water every 20 minutes until discomfort ceases. Add one level of bicarbonate of soda (unless you suffer from heart problems) to the first glass to relieve burning pain.
* Keep warm and take rest. A hot water bottle front and back may help.
* A warm bath with five drops of lavender or juniper essential oil added may ease discomfort.
* Light circular massage of the abdomen can ease pain.
* Take a urine specimen to your doctor for analysis.
* If prescribed antibiotics, take a probiotic supplement (containingLactobacillus acidophilus and Bifidobacterium bifidus) to restore healthy bacteria during the course and for a week after it’s completed.

This article was last medically reviewed by Dr Stephen Hopwood in April 2009.