Cystitis

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Latest Edit: Hector 2014-05-15 (EDT)

Cystitis is a term that refers to urinary bladder inflammation, but it is also used to describe a number of other types of cystitis. In general, more women than men are affected by urinary bladder infections because of their shorter urethra length and the close proximity of the urethra to the anus and vagina, both which can be sources of bacteria.[1]

Urinary Conditions
Bladder infection.jpg

Bladder Infection
Causes Dietary Factors, Dehydration, Hygiene, Infections, Stress, Prescription Medications, Incomplete voiding
See Also Urinary Conditions, BPH
Books Books on Urinary Conditions
Articles Articles on Urinary Conditions

Naturopathic Assessment

The diagnosis of a cystitis is typically based on a person’s presenting symptoms.

Causal Factors

Urination is part of the primary route for the elimination of toxins from the body. In order to stimulate the innate ability of the body to heal the causes of disease must be identified and addressed. The causes are variable hence detailed assessment is required to determine which factors are contributing to cystitis.

Lifestyle

  • Non-cotton underwear that is too tight fitting can increase the risk of UTI and cystitis.
  • Delay in urination or holding of urine can contribute to the development of cystitis.[1]

Social

  • Emotional Health
  • Decreased mental state, including the presence of anxiety, stress, depression and overall satisfaction with life, is associated with increased risk of cystitis, especially in women.[2]
  • Childhood traumatic events, in particular sexual abuse and extreme illness increase the risk of cystitis later in life.[3]

Environmental

  • The most common form of cystitis is a urinary tract infection. It is typically caused by E.coli, a gram-negative bacteria or Staphylococcus saprophyticus.[4]
  • Cystitis cystica is a chronic cystitis glandularis accompanied by the formation of cysts. This disease can cause chronic UTIs. Cystitis cystica appears as small cysts filled with fluid and lined by one or more layers of epithelial cells. These cysts are due to hydropic degeneration in center of Brunn's nests.[5]

External

  • Sexual Intercourse
  • Sexual intercourse can increase the occurrence of UTIs and the risk of traumatic cystitis. Traumatic cystitis is due to bruising of the bladder, usually by sexual intercourse that is either too forceful or when the length of the vagina and penis are disproportionate.[6]

Medical Interventions

  • Over-the-Counter Medications and Prescription Medications
  • The use of spermicides or a diaghragm can increase the risk of urinary tract infections and subsequent cystitis.[1]
  • Eosinophilic cystitis may be caused by medications, especially in children.
  • Medical Treatments
  • Hemorrhagic cystitis, can occur as a side effect of cyclophosphamide, ifosfamide, and radiation therapy. Radiation cystitis, one form of hemorrhagic cystitis is a rare consequence of patients undergoing radiation therapy for the treatment of cancer.[7]

Physiology

  • Incomplete Voiding
  • When the ligaments that suspend the bladder become weakened the positioning of the bladder can shift which can impact the ability to void completely. Urine that remains in the bladder increases the risk of a UTI and subsequent cystitis. Ineffectual voiding is a common cause of urinary tract infections and cystitis especially in the elderly.[1]

Diagnostic Tests

  • A urinalysis may reveal the presence of white blood cells (WBCs) or red blood cells (RBCs). The pH of the urine will help in determining the type of bacteria that is a concern and hence the most appropriate treatment regimen.
  • A urine culture (clean catch) or catheterized urine specimen may be performed to determine the type of bacteria in the urine which will assist in determining the appropriate treatment.

Related Symptoms and Conditions

Urination is a primary pathway for the elimination of toxins. When this pathway is impeded on a chronic basis it can disrupt the acid alkaline balance of the body and can contribute to other symptoms and conditions.

Conditions related to cystitis include:[8][1]

  • The symptoms of a yeast infection can sometimes mimic those of a bladder infection.

Characteristics

The different syndromes associated with cystitis each have their own common causes and risks. The syndromes include:

Article The Emerging Diagnosis of Lower Urinary Dysfunctional Epithelia: Comparison with Prostatitis and Interstitial Cystitis, NDNR, 2011 November
  • Urinary tract infection, also known as UTI or bladder infection
  • Interstitial cystitis
  • Traumatic cystitis
  • Eosinophilic cystitis
  • Hemorrhagic cystitis
  • Cystitis cystica

Common Symptoms

Symptoms may be mild to severe, depending on the individual, and in some cases an infection may occur even though there are no symptoms. If left untreated, a bladder infection may progress up the ureters to the kidneys, resulting in a kidney infection, which can be very serious. Common cystitis symptoms include:[1]

Naturopathic Treatment

The goal of naturopathic treatment is to support and work in tandem with the healing power of the body and to address the causal factors of disease with individual treatment strategies. The naturopathic treatment for cystitis involves addressing dietary factors, supporting the elimination or toxins, providing symptomatic relief and addressing other causal factors.

As bladder infections or UTIs are typically an acute reaction the initial treatment focus is on eliminating the causative bacteria. The next step, especially if the UTIs tend to be frequent or chronic, is to address the causative factors. Resolution of cystitis is often more effective when a multi-dimensional approach is used. If the recommended treatment does not relieve the symptoms within a week it is best to have further diagnostic testing done to clarify the type of cystitis and the ideal treatment regimen.

It is always advisable to work with a naturopathic doctor before engaging in any treatment plan.

Home Care

Home Care strategies include:

  • Prevention measures are generally directed at women and include drinking lots of water to ensure good urine flow to wash out the bladder, wiping from front to back, urinating soon after sexual intercourse, and wearing loose-fitting, breathable clothing and underwear. [9]

Lifestyle

Lifestyle recommendations include:

  • Increasing fluid intake in the form of pure water, herbal teas, and diluted fruit and vegetable juices will increase urine flow. Fluids such as pop, concentrated fruit drinks, coffee, and alcoholic beverages should be avoided. [1]
  • Avoid foods that will "feed" a bacteria such as sugar, concentrated fruit juice, sodas, refined carbohydrates.[1]
  • Avoid food intolerances
  • Ensure adequate hydration.
  • Stress can lead to immunosuppression and increase the risk of infection. Stress reduction can benefit the immune system and help to treat and prevent UTIs.[4]

Naturopathic Therapies

The prescribing of naturopathic therapies requires the guidance of a naturopathic doctor as it depends on a number of factors including the causal factors, a person's age, prescription medications, other conditions and symptoms and overall health. It is always advisable to work with a naturopathic doctor prior to taking any natural therapies.

Naturopathic Therapies for cystitis include:

Traditional Chinese Medicine recognizes the varied presentations of disease, and treatment is dependent on detailed assessment. Treatment principles utilized in Traditional Chinese Medicine to address cystitis include:[12]
  • Resolve Damp
  • Clear Damp Heat
  • Clear Liver Fire
  • Clear damp and toxic heat

References

Reviewed by Iva Lloyd, BScH, RPE, ND [1]

  1. 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 1.9 Murray MT, Bongiorno PB (2006) Pizzorno Textbook of Natural Medicine 3rd ed Chap 161 Cystitis Elsevier.
  2. Nickel JC, Tripp DA, Pontari M, Moldwin R, Mayer R, Carr LK, Doggweiler R, Yang CC, Mishra N, Nordling J (Jan 2010) Psychosocial phenotyping in women with interstitial cystitis/painful bladder syndrome: a case control study. J Urol.;183(1):167-72. PMID: 19913812.
  3. Nickel JC, Tripp DA, Pontari M, Moldwin R, Mayer R, Carr LK, Doggweiler R, Yang CC, Mishra N, Nordling J (Dec 2011) Childhood sexual trauma in women with interstitial cystitis/bladder pain syndrome: a case control study. Can Urol Assoc J.;5(6):410-5. PMID: 22154637.
  4. 4.0 4.1 4.2 Hadley S (2007) Rakel: Integrative Medicine 2nd ed Chap 24 Urinary Tract Infections Saunders
  5. Wood DP (2011) Wein: Campbell-Walsh Urology 10th ed Chap 80 Urothelial Tumors of the Bladder Saunders
  6. http://en.wikipedia.org/wiki/Cystitis
  7. Bekelman J, Jackson N, Donehower RC (2006) Piccini and Nilsson: The Osler Medical Handbook 2nd ed. Chapter 47: Oncologic Emergencies Johns Hopkins University
  8. Passaretti C, Ardehali H, Nueremberger E (2006) Piccini and Nilsson: The Osler Medical Handbook 2nd ed. Chap 59 Urinary Tract Infections Johns Hopkins University
  9. Boon Heather, Smith Micheal (2009) 55 Most Common Medicinal Herbs, Second Edition, Institute of Naturopathic Education and Research, Toronto.
  10. Abascal K, Yarnell E (2008) Botanical Medicine for Cystitis. Alt and Comp Ther 14(2):69-77
  11. Cummings S, Ullman D (1991) Everyone's Guide to Homeopathic Medicines: Taking Care of Yourself and Your Family with Safe and Effective Remedies. GP Putnam Son's
  12. Kuoch DJ. (2007) Acupuncture Desk Reference 2nd ed Acumedwest.