Cystitis - Diagnosis and treatment (2023)

Diagnosis

If you have symptoms of cystitis, talk to your health care provider as soon as possible. Your provider can diagnose cystitis based on your symptoms and medical history.

When more information is needed for a diagnosis or treatment plan, your provider may recommend:

• Urine analysis. For this test, you collect a small amount of urine in a container. Your provider checks the urine for signs of infection, such as bacteria, blood or pus. If bacteria are found, you may also have a test called a urine culture to check what type of bacteria is causing the infection.
• Imaging. An imaging test usually isn't needed for cystitis. But in some cases, imaging may be helpful. For example, an X-ray or ultrasound may help your provider find other potential causes of bladder inflammation, such as a tumor or anatomy problem.

Treatment

Cystitis caused by bacterial infection is generally treated with antibiotics. Treatment for other types of cystitis depends on what's causing it.

Treating bacterial cystitis

Antibiotics are the first line of treatment for cystitis caused by bacteria. Which drugs are used and for how long depends on your overall health and the bacteria found in the urine.

• First-time infection. Symptoms often improve a lot within the first few days of taking antibiotics. But you'll likely need to take antibiotics for three days to a week, depending on how severe your infection is.

  Take the pills exactly as directed by your provider. Don't stop the pills early, even if you're feeling better. This helps make sure that the infection is completely gone.

• Repeat infection. If you have recurrent UTIs, your provider may have you take antibiotics for a longer period of time. You may also be referred to a doctor who specializes in urinary tract disorders (urologist or nephrologist). A specialist can check for any urologic problems that may be causing the infections. In some cases, taking a single dose of an antibiotic after sex may be helpful for repeat infections.
• Hospital-acquired infection. Hospital-acquired bladder infections can be a challenge to treat. That's because bacteria found in hospitals are often resistant to the common types of antibiotics used to treat community-acquired bladder infections. Different types of antibiotics and different treatment approaches may be needed.

Women who have gone through menopause may be particularly at risk of cystitis. As a part of treatment, your provider may give you a vaginal estrogen cream. But vaginal estrogen is recommended only if you're able to use this medicine without increasing your risk of other health problems.

Treating interstitial cystitis

There's no single treatment that works best for someone with interstitial cystitis. The cause of inflammation is uncertain. To relieve symptoms, you might need medication given as a pill you take by mouth. Medicine can also be placed directly into the bladder through a tube. Or you might have a procedure called nerve stimulation. This uses mild electrical pulses to relieve pelvic pain and urinary frequency.

Surgery is a last resort option, to be considered only when other treatments fail. Surgery might not work to relieve pain and other symptoms.

Treating other forms of noninfectious cystitis

Some people are sensitive to chemicals in products such as bubble bath or spermicide. Avoiding these products may help ease symptoms and prevent more episodes of cystitis. Drinking plenty of fluids also helps to flush out substances that may be irritating the bladder.

For cystitis that develops as a complication of chemotherapy or radiation therapy, treatment focuses on managing pain by taking medicine.

Lifestyle and home remedies

Cystitis can be painful. To ease discomfort:

• Use a heating pad. A heating pad placed on your lower abdomen may soothe bladder pressure or pain.
• Stay hydrated. Drink plenty of fluids to keep yourself hydrated. Avoid coffee, alcohol, soft drinks with caffeine and citrus juices. Also avoid spicy foods until your infection clears. These items can irritate the bladder and make a frequent or urgent need to urinate worse.

For recurrent bladder infections, ask your provider about ways you can reduce the chance that you'll have another infection.

Preparing for your appointment

If you have symptoms common to cystitis, make an appointment with your primary care provider. After an initial visit, you may then see a doctor who specializes in urinary tract disorders (urologist or nephrologist).

What you can do

To prepare for your appointment:

• Ask if there's anything you need to do in advance, such as collect a urine sample.
• Write down your symptoms, including any that seem unrelated to cystitis.
• Make a list of all the medicines, vitamins or other supplements that you take.
• Take a family member or friend along, if possible. Sometimes it can be hard to remember all the information you're told during an appointment.
• Write down questions to ask your provider.

For cystitis, basic questions to ask include:

• What's likely causing my symptoms?
• Are there any other possible causes?
• What tests do I need?
• What treatment approach do you recommend?
• If the first treatment doesn't work, what will we do next?
• Am I at risk of complications from this condition?
• Could this problem happen again?
• What can I do to prevent this from happening again?
• Should I see a specialist?

Be sure to ask other questions during your appointment as they occur to you.

What to expect from your doctor

Your provider is likely to ask you a number of questions, such as:

• When did you first notice symptoms?
• Have you been treated for a bladder or kidney infection in the past?
• How much pain are you in?
• How often do you use the bathroom?
• Do you feel better after urinating?
• Do you have low back pain?
• Have you had a fever?
• Have you noticed vaginal discharge or blood in your urine?
• Are you sexually active?
• Do you use birth control? What kind?
• Could you be pregnant?
• Are you being treated for any other medical conditions?
• Have you ever used a catheter?
• What medicines, vitamins or supplements do you take?

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