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Chronic cystitis is a recurrent bladder infection. Women get it more often than men. The main symptoms are recurring pain when peeing and a constant urge to go to the bathroom. Acute cystitis is usually caused by bacterial infection, but they can also be caused by an underlying disease (e.g. diabetes) .

Chronic cystitis is more common in women over 30 and even more so in women in their 50s. The problem is that very often, there is no obvious cause for the chronic infection, which makes it difficult to treat. However, the first line treatment for cystitis is the same, regardless of whether it is acute of chronic. 

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What Causes Chronic Cystitis?

Bladder infections happen when bacteria such as E. coli, which usually live in the bowel, get into the urethra and migrate to the bladder where they multiply and cause an infection. These bacteria are regularly passed with excrement and can be found on the skin around the anus.

When women wipe their bottom from back to front (instead of front to back), they move these bacteria closer to the opening of the urethra. Since the urethra in women is very short, it is easy for bacteria to reach the bladder and start an infection in an environment that is normally “germ-free”. However, this is not the only reason that cystitis occurs.

Other Causes Of Chronic Cystitis & Risk Factors

The natural acidity of the vaginal area normally prevents bacteria from multiplying in this area. However, if this natural defense system is weakened, bacteria can thrive and enter the urethra. A weak immune system can be one of the causes of chronic cystitis, especially if the infection develops and spreads to the kidneys. There are several risk factors which can facilitate recurrent bladder infections:

  • Bladder or kidney stones
  • Diabetes
  • Congenital abnormalities in the urinary tract that can cause incomplete emptying of the bladder
  • Recent urological operations

It seems that the lower urinary tract (from the bladder to urethra) reacts to oestrogen levels, which may explain why some women get recurrent bladder infections after the menopause – a time during which hormonal changes occur.

Women who have had infectious cystitis (with lab tests confirming the presence of bacteria) at least three times in six months should see their doctor or a urologist to establish the cause and find the best treatment.

Causes Of Severe Cystitis

Sometimes it remains unclear why some women suffer from severe bladder infections. However, severe cystitis can occur when pre-existing conditions worsen or cause the infection. Women who suffer from diabetes, a blockage in the kidney or bladder (e.g. stones, congenital abnormalities) as well as women who have problems emptying their bladder, are more likely to suffer from severe cystitis.

The symptoms of severe cystitis are largely the same as those of a “normal” cystitis, but often more intense. They include: the urge to urinate very frequently, pain during urination, cloudy and smelly urine, pain in the flanks or back. The treatment options are also similar, although it helps to have a urine sample tested to ensure that your doctor can prescribe the most suitable antibiotic. 

How Common Is Chronic Cystitis?

Chronic cystitis affects 5% of women who seek medical help for cystitis each year. However, about one in five women will get a re-infection, mostly because of poor hygiene or sexual activity. The risk of chronic cystitis increases with age, especially from the age of 60 onwards.

Recurrent Bladder Infections In Men

There is very little research on the causes of chronic cystitis in men, because it’s a very rare condition. There are, however, some factors which are suspected to contribute to recurrent bladder infections in men:

  • Sexually transmitted infections, specifically chlamydia
  • Prostate infection (prostatitis) and other issues with the urinary tract that usually appear in men in their 50-60s
  • Kidney stones

Please note that DrEd only offers cystitis treatment for women.

Treatment For Chronic Cystitis

Antibiotics are the most common treatment for chronic bladder infections. If your symptoms are mild, your GP might ask you to wait for the results of a urine test. This way, your doctor can prescribe the most suitable antibiotic for fighting the bacteria which are causing your infection.

In some cases, women are given antibiotics in advance (usually a 3-day course) so that they can treat their infection without having to visit their doctor. If antibiotics seem to work well for you but your bladder infection keeps on coming back, you doctor may give you a long-term antibiotic treatment which consists of a much lower dose. Some patients need to take this every day for several months (from 6-24 months). You can order trimethoprim or nitrofurantoin online from DrEd. Our online doctor will review your request and confirm whether you can take an antibiotic for your bladder infection.

When Antibiotics Fail

Sometimes, antibiotics may fail to cure recurrent bladder infections. You should consider consulting your GP if this happens. You may need to undergo further tests before your GP can determine the cause of infection.

You should follow these recommendations:

  • Drink plenty of fluids (preferably water)
  • Go to the toilet whenever you need to
  • Wipe your bottom from front to back (not from back to front)
  • Avoid irritating your anus and vagina while washing – use water and avoid using soap
  • Avoid using a contraceptive diaphragm and spermicide as well as anything that “messes” with your normal vaginal balance
  • Pee after sex in order to remove any bacteria transferred during sex

Many women report, that cranberry juice helps their cystitis. A 2011 study suggests, that you would need quite a lot of cranberry juice to effectively protect your bladder. However, cranberry capsules can be effective in preventing chronic cystitis. Be careful if you are taking blood thinning medication, because cranberry juice can interact with it.

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