Acute Cystitis: Causes, Symptoms, and Treatment Options

Urinary tract infections (UTIs) affecting the bladder, such as those causing acute cystitis, are common among Americans, affecting about 46% of women and 1.6% of men.

Acute cystitis can be uncomfortable to deal with, so understanding this condition and getting proper treatment is essential for preventing further complications.

What is Acute Cystitis?

Acute uncomplicated cystitis is an often painful and unpleasant condition that primarily affects the bladder and urethra.

Compared to men, women are more frequently affected by acute cystitis due to their shorter urethra, which provides an easier pathway for bacteria to enter the lower urinary tract.

This condition is characterized by bladder infection and inflammation of its lining, which can cause symptoms like:

• Persistent urge to urinate
• Burning sensation during urination
• Passing frequent but small amounts of urine
• Urine that appears cloudy and bloody with a foul smell

Some individuals may also experience pelvic discomfort or pressure in the lower abdomen. In more severe cases, symptoms might also include fever and a general feeling of unease.

What is the difference between acute and normal cystitis?

Acute and normal cystitis refers to the same condition — inflammation of the bladder. The difference between the two is in the duration and intensity of the symptoms.

Normal cystitis — also known as chronic or interstitial cystitis — is typically less severe, and symptoms may persist over a longer period. Discomfort is usually mild, although symptoms may still interrupt daily activities.

This type of cystitis is ongoing, and treatment may require long-term management strategies, depending on the underlying cause.

Acute cystitis occurs when an individual develops a sudden onset of inflammation, typically due to a bacterial infection. Symptoms also tend to appear immediately.

The symptoms of acute cystitis are intense but short-lived, and will usually resolve with the appropriate treatment. This type of infection typically clears up within a few days to a week.

Causes of Acute Cystitis

Bacterial infection

The most common cause of acute cystitis is an infection caused by the bacterium Escherichia coli (E. coli).

E. coli naturally occurs in your intestines, but can enter the urinary tract when you don’t properly wipe or clean yourself after a bowel movement.

In women, the urethra is closer to the anus, which makes it easier for the bacteria to travel from the bowel to the bladder. This can cause a urinary bladder infection.

The bacteria can also infect men, and it usually occurs alongside issues like an enlarged prostate. This condition can obstruct the flow of urine and create an environment that favors bacterial growth.

Hormonal changes

Hormonal changes can significantly increase the risk of developing acute cystitis, especially in older women.

During menopause, there’s a natural decrease in estrogen levels. This can negatively impact the urinary tract.

Estrogen helps to maintain the vaginal microbiome — a protective barrier made up of ‘good’ bacteria that help to keep the vagina healthy by preventing the growth of harmful pathogens.

When estrogen levels decrease, this barrier weakens, making you more susceptible to contracting an uncomplicated urinary tract infection.

Lower estrogen can also cause the bladder and urethral linings to become thinner and drier, leaving them more vulnerable to irritation or infection.

Other causes

Infection is the most common cause of acute cystitis, but there are various other factors that can increase your risk of developing this condition. These may include:

• Certain medications
• Chemotherapy drugs – particularly cyclophosphamide and ifosfamide
• Radiation treatment in the pelvic area
• Sensitivities to certain products, including feminine hygiene sprays or lotions
• Complications of other conditions, like diabetes, kidney stones, or enlarged prostate
• Long-term use of a catheter

It’s important to note that developing acute cystitis from these factors is rare, especially if you’re not exposed to them frequently.

How is Acute Cystitis Diagnosed?

The diagnostic process for acute cystitis is generally straightforward and can be done using various testing methods.

Acute cystitis should be diagnosed by a healthcare professional to ensure an accurate interpretation of your condition. This also helps to ensure that you get proper treatment.

Your doctor will likely take the following steps to diagnose acute cystitis:

• Assess your medical history by asking you questions about previous infections, medications you may be taking, and your lifestyle habits.

• Request a urine test (urinalysis) to examine the urine for signs of infection, including the presence of red and white blood cells, and bacteria.

• Perform a urine culture which involves growing bacteria from a sample to identify the specific type of organism causing the infection.

In certain cases, such as when the infections are recurrent, your doctor may require additional tests to determine your diagnosis.

These may include imaging tests — like an ultrasound or a cystoscopy (where a camera tube is inserted into the urethra for a visual examination) — to determine the cause of your infection.

Further testing can help your doctor identify any abnormalities in the urinary tract and rule out any other conditions that might contribute to the development of acute cystitis.

Depending on the results of all these tests and assessments, your doctor will make a diagnosis and recommend an appropriate treatment method to help you overcome your infection.

Treatment Options for Acute Cystitis

Managing acute cystitis effectively often involves using a combination of medical treatments and self-care strategies.

This can help you overcome the infection, alleviate uncomfortable symptoms, and prevent recurring issues.

Antibiotics

Antibiotics are usually the first-line treatment option for acute cystitis.

Once your doctor has determined your diagnosis, they typically prescribe a course of antibiotics to combat the specific cause of your infection. Commonly used antibiotics include:

• Nitrofurantoin
• Trimethoprim-sulfamethoxazole
• Fosfomycin

Duration of treatment may vary, but it typically ranges from three to seven days, depending on your medical history and the severity of your infection.

It’s important to complete your entire course of antibiotics — even if your symptoms improve — to ensure that the infection is fully treated.

Over the counter (OTC) remedies

OTC medications can be used alongside antibiotics to manage discomfort and alleviate symptoms.

Phenazopyridine is a common OTC medication that helps to reduce the burning sensation and urinary urgency associated with acute cystitis.

Other remedies include pain relievers — like Tylenol or Advil — and medications that can reduce inflammation.

It’s important to note that these medications aren’t suitable to treat the infection, but they are helpful for providing symptomatic relief.

Self-care measures and lifestyle changes

Self-care measures can also help you manage your symptoms and aid recovery. These practices may include:

• Ensuring that you drink plenty of water to flush bacteria from the urinary tract
• Avoiding known bladder irritants like caffeine, alcohol, and spicy or acidic foods
• Applying a warm heating pad to the abdomen to soothe bladder pressure

These measures should always complement a treatment plan that includes antibiotics and OTC medications to ensure a comprehensive approach to overcoming your infection.

Your doctor may also recommend other management techniques that you can implement, depending on your specific lifestyle habits.

Complications and Considerations

While acute cystitis is typically straightforward to treat, it's important to be aware of potential complications and consider individual risk factors that might affect recovery.

Kidney infection

One of the most serious complications of untreated acute cystitis is an increased risk of developing a kidney infection — also known as pyelonephritis.

This occurs when bacteria moves from the bladder to one or both kidneys. Symptoms of a kidney infection include:

• High fever
• Chills
• Severe back or side pain
• Nausea and vomiting

If you’re experiencing any of these symptoms, it’s recommended to seek emergency medical care as soon as possible.

A kidney infection is a much more serious condition than acute cystitis, and can lead to organ damage or sepsis if it’s not treated promptly.

Individual risk factors

Certain individuals may have risk factors that can complicate the treatment and recovery process of acute cystitis. These factors include:

• Age and gender: Young children and postmenopausal women experiencing hormonal changes are at increased risk of complications.

• Pregnancy: Pregnant women are more susceptible to infections spreading to the kidneys, which can have implications for both maternal and fetal health.

• Underlying medical conditions: People with diabetes, weakened immune systems, or neurological disorders that affect bladder function are at higher risk for complications and recurrent infections.

• Anatomical abnormalities: Individuals with structural abnormalities in the urinary tract or those with a history of kidney stones may experience more frequent and complicated episodes of cystitis.

• Catheter use: Long-term catheter use can increase the risk of chronic or recurrent UTIs and subsequent complications.

If you fall into any of these groups, it’s recommended to speak to your doctor about potential complications and preventative measures you can implement during and after treatment.

Can Acute Cystitis Be Prevented?

While not all cases of acute cystitis can be prevented, there are several measures that can significantly reduce the risk of developing this condition. These may include:

• Staying hydrated: Drinking plenty of fluids, especially water, helps dilute urine and ensures frequent urination, which flushes bacteria from the urinary tract.

• Urinating regularly: Avoid holding urine for long periods. Urinating regularly can help flush bacteria from the urinary system.

• Improving bathroom hygiene: Wiping from front to back after bowel movements helps prevent bacteria from the anal area from spreading to the urethra.

• Urinating after sexual activity: Both men and women should urinate soon after sexual intercourse to help flush out bacteria that may have entered the urethra during sex.

• Avoiding irritating feminine products: Using deodorant sprays, douches, or powders in the genital area can cause irritation in the urethra. Avoiding these products can reduce the risk of irritation and subsequent infection.

• Wearing cotton underwear and loose clothing: Wearing loose, breathable clothing and cotton underwear helps keep the area around the urethra dry, reducing the risk of bacterial growth.

• Managing postmenopausal hormone changes: Postmenopausal women with recurrent cystitis may benefit from discussing vaginal estrogen therapy with their healthcare provider, as this can help maintain the health of the urinary tract.

When Should You See a Doctor About Acute Cystitis?

It’s generally recommended to consult your doctor if you suspect that you’ve developed acute cystitis. You should also see your doctor if you:

• Experience persistent or severe symptoms that don’t improve with treatment
• Develop a high fever (above 101°F) and symptoms like chills or lower back pain
• Have underlying health conditions, like diabetes, a weakened immune system, or kidney problems
• Are pregnant and experiencing symptoms of cystitis
• Suffer from recurrent cystitis infections

Even if you only experience mild symptoms, you should consult your doctor, because early treatment can help you prevent the infection from becoming more severe and causing further complications.

Where Can You Learn More About Acute Cystitis and Similar Conditions?

If you’re concerned about your symptoms or want to know more about treating acute cystitis, LifeMD is here to help.

LifeMD can connect you to a team of medical professionals who can assist you with information and provide guidance on managing this condition while avoiding further complications — all from the comfort of your home.

Make an appointment today to get started.