Common Risk Factors And Causes Of Cystitis

Cystitis is bladder inflammation usually caused by an infection, in which case it's called a urinary tract infection (UTI), and it can affect any part of the urinary system such as the urethra, bladder, or kidneys. Cystitis is the most common UTI, and it usually affects women. It comes with inflammation that causes irritation of the bladder, a low-grade fever, an intense urge to urinate more frequently, and pain during urination. While cystitis isn't usually serious and can be treated with antibiotics, it can travel from the bladder to the kidneys where it can cause more severe symptoms.

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Bacterial Infections


Bacterial infections are responsible for about eighty percent of all cases of cystitis. Cystitis is usually caused by E. coli bacteria, but other types of bacteria can be to blame. The urinary system is responsible for removing waste from the body. The kidneys filter waste from the blood and control the concentrations of substances while the ureters carry urine from the kidneys to the bladder. Urine is stored here until it exits the body through the urethra. When bacteria enter through the urethra, it will begin to multiply. This causes infection and inflammatory response from the body. This type of cystitis can spread beyond the bladder if it isn't treated.

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Use Of A Diaphragm


Women who use diaphragms are about twice as likely to develop cystitis than women who use other forms of birth control. The use of a diaphragm or spermicide doesn't just make cystitis more likely; it also increases the risk of recurrent cystitis. Most urinary tract infections are caused by bacteria, especially E. coli, which lives in the rectum and colon. Diaphragms and spermicide can work to kill off protective bacteria and change the pH balance of the vagina. Both factors can increase the growth of harmful bacteria that can cause an infection.

It isn't understood exactly why this happens, but research is clear normal vaginal bacteria are altered in women who use diaphragms. It's possible the diaphragm simply obstructs the urethra that leaves a small amount of urine in the bladder while allowing bacteria to multiply. If women use spermicide or a diaphragm, they may want to consider switching to a different birth control method like oral contraceptive or an intrauterine device.

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Urinary Catheters


Catheters are thin tubes placed in the bladder to drain urine out of the body. They are used if individuals cannot urinate on their own to measure the amount of urine their body produces, or during some forms of surgery.

The use of urinary catheters is a significant risk factor for developing bacterial cystitis because using a catheter introduces bacteria into the bladder by allowing the bacteria to travel along the thin tube. Catheter use also promotes bacterial colonization by giving the bacteria a surface for adhesion and irritating the lining of the bladder. Between ten and thirty percent of patients who use a catheter even in the short-term develop bacteria in their urine. Catheters should always be inserted using a sterile technique and left in place only as long as necessary to reduce this risk.

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Wiping Back To Front


How women wipe after using the restroom can impact whether or not they develop cystitis. Wiping back to front can introduce bacteria like E. coli into the urethra where it can make its way to the bladder or kidneys and cause a urinary tract infection. Not all bacteria will grow in the urinary tract, but E. coli from fecal matter around the rectum is the most common source of urinary tract infections. Women are more likely to get a UTI than men because women have urethras closer to the anus as well as shorter urethras. Both of these make it easier for bacteria to move from the anus into the urethra and then to the bladder. To reduce the risk of a urinary tract infection, individuals should wipe from the front to the back, especially after bowel movements.

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Chemical Irritants


While not common, sometimes chemical irritants or certain medications are responsible for cystitis, including feminine hygiene sprays and spermicidal jelly. Some individuals are simply very sensitive to chemicals in certain products and develop an allergic-type reaction in the form of bladder inflammation. It's even possible for a bubble bath to cause cystitis. Some research indicates scented products are more likely to result in a reaction or infection than the unscented variety. While feminine care products, contraceptives, and bath products are most likely to cause cystitis in sensitive individuals, cystitis is also linked with certain foods and drinks like alcohol, caffeine, chocolate, tomatoes, spicy food, and acidic food.

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Radiation Therapy


Radiation therapy in the general pelvic region can cause an individual to develop cystitis in the bladder from their treatment. Most individuals who experience cystitis have been treated with radiation therapy for urogenital and pelvic cancers, such as cervical cancer and prostate cancer. It can take anywhere between a few months to several years from the time of the radiation treatment for cystitis symptoms to manifest. Radiation therapy uses high energy beams to impair the DNA of cancerous cells so they will die or stop multiplying. While radiation therapy can be an effective treatment for malignancy, it can affect healthy cells in the general vicinity of the malignancy. Any of the cells that make up the bladder can become damaged as a result of radiation exposure. Most often, cystitis is triggered by damage to the cells lining the interior wall of the bladder, or the next layer of muscular connective tissue. When radiation beams cause damage to these cells, the body responds with an inflammatory response to mediate and attempt to repair the cellular damage. This response results in swelling of the tissues and other cystitis symptoms that can last many years following radiation therapy.

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Certain Medications


An individual who has taken certain medications can develop cystitis as a result of their treatment. Drugs used in chemotherapy have been known to cause the onset of cystitis in affected individuals. These are potent drugs that enter the body, create waste products, and are broken down before the kidneys filter them from the blood. Just like anything else, what goes in the body must come out. These drug components and the waste products they produce are filtered into the individual's urine, which sits in the bladder until it is ready to be emptied. These substances cause irritation and even damage to the cells lining the bladder in this process of bodily elimination. Drugs commonly implicated in this mechanism are ifosfamide and cyclophosphamide. Drugs that cause an impairment of the healthy bladder emptying process and flow of urine can increase the risk of developing cystitis. Immunosuppressive medications may be used in individuals with autoimmune disorders to help minimize the symptoms of their disorder, but increase their vulnerability to pathogens that cause bladder infections. Immunosuppressant drugs are also used in individuals who have received an organ transplant to prevent donor organ rejection. An impaired immune system due to medication can increase the risk of cystitis.

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Complication Of Other Conditions


Cystitis can develop in an affected individual as a complication of other conditions. Such conditions include those that interfere with the healthy function of an individual's immune system and the function of organs in the urinary system. The larger weight and size of a woman's uterus during pregnancy can inhibit the complete emptying of the urine. Numerous injuries and diseases may cause spinal cord damage around an individual's bladder, preventing complete drainage of urine from the bladder. Urine that sits in the bladder persistently due to impaired bladder emptying can provide a favorable place for bacteria to colonize. This mechanism is also a factor in individuals affected by an enlarged prostate, kidney stones, or any other problem that inhibits the normal flow of urine. Urinary tract abnormalities such as vesicoureteral reflux and numerous others can promote the growth of infection-causing bacteria in the bladder. Urinary catheter use and bowel incontinence can pose a hygienic issue that enables the entry of bacteria in the bladder. Diseases that impair an individual's immune system function can cause them to be at a higher risk of developing cystitis, including HIV, AIDS, diabetes, cancers, Crohn's disease, and common variable immune deficiency.

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Use Of Certain Hygiene Products


The use of certain hygiene products can cause an individual to be at a higher risk of developing cystitis than others. Usually, the urinary tract is completely sterile. However, this changes when allergens and other irritants are introduced to the genitourinary region. Many individuals enjoy using hygiene products like a bubble bath with added powdered crystals, certain liquids, and perfumes to create foam in their bathwater. Those products, spermicidal jellies, feminine sprays, tampons, diaphragms, vaginal douches, and sanitary napkins can irritate the urethra and vagina. This irritation can promote bacterial passage and colonization in the individual's urinary tract. Bath oils, vaginal lotions, vaginal creams, and certain soaps that are used on the skin around the urethra and vagina can stimulate changes in the vaginal flora that cause the development of cystitis. The vaginal lactobacilli are helpful flora in the vagina that prevents regional colonization of pathogens. Some females naturally lack enough lactobacilli, but more commonly, hygiene products cause the impairment of the function of this microbiota. This impairment puts the female at a higher risk of developing infections and cystitis.

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Women who are going through menopause are at an increased risk of developing cystitis. Menopause is the stage that occurs after a female's last menstrual period. It is characterized by a loss of estrogen, vaginal epithelium thinning, vulvovaginal atrophy, and lower amounts of lactobacilli in the vaginal microbiota. Estrogen is an important hormone in the body that prevents infection in the urinary tract through several mechanisms. Estrogen increases the natural production of proteins that have strong anti-microbial properties in an individual's bladder. The cells in the bladder infected with bacteria tend to shed as a defense strategy, which leaves underlying cells vulnerable to infection by the bacteria. High estrogen levels help the cells in the bladder bind together better, which helps prevent the shedding associated with infection progression. The general weakening of tissues can be characteristic of postmenopausal women, putting them at a greater risk of prolapse of pelvic organs. The altered structure of the connective tissues near the vagina and urethra have the potential to increase the risk of cystitis in women going through menopause. Additionally, the loss of estrogen and a decrease in lactobacilli in the vaginal microbiota are also known to contribute to the elevated risk of cystitis.


    HealthPrep Staff