An introduction to the causes of cystitis
Cystitis is usually caused by bacteria infecting the bladder, the most common being Escherichia coli. E.coli is found in small quantities in the digestive tract naturally, (this isn't the same strain that can cause more serious sicknress bugs) and normally, certain types of this bacteria are harmless and may even have an important role in the absorption of some key nutrients.
Whilst certain types of bacteria are good for some things, if they finds their way into the wrong places, i.e. your urinary tract, it can result in the unpleasant symptoms associated with cystitis.
These bacteria are clever, the have special fribrous protections which can allow them to grab onto the cells lining your urinary tract - hence why the infections they create can be so stubborn in some cases! Some of the remedies which help prevent cystitis, such as Cranberry, contain a special structure which tricks the bacteria into sticking to them instead, which allows them to be safely carried out of your urinary tract.
There are several reasons why this may occur, and certain types of people are more prone to bladder infections than others.
Transfer of bacteria
Perhaps the most common or easiest way to develop cystitis is the transfer of bacteria into the bladder, often from the back passage. As a result, women are more susceptible to cystitis as anatomically, their anus is situated much closer to the urethra than in men, making it easier for the bacteria to reach the bladder. Additionally, a woman’s urethra is much shorter than a man’s so that the bacteria have a shorter distance to travel to the bladder.
In a similar way, insertion of urinary catheters, tampons or contraceptive diaphragms can all provide an easy pathway for bacteria to enter the bladder, increasing the risk of developing cystitis.
Urine retention is another leading cause of bladder infections, as the bacteria is not removed with the urine. Stagnant urine is a breeding ground for bacteria, so it is important to be able to drain the bladder fully. Constipation can increase pressure on the urethral tube, blocking the flow of urine out of the bladder.
Urine retention is very common amongst men who have an enlarged prostate. The prostate gland is situated around the neck of the bladder, so any swelling of the gland increases pressure on the bladder and, in a similar way to constipation, can prevent the bladder from fully emptying.
It is important to understand if urine retention is the cause of your cystitis as, until the bladder is effectively draining, it will be difficult to clear up the infection.
Change in the balance of bacteria
As with the digestive system, the urinary tract contains a careful balance of bacteria, which is essential to keep it healthy. However, when one type of bacteria begins to take precedence over another, this can result in cystitis.
This can occur if using strong chemicals, such as in perfumed soap and bubble bath, as these can kill off good bacteria. If you are prone to urinary tract infections, consider using soaps which are natural and will not affect your bacterial balance.
Additionally, menopausal women are particularly prone to developing cystitis. Fluctuating hormones at this time of life can affect the bacterial balance throughout the body, including in the urinary tract. The tissue and skin in the urinary tract becomes weaker and thinner at this time too, meaning that it is more easily injured or traumatised, making infection easier to establish. It becomes less resilient and may struggle more to keep infection at bay.
Certain medical conditions can increase susceptibility to developing cystitis. For example, diabetics tend to have elevated levels of sugar in the urine, and bacteria thrive in that type of environment. It means that if the bacteria enter the bladder, they will be able to multiply more quickly and abundantly than in a non-diabetic. This means that even a very mild infection can quickly become more problematic. If you are diabetic and suspect a urinary infection, this should be checked by a doctor.
Although in most cases of cystitis bacteria is at the root of the cause, in interstitial cystitis this isn’t the case. Damage, structural changes, allergic responses or stress may all be potential underlying factors.
Although we’ve outlined some of the main causes of cystitis above some other factors may also be contributing:
Diet – Although diet isn’t likely to be the sole cause of cystitis, it can contribute and a diet high in sugar or inflammatory foods or drinks including caffeine or alcohol, could be exacerbating your symptoms. A diet low in fresh fruit and vegetables (even worse, together with inflammatory foods) can change the pH of your urine making it more alkaline. More alkaline urine creates a more suitable environment for bad bacteria, whereas they will struggle to survive if your urine is slightly acidic.
Hormones – Changing hormones at certain stages of a woman’s life may make here more susceptible to infection. Some examples include:
- At times different times throughout the monthly cycle. Cystitis may be more likely to pop up around the time of a woman’s period, for example.
- In peri-menopause
- Post menopause
- During pregnancy
- During the use of hormonal contraceptives
Sex – Although sex doesn’t directly cause cystitis, irritation, damage or the transfer of bacteria can occur as the result of sex which can contribute to cystitis.
Chemical cystitis – Different medications, chemicals found in cosmetic and personal hygiene products, or synthetic materials in clothes may damage or irritate of the lining of the urinary tract which may contribute to cystitis
Depleted immune functions – If your immune functions are depleted, for example after an infection, than incidences of cystitis can become more likely. The bad bacteria at the root of the cause is more likely to go undetected if your immune functions are down which means the infection can become more established
Stress – Stress may also exacerbate symptoms of cystitis. It can deplete your immune functions but it may also have a part to play in some cases of interstitial cystitis.