Acute and Chronic Cystitis: Overview Acute Cystitis: 1. Definition: Acute cystitis is an infection of the bladder, often caused by bacteria, leading to inflammation of the bladder wall. It is commonly referred to as a urinary tract infection (UTI). 2. Etiology: o Bacterial Causes: The majority of cases are due to Escherichia coli (E. coli), but other bacteria like Klebsiella, Proteus, and Pseudomonas can also be involved. o Risk Factors: Female gender, as women have a shorter urethra, sexual activity, pregnancy, diabetes mellitus, and the presence of urinary catheters. 3. Symptoms: o Dysuria (painful urination) o Increased urinary frequency and urgency o Suprapubic pain or discomfort o Hematuria (blood in urine) o Sometimes fever and chills 4. Diagnosis: o Urinalysis: Shows pyuria (pus in urine) and bacteriuria (bacteria in urine). o Urine Culture: Identifies the causative organism and its antibiotic sensitivity. 5. Treatment: o Antibiotics: Commonly prescribed antibiotics include trimethoprimsulfamethoxazole, nitrofurantoin, or ciprofloxacin, depending on the local resistance patterns and patient allergies. o Pain Relief: Phenazopyridine can be used to relieve symptoms. o Hydration: Drinking plenty of fluids to help flush out the bacteria. 6. Prevention: o Adequate hydration o Urinating before and after sexual activity o Proper genital hygiene o Avoiding irritants like spermicides and douches Chronic Cystitis: 1. Definition: Chronic cystitis is a long-term inflammation of the bladder, which may be due to persistent bacterial infection, irritants, or underlying conditions. It is characterized by recurrent or persistent symptoms. 2. Etiology: o Chronic Infection: May result from inadequate treatment of acute cystitis or persistent bacterial presence. o Irritants: Chronic use of certain medications or exposure to chemicals. o Interstitial Cystitis: A condition with no clear infection but with symptoms similar to cystitis, characterized by bladder pain and frequent urination. 3. Symptoms: o Persistent dysuria o Frequent urination o Chronic pelvic pain o Sometimes symptoms similar to those of acute cystitis 4. Diagnosis: o Cystoscopy: Examination of the bladder using a flexible tube with a camera to inspect the bladder lining. o Bladder Biopsy: May be done to rule out cancer or identify interstitial cystitis. 5. Treatment: o Long-term Antibiotics: For chronic bacterial infections. o Medications: Pentosan polysulfate sodium or other bladder protectants for interstitial cystitis. o Lifestyle Changes: Dietary modifications, stress management, and pelvic floor therapy. o Surgery: In severe cases, procedures like bladder augmentation may be considered. 6. Prevention: o Addressing and managing underlying conditions o Avoiding known irritants o Regular medical follow-up for chronic conditions Understanding the distinction between acute and chronic cystitis is crucial for effective management and treatment.