Most women are all too familiar with the pain of cystitis, a common bladder infection. An estimated 35 per cent of women between the age of 25 and 40 have had at least one bladder infection, frequently referred to as urinary tract infection or UTI. Men can get bladder infections too, but they are more common in women.

Women tend to suffer most from this condition because in women the tube (urethra) that runs from the bladder to the outside of their body is considerably shorter (about 5cm/2ins) than it is in a man (about 18cm/7ins) and this makes it easier for bacteria to make its way into a woman’s bladder. In addition, the opening to the urethra is much closer to the anus than it is in men, so the bacteria have easy access to the urethra and from there to the bladder. 

 

Cystitis is an inflammation of the bladder lining caused by infection, irritation or bruising, or a combination of all three. The inflammation makes you want to pass water more urgently and frequently, even if there is very little to pass, and there is typically a burning sensation on urination. You may also experience lower abdominal pain, nausea and vomiting, dark, foul-smelling urine (perhaps with traces of blood) and fever. Cystitis is not only painful it can progress to more serious infections of the kidney if not stopped in time.

 

The Causes

 

Bacterial cystitis is an infection responsible for about 50 per cent of cystitis cases. It is normally caused by E-coli bacteria (Escherichia coli – not the E-coli 0157 that causes food poisoning). E-coli is normally present in the bowels, but once this bacterium enters the urethra it sticks to the walls of the bladder and multiplies causing pain, inflammation and infection. If you regularly use tampons you are more susceptible to bacterial cystitis than women who use pads. This is because the chemicals from tampons can irritate the lining of the vagina and this irritation can encourage inflammation and infection. The string on the tampon used to pull it out can also provide bacteria easy access to the body.

 

There is another type of cystitis that is non-infectious and sometimes nicknamed ‘honeymoon cystitis.’ It is typically caused by bruising or irritation during sex, which causes inflammation and this inflammation can make infection more likely. Other triggers for non-bacterial cystitis include: wearing a sanitary pad for too long; tight underwear, tights or trousers and chemical irritants, including soaps and bubble baths. Some women are sensitive to chlorine from swimming pools.

 

The hormonal changes that take place at the menopause can also spur on the development of cystitis. When oestrogen levels drop the balance of bacteria in the vagina changes and the number of good bacteria declines, which may explain why the incidence of cystitis can increase by 2 per cent each decade after the menopause. In addition, vibrations from riding a horse, bike or motorcycle can also cause bruising, which can lead to symptoms of cystitis. Some women experience cystitis in pregnancy because the urethra is relaxed by high levels of progesterone.

 

Other causes of non-infectious cystitis include dehydration, which can make the urine more concentrated and more likely to cause irritation of the urethra and the bladder. Certain foods may also irritate the bladder and the urethra and these include spicy foods, alcohol, caffeine and fresh fruit juice.

 

Getting to the cause of the problem

If you’re plagued by bladder infections, here’s what you need to know to both prevent and treat the problem:

 

• Urinate after sex: It has been found to be helpful to urinate after intercourse. This can wash out any bacteria that might have worked their way up into the bladder.
• Drink fluids: If you feel symptoms coming on drink fluids to help dilute your urine.
• Stick with cranberry juice: You’ve probably heard that cranberry juice is good for bladder infections. This advice has been around a long time, but recent studies have given credence to the claim by showing that cranberry juice can significantly reduce the bacteria associated with urinary tract infections. This is because cranberries contain substances called tannins, which can stop bacteria like E-coli sticking to the walls of the urethra. If you are prone to bouts of cystitis I recommend cranberries and cranberry juice as a preventative natural medicine, but don’t ever buy cranberry juice with added sugar or artificial sweeteners. Sugar has a destructive impact on your immune system and will make it difficult for your body to fight infection.
• Use towels instead of tampons: Again, this will reduce the likelihood of infection.
• Don’t hold on. Urinate regularly and, if you feel the need to go, find a toilet rather than putting it off.
• Take showers instead of baths if you are prone to frequent bouts of cystitis and use natural soaps free from chemical irritants.
• Avoid wearing tight underwear, tights or trousers.
• Use sanitary towels instead of tampons, but make sure you change your pads every two hours.
• Avoid all sugar, including hidden sugar found in many refined foods and sauces, such as tomato sauce. Start reading labels to find out how much sugar you are actually consuming. Refined carbohydrates, such as the white flour found in pastries, cakes and pies, is also broken down into sugar (glucose) quickly so should be avoided.
• Acidic food and drink can trigger flare ups so avoid caffeine (in tea as well as coffee), alcohol, sugar, meat, spicy foods and undiluted fruit juices. Some, but not all, women with cystitis find that certain healthy foods, can aggravate the condition and these foods include strawberries, potatoes, tomatoes, spinach and rhubarb.
• Abstain from sex just before your period: If you are vulnerable to bladder infections during certain phases in your menstrual cycle you may want to avoid sex just before your period when levels of oestrogen, the hormone that maintains vaginal health, are low.
• Switch contraceptives: If you are using contraceptive jellies and foams and get recurrent infections talk to your doctor and consider using other methods of birth control. The jelly can make it easier for bacteria to get into the vagina.
• Get treated: Sometimes even if you do all the right things you can still get an infection. As soon as you suspect you have an infection visit your doctor. Your doctor will be able to tell you if your condition is infectious or not. This is important because it can spread from the urinary tract to the bladder and kidneys, where it can cause kidney infection. If bacterial cystitis is diagnosed it will be treated with antibiotics. If you take antibiotics you need to be aware that although they will eliminate the infection, they will also destroy beneficial bacteria in the gut, increasing the likelihood of recurrent infection and thrush. So if you need to take antibiotics make sure you always take a probiotic with them to help recolonise your gut with beneficial bacteria (the one I use in the clinic is called BioKult – see the Resources Page)
• Garlic: Often called ‘nature’s antibiotic’, research has shown that it can help eliminate bacteria associated with cystitis, such as E coli and staphylococcus. To get the full benefits of garlic you need to eat it raw. This sounds unpleasant, but just add raw garlic to salad dressings or crush it and use as a garnish. Alternatively, if you can’t bear the smell, you can take a garlic supplement – the most effective one I have found is called Aged Garlic, which is a concentrated form of organic garlic (see the Resources Page).
• Pineapple: This fruit contains a digestive enzyme called bromelain, which has anti-inflammatory properties. Studies have shown it can have a beneficial effect on cystitis. Take 500mg, 3 times a day, between meals (see the Resources Page for how to obtain bromelain).
• Live yogurt: Lactobacillus acidophilus (healthy bacteria) can be found in live yogurt but not at a therapeutic level, which is needed along with other beneficial bacteria when you have cystitis.  So you also need to take a probiotic. You need a probiotic containing at least 14 beneficial strains of bacteria with a 10 billion viable organisms per gram. (I have found BioKult to be an excellent probiotic.) 
• Echinacea: This herb has been shown to increase the white blood cell count and activity in order to effectively engulf bacteria and viruses, so it may be a helpful herb for cystitis treatment and prevention.
• Uva Ursi (Arctostaphylos uva-ursi) is a herb with antiseptic properties that may be effective against E-coli bacteria. Goldenseal (Hydrastis canadensis) is also anti bacterial. The best approach is to have a mix of both golden seal and uva ursi, but don’t take this tincture for any longer than two weeks. Both these herbs should be used in the short term only in order to try and prevent the need to take antibiotics. If you are pregnant or hoping to be or have a history of heart disease, glaucoma or diabetes, you should consult your doctor or practitioner before using goldenseal.
• D-mannose: This is a naturally occurring glyconutrient which sticks to the urinary tract. The E-coli adheres to the D-mannose, rather than the bladder wall, and the E-coli bug gets flushed out as your urinate. I have found D-mannose to be an excellent remedy for cystitis (in order to obtain it go see information on the Resources Page).

 

Self-help:

 

– Massage your stomach with two drops each of juniper and lavender oils in two teaspoons of warmed sweet lavender oil. Or add 1 to 2 drops each of tea tree, juniper, cypress and eucalyptus essential oils to your bath.

 

– To  help make your urine more alkaline and relieve the burning sensation try dissolving a teaspoonful of bicarbonate of soda (also called baking soda) in about half a litre of warm water and drink twice daily, or sip throughout the day.

 

– Barley water can act as an anti-inflammatory agent for the urinary system. Buy whole barley, put 1.5oz (40g) in 2 pints (1200 ml) water, boil and then simmer for 30 minutes. Add a slice of lemon, or the juice of one lemon, for the last 10 minutes of simmering. Sip the barley water during the day.

 

Note: If you get more than six bladder infections a year it is essential that you work with your doctor to identify the problem. Find a health professional who will outline a plan of diagnosis and treatment, including a review of your diary of activities.

Far from making you feel more tired, physical activity can actually give you more energy. If you don’t fancy going to the gym there are plenty of activities you can easily fit into your daily routine that will help to keep you fit and healthy and boost your energy levels at the same time. Here are some examples: 

• Increase your steps: Take the stairs instead of the lift, leave the car at home and get off the bus a stop before your own, use the upstairs toilet  rather than the downstairs one (if you have one), hide the remote controls and get up to switch your appliances on and off. Buy a pedometer to count your steps.
• Get out in the garden: Researchers at Kansas State University say gardening can strengthen limbs, help the cardiovascular system and develop flexibility. So get out there and start digging. Take the opportunity to have a good stretch after you’ve been kneeling down.
• Do it to music: Put on a lively CD and do your housework in time to it. You’ll be working out without even knowing it.
• Rediscover your sexual energy: Sex is a calorie burner and can be a good aerobic workout too. It also releases feel good hormones that increase your energy levels and put you in a good mood. So feel free to indulge yourself.

Don’t make the mistake of skipping strength training and working only on your cardiovascular system. For sustained energy levels throughout the day you need muscle power. 

Strength training won’t make your muscles look bulky and unattractive if done correctly – Marilyn Monroe used to lift weights. Clever strength exercises – lifting weights, yoga, or light dumbbell work on your own at home – can reap great streamlining, energy-boosting rewards. If none of these appeal to you, find ways in your daily life to use your muscles more. Carry your shopping bags, lift your kids or do some squats, sit-ups and press-ups as you watch television.

 

Squats: Stand with your feet shoulder-width apart. Bend your knees and slowly start to sit down. Once your bottom is nearly in line with your knees, simply push up into a standing position, squeezing your bottom as you go. Do three sets of 10 repetitions; more if you feel able. Rest for a minute between sets.

 

Press-ups: Go down on your hands and knees, and gently bend your elbows and straighten them again, keeping your back as straight as you can. If you have the muscle strength, assume the proper press-up position with your legs stretched out behind balancing on the balls of your feet and your body parallel to the floor. Do three sets of 10 repetitions; more if you feel able. Rest for a minute between sets.

 

Sit-ups: Lie flat on the floor on your back with your knees bent and feet flat on the floor. Place your hands lightly behind your head. Using your abdominals, lift your shoulders a few inches off the floor, pause briefly and return to your starting position. Complete three sets of ten repetitions; more if you feel up to it. Rest for a minute between sets.