CYSTITIS: inflammation of the urinary bladder.
Bladder infections plague one in three women sometime in their lives. They are the second leading cause of lost work days for women and are responsible for millions of doctor visits annually.
SYMPTOMS: frequency, a sense of urgency, painful burning, and sometimes bleeding on urination. Women are far more likely to get the condition than are men, apparently because a woman's urethra is shorter than a man's and is close to the anus and vagina.
CAUSES: most bladder infections are caused by the bacteria Escheri- chia coli normally found in the intestines. Improper wiping is a possible route of infection, but lack of estrogen may also affect internal flora and contribute to bladder infections. Use of the spermicide nonoxynol-9 has been found to increase infections by three times, as it has a tendency to kill not only sperm, but the friendly bacteria residing in the urinary tract, leaving it susceptible to invasion by unfriendly bacteria.
INTERSTITIAL CYSTITIS: a chronic idiopathic cystitis characterized by painful inflammation of the subepithelial connective tissue and often accompanied by Hunner's ulcer is an ailment that does not show up on bacterial cultures. It was previously thought to be a psychosomatic condition, but approximately 450,000 sufferers urinate dozens of times daily and experience lower abdominal pain.
DRUG TREATMENT: Antibiotics are the usual treatment for cystitis, following a bacteria culture (remember with interstitial cystitis, bacteria does not show on a culture). For 20% of women the antibiotics do not work, and another 25% have short term help, but the cystitis returns.
When antibiotics don't work other medications may be prescribed. Elmiron (creates a protective coating over the bladder lining) helps about 1/3 of patients. Also used are DMSO and hydrocortisone. Elavil, an antidepressant is often used to relieve chronic pain. Uristat is sold over the counter to relieve bladder infection distress.
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