Several different causes may be found in the background of the disease.
When the vaginal flora is weakened for some reason (usually as a consequence of an antibiotic treatment, but hormonal changes ie. estrogen deficiency may cause it, too) and the natural defense is disturbed, bacteria from the intestinal and the skin flora may get into and multiply in the vagina, then they are transferred to the bladder and cause inflammation.
Therefore the restoration of the vaginal flora is a main step of the treatment.
Besides efforts to prevent the reoccur of inflammation has to be done. Prevention may be achieved by a small amount of antibiotics accumulating in the urine that can be taken for years. The medication has to be taken for a month at least before going to bed, and it has to be repeated following a sexual intercourse.
“Chill” may play a role in the development of cystitis, but bacteria are in the background even at such cases too; the cold has a negative effect only by decreasing local immune response. So when the symptoms are caused by chill antibiotic prevention is recommended; like following a bathe on the beach, sitting on the ground or riding a motorcycle.
It is quite common that symptoms occur following a sexual intercourse or it may even get worse, too. On the one hand it may be the negative effect of the alkaline semen on the acidic vaginal flora; on the other hand the male partner may have bacteria or other sexually transmitted pathogens (Chlamydia, Ureaplasma, Mycoplasma, Trichomonas etc.) in his semen or urethra. When the patient and her partner get rid of the above mentioned problems and cystitis still occurs following a sexual intercourse, low dose antibiotics are required after the intercourse.
Blueberry and blueberry products may be applied as a supplemental treatment of recurrent cystitis. The proanthocyanidin in the blueberry decreases the attachment of bacteria to the bladder. Regular probiotic treatment, consumption of kefir and increased fluid intake are recommended for patients susceptible for re-infection.
When cystitis doesn’t disappear despite the above detailed treatments or recurs, a complete medical check-up is required to expose the cause. Urine culture and a targeted treatment with the chosen antibiotic based on the antibiogram of the cultured bacterium (it is usually an intestinal bacterium, called E. coli).
A complete urinanalysis, an abdominal-pelvic ultrasonography, or sometimes cystoscopy may help to reveal the causes in the background.
No severe changes are found in most of the cases and the diseases may be maintained by the above detailed life style changes and a prolonged treatment of a low-dose antibiotic.