• Urine test by using a dipstick in the urine sample
• Urine culture where specimen is sent to a laboratory to examine bacteria

For recurrent cystitis or in the case of inexplicable infections, further tests may include:

• Ultrasound scan
• X-ray
• Cytoscopy (fiber-optic examination of the bladder)

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• Burning sensation when urinating
• Frequent urination
• Feeling of incomplete emptying after urination
• Sense of urgency to urinate
• Dark, cloudy, strong smelling urine
• Pain felt directly above pubic bone
• Pain in lower back or abdomen

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• Poor toilet hygiene – women must wipe themselves front to back to avoid bacteria being spread from the anus to the urethra
• An enlarged prostate gland in men causes blockage of urine outflow and bladder infections can occur in the ‘stagnant’ urine in the bladder
• Individuals with a catheter have a higher risk of infections such as cystitis and blood infections
• Congenital deformity in the urinary system preventing the complete emptying of the bladder
• Pregnant women may have bacteria in their urine caused by not emptying their bladders completely. If this is the case, a urine culture test is often performed twice to prevent the risk of kidney infection and pre-term delivery
• ‘Honeymoon cystitis’ often occurs when women engage in vigorous or frequent physical activity which causes bruising and physical damage
• Contact dermatitis can develop when women use irritants such as bath oil or talc on their genital area, leading to cystitis
• Postmenopausal women experience many changes in their body due to a lack of female sex hormones, and as a result the urinary system is more prone to developing cystitis.
• Women who use a diaphragm as a method of contraception are more prone to cystitis

Note: Venereal diseases such as Gonorrhea and Chlamydia have cystitis-like symptoms, such as a burning sensation when urinating, an inflamed cervix, vaginal discharge, and bleeding after intercourse. If cystitis infection does not respond well to treatment, it is important to have a medical examination to rule out other conditions which may need treatment.

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• Over-the-counter drugs such as painkillers or antispasmodics, eg. paracetamol or ibuprofen
• Over-the counter solutions to relieve cystitis symptoms such as citrate or potassium citrate
• Antibiotics such as Amoxicillin and Sulfa drugs (sulfonamides)
• Surgery may be recommended for complicated cystitis if there is an underlying physical abnormality or cause

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• Acupuncture
• Naturopathy
• Nutritional therapies
• Pelvic floor treatments (to strengthen the pelvic floor muscles)
• Massage
• Biofeedback

Pregnant women should consult their GP or pharmacist before taking any medication. Use these therapies as part of your broader treatment plan to reduce discomfort and pain.

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Natural treatments such as herbal medicine and homeopathic therapies can be very successful in clearing infection and alleviating the symptoms of cystitis, while also promoting overall health and well-being. Herbal remedies are safe, effective, and free of harmful side effects. Some commonly recommended herbal remedies for bladder infections and cystitis include Agothosma betulina (Buchu), Arctostaphylos uva-ursi , Melissa Officinalis (Lemon balm), Avena Sativa, Hypericum perforatum (St. John's Wort), Vaccinium myrtillus (Billberry) and Echinacea angustifolia. Homeopathic remedies can also be very successful and will depend on the symptoms experienced as well as the physical composition of the individual.

One of the advantages of natural treatment is the avoidance of antibiotics, which are well known to increase the incidence of repeat infections. Consult an herbalist or homeopath to help you choose a remedy based on your symptoms.

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Cystitis can definitely be more easily controlled and prevented by following some of the useful tips below:

• Drink lots of water, at least eight glasses a day, to flush the system completely (which can result in healthy frequent urination)
• Avoid foods that may damage the bladder wall such as coffee, tea, soda, concentrated fruit juices, citrus fruit, bananas, tomatoes, spices or chocolate – a process of elimination helps
• Avoid alcohol
• Pay attention to signs of your body, including noticing the presence of symptoms such as strong smelling urine
• Drink cranberry juice to fight off the infections and prevent bacteria
• Empty your bladder completely when you go to the toilet
• Do not try to hold urine; urinate when you feel the urge
• When you visit the toilet, wipe from front to back
• Avoid vaginal douches which can introduce infection into the urethra
• Wear cotton underwear and avoid tight trousers and jeans
• Avoid using irritants such as soap, talc, bubble bath, or feminine products around your genital area
• Urinate immediately after intercourse to flush out bacteria, and wash before and after intercourse
• Reduce stress by practicing muscle exercises and managing anxiety

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