cystitis [key], common acute or chronic inflammation of the urinary bladder. The disease occurs primarily in young women and frequently results from bacterial invasion of the urethra from the adjacent rectum, most commonly with normally occurring intestinal bacteria such as E. coli. It is also common in menopausal women; in them, the bacteria is transmitted from a vagina left more susceptible to bacterial overgrowth by changes in estrogen levels. In men cystitis rarely occurs without some other urinary tract disorder, such as kidney stones or, especially in older men, an enlarged prostate gland. Other predisposing factors are pregnancy, diabetes, and various systemic disorders.
Usual symptoms are frequent urination with burning pain, blood in the urine, and pain in the pubic area; chills and fever, back pain, and nausea may indicate kidney involvement. Treatment is with antibiotics and can also include the relief of any obstructions.
Interstitial cystitis is an inflammation of the bladder wall of unknown cause. It has the same symptoms as cystitis plus severe pelvic pain and frequency of urination (sometimes more than 60 times daily) that interferes with sleep, work, and daily life. No bacteria are present in the urine and it does not respond to antibiotics. It is diagnosed by the presence of lesions seen on the bladder wall during cystoscopy. Ninety percent of those affected are women. Diagnostic criteria were standardized only in 1988; it was often treated as a psychological disorder prior to that time. Treatment includes direct instillation of dimethyl sulfoxide (DMSO) into the bladder for relief of pain and inflammation, tricyclic antidepressants for pain relief, and a low-acid diet.
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