Ever feel the urgent need to pee, accompanied by burning sensations and lower abdominal pain? These are the symptoms of cystitis – more commonly known as a urinary tract infection (UTI) – an infection of the bladder that affects one in every two women.

While not as serious as other infections, a UTI can be extremely painful. Dr Martine Jolivet-Tremblay, a urologist at the University of Montreal Hospital Centre, explains that although burning or tingling while urinating are the most recognized symptoms of this disease, they are not always present. However, the severity of these symptoms tends to decrease with age. Cystitis manifests itself usually by a pressing need to urinate up to 8 times a day, sometimes with very little flow. The urine can appear pink or red, and many women feel contraction-like pains in their lower abdomen.

Who is at risk?
UTIs primarily affect women because of their basic anatomy. The female genitalia and rectum are in close proximity to the opening of the urethra – the opening conduit of the urinary tract – which makes it relatively easy for contamination of the urinary tract with bacteria. Most of the time, the body is able to prevent infection by eliminating the bacteria through the flow of urine. Certain bacteria – in particular a species known as E. Coli – are able to attach themselves to the walls of the urethra and bladder, where they are free to replicate and produce an infection.

A urinary tract infection can also follow sexual intercourse, as sex has a tendency to displace bacteria towards the urinary tract. An infection can also be triggered by the hormonal changes of pregnancy and menopause. Diabetes is another risk factor, as it causes increased sugar in the urine, which produces a more favourable environment for bacteria.

When to see your doctor
A routine urinary tract infection may not be dangerous, but it must be taken seriously. Women should see their doctor shortly after the onset of symptoms as quick treatment decreases the risk of progression of the infection to something more serious, like kidney infection.

Before you visit the clinic, Dr Jolivet-Tremblay recommends drinking 2 to 3 litres of water to help eliminate the bacteria through the urine and decrease the pain. Peeing every two to three hours will ensure that urine does not become concentrated which could encourage bacterial multiplication and possibly worsen the burning. Consulting a doctor is especially important if you’ve had the following symptoms for more than one day: fever, chills, back pain, abdominal pain, blood in the urine, vaginal discharge, nausea or vomiting. A short course of antibiotics – between 3 to 7 days depending on your risk factors – will help you get back to normal.


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“Your doctor will usually treat based on symptoms,” explains Dr. Jolivet-Tremblay. “A culture and urine analysis are usually reserved for pregnant women, those who are diabetic, recently hospitalized patients, or women with recurrent infections.” Since men and children don’t typically contract urinary tract infections, when they do have symptoms, additional tests are often required to find the cause.

An over-the-counter medication can help to reduce the pain associated with cystitis by decreasing the acidity of the urine. Although it won’t treat the infection itself, it can relieve the burning symptoms while waiting for the antibiotics to take effect.

Risk of recurrence
Frequent recurrences are a significant problem with UTIs. Women can lessen the risk of recurrence by drinking at least one and a half litres of water everyday, maintaining adequate personal hygiene, and visiting the bathroom right after sex. Try using scent-free hygiene products and avoid synthetic underwear which tend to absorb less humidity than natural fibres like cotton.

Cranberry juice and acupuncture
If you suffer from repeated UTIs – more than four per year – your doctor may prescribe preventive antibiotics. Although a vaccine is in the works and has been tested in Europe, it has thus far had unconvincing results and is not available in Canada, says Dr. Jolivet-Tremblay. As for cranberry juice, it seems to have an intrinsic ability to prevent infections. Studies have shown that chemicals from the fruit coat bacteria, preventing them from attaching to the bladder wall. In addition, it acidifies the urine – something that also inhibits bacterial growth. Other home remedies include drinking orange, lemon or grapefruit juice and taking vitamin C.

Acupuncture is another effective remedy for patients with frequent recurrences. A Norwegian study group has shown the effectiveness of this technique for over ten years and recently published a study that showed that 73 per cent of women treated through this method had no new episodes for the following six months, compared to 52 per cent without treatment. According to the authors of the study, this effect could be due to the acupuncture needles, which are thought to decrease the quantity of residual urine in the bladder after voiding.

*It is important to distinguish cystitis from a condition known as “Interstitial cystitis,” a chronic inflammation of the bladder which can sometimes mimic a urinary tract infection, but which does not respond to antibiotics. The urine tests are also sterile. Characteristic symptoms of interstitial cystitis include pain, urgency and frequency, accompanies by increasing difficulty to urinate as the disease progresses. Extremely painful, this condition leads to the breakdown of the inner lining of the urinary tract.


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