Cystitis

• Inflammation of the bladder.
• The causes can be multifactorial but the most common cause is due to a bacterial infection (UTI – urinary tract infection)

Due to the shorter length of the urethra and the proximity of it to the anus. Both things make it more prone to invading pathogens.

• Prostate disease
• incontinence
• some other condition.

• Sexual activity 
• Douching and washing habits
• Diabetes
• Pregnancy
• Childlbirth 
• Catheter
• Antibiotic use
• Incomplete voiding of bladder

• Dysuria
• Urinary urgency and frequency
• Sensation of bladder fullness or lower abdominal discomfort
• Suprapubic tenderness
• Flank pain
• Blood in the urine
• Fevers, chills, vomiting, nausea and lower back pain (RF for kidney infection)

• Urine analysis with dipstick or culture
• Microscopic may show high levels of white blood cells (WBCs) and bacteria, haematuria  and/or low-grade proteinuria
• Recurrent infections may require further investigation to rule out functional pathologies
• Treatment = antibiotics

• Enhance flow of urine with proper hydration.
• Promote a pH that inhibits the growth of the organism.
• Preventing bacterial adherence to the endothelial cells of the bladder.
• Enhancing the immune system.
• Improving microflora balance – both in the vagina and large intestine
• Evaluate and remove possible mechanical or hygiene causes

• Eliminate refined foods, caffeine, alcohol, and sugar
• Avoid sexual activity until infection is resolved.
• Drink 2L water /day. 
• Reduce pro-inflammatory foods and emphasise foods high in antioxidants, phytonutrients, bioflavonoids and anti-inflammatory essential fatty acids such as oily fish and nuts / seeds.
• Stress management techniques should be implemented.
• Improve microbial balance though probiotic and prebiotic food

• Cranberries contain high levels of Vitamin C, fructose, and proanthocyanins 
• PAC and fructose increase the bacterial anti-adhesion activity of urine 
• Preventing the adhesion of E-coli to the urothelium
• However better for prevention than for curing active infection
• Contraindications - May cause stomach distress and diarrhoea, increase the risk of kidney stones
• Use cautiously with anticoagulants, medications that affect the liver, aspirin, those with altered hepatic function or in those taking cytochrome P450-metabolised agents.

• Simple sugar found in blackcurrants and redcurrants, gooseberries, aloe vera, soy beans and vegetables including cabbage, eggplant and tomatoes.
• Supplemental mannose can bind bacteria and prevent attachment to the urinary tract lining.
• Use in caution with diabetics

• The main difference is that it is a chronic irritation of the bladder and urine is normal and sterile 
• Cause and pathogenesis are still undetermined
• Diagnosis is essentially one of exclusion
• Pain is the most common symptom
• Association systemic lupus erythematosus, irritable bowel syndrome, and fibromyalgia

• Leaky urothelium
• Irritant chemicals in urine (from micro-organisms, metabolites or food intolerance)
• Autoimmune diseases and antibody complexes that irritate the bladder lining
• An initial infection that sets up an post-infection inflammation
• Lymphatic/vascular obstruction
• Reduced nitric oxide synthase (NOS) activity
• Neurogenic inflammation involving mast cells.

• 1. Working on leaky urothelium theory, it is wise to consider a grand elimination diet and food diary as food allergens can make the underlying nerves sensitive to Ka+.
• 2. Due to links with other autoimmune diseases and IBS, immune support and gut support may also be required.
• 3. Stress management

• Arginine – source of nitrogen for NO production; NOS have antibacterial, smooth muscle relaxant, hormone-releasing, and immune-modulating
• Chondroitin sulphate – repair mucosal damage 
• Glucosamine – repair mucosal damage Methylsulfonylmethane (MSM) – anti-inflammatory.
• Quercetin -inhibits histamine release from mast cells and has anti-inflammatory and antioxidant properties
• Gotu Kola - improve integrity of connective tissue
• Probiotics may be helpful but avoid fermented foods