Cystitis (inflammation of the bladder) is often due to a bacterial infection of the lower urinary tract. Each year, around 5% of women present to their GPs with typical symptoms of cystitis, such as pain when passing urine and urinary frequency, about half of whom are found to have a urinary tract infection (Hamilton-Miller 1994).
The remaining women will have symptoms in the absence of bacterial infection, which is often referred to as interstitial cystitis or painful bladder syndrome (Rovner 2010). Typical symptoms of cystitis include pain when passing urine, and frequency and urgency of urination. Suprapubic pain, cloudy or foul-smelling urine, haematuria, or confusion (in older patients) may also occur.
Most urinary tract infections occur in women who are otherwise healthy; Escherichia coli is the cause of at least 70% of such uncomplicated urinary infections presenting in general practice (Gruneberg 1994). The key risk factors for uncomplicated infections include sexual intercourse, a personal or family history of urinary infection, and the use of a contraceptive diaphragm plus spermicide (DTB 1998). Recurrent cystitis is usually defined as three episodes of urinary tract infection in the previous 12 months, or two episodes in the previous 6 months. Around of half of all women who have an attack of cystitis will experience another within a year (Sen 2007).
Antibiotics such as trimethoprim are used in the treatment of cystitis due to a bacterial infection. General measures to treat urinary infection include drinking more to increase urinary output, and an analgesic or antipyretic for pain or fever. Oral treatments that alkalinise the urine are sometimes used to alleviate symptoms of cystitis (DTB 1998).
Sen A. Recurrent cystitis in non-pregnant women. BMJ Clinical Evidence. Search date April 2007
Gröneberg RN. Changes in urinary pathogens and their antibiotic sensitivities, 1971-1992. J Antimicrob Chemother 1994; 33 (suppl A): 1-8.
Hamilton-Miller JMT. The urethral syndrome and its management. J Antimicrob Chemother 1994; 33 (suppl A): 63-73.
Managing urinary tract infection in women. DTB 1998; 36: 30-2.
Rovner ES et al, 2010. Interstitial cystitis. eMedicine [online]. Available: http://emedicine.medscape.com/article/441831-overview [Accessed: 4th July 2010]
How acupuncture can help
There is little published clinical data on the effects of acupuncture for cystitis. Two controlled trials in Norway with positive results have indicated that acupuncture may be a worthwhile alternative in the prevention of frequently recurring cystitis in women (Aun 1998; Alraek 2002) (see Table overleaf)
Acupuncture may help in the treatment of cystitis by:
- reducing inflammation, by promoting release of vascular and immunomodulatory factors (Kim 2008, Kavoussi 2007, Zijstra 2003);reducing pain and swelling (Lorenzini 2010)
- improving bladder irritation by inhibition of capsaicin-sensitive C-fibre activation (Hino 2010).