What is Cystitis?
Cystitis is an infection of the lower urinary tract characterized by inflammation (called inflammation) of the bladder mucosa. It is one of the most frequent infections in the population and mainly affects women: almost 1 in 2 women experience cystitis problems during their life. Lower urinary tract infections have a recurrence rate of around 20%, even after adequate antibiotic therapy. In some cases, recurrences (relapses) take on very high frequencies, especially in menopausal women. It can be said that a woman suffers from recurrent cystitis
when she presents:
- At least three episodes of acute cystitis in one year
- At least two episodes of acute cystitis in six months
It is essential to underline that recurrent cystitis is not the consequence of a poorly treated acute first attack. In most cases, it is, in fact, a new episode of the disorder.
One of the most frequent complications of cystitis is pyelonephritis, which can manifest itself in particularly severe forms in the elderly, children, and people with low immune defenses. Causes and predisposing factors of cystitis Very often, the origin of cystitis is bacterial, caused by the ascent towards the bladder of pathogens coming from the feces or infectious states of the vagina or urethra.
The factors that predispose to such inflammation are:
- The female sex, because the distance between the urethra and the anus is shorter than in men and also because the use of contraceptive systems, such as spermicidal cream and the diaphragm, favours the onset of cystitis
- The excessive use of antimicrobials in women alters the regular balance of the bacterial flora of the vagina, causing persistent vaginal colonization by uropathogens (e.g., Escherichia Coli)
- Menopause, since the drop in estrogen negatively affects vaginal tropism (loss of tissue elasticity)
- Frequent sexual intercourse
- Pregnancy, due to the numerous anatomical and pathophysiological changes that follow
- Alterations of the urinary tract, also due to congenital malformations
- Diseases of the prostate
- Surgery on the bladder or urogynecological ones
- Urinary incontinence (click here to download the special diet for free)
- The use of bladder catheters
- A difficult urinary outflow caused, for example, by the presence of bladder stones
- Some diseases, such as diabetes (click here to download the special diet for free), acquired immunodeficiency syndrome (AIDS ), or spinal cord injuries
Symptoms and Diagnosis of Cystitis
Cystitis can be asymptomatic (without symptoms), presenting only a high bacterial load in the urine ( bacteriuria ), but, more often than not, the symptoms are specific and include:
- Pollakiuria, i.e., an increase in the number of daily urination
- Dysuria, i.e., difficulty in urinating. In these cases, urination can be slow and not very abundant, requires excessive effort, the pelvic muscles appear contracted, and the stream of urine can be changed in volume or shape (deviated, tortuous, etc.) or suddenly and involuntarily stop
- Stranguria, that is, burning or pain when urinating, often accompanied by a cold shiver
- Bladder tenesmus, that is, the painful spasm followed by the urgent need to urinate
- Cloudy, sometimes foul-smelling urine
Symptoms of chronic cystitis are similar to those listed above but milder.
In more severe cases, cystitis can be accompanied by hematuria (blood in the urine), pyuria (pus in the urine), fever above 38-39 ° C, and nonspecific pelvic pain.
These infections can be diagnosed through a specific urinalysis (urine culture ). Once the bacterium responsible for the disorder has been identified, an antibiotic with particular action on the identified pathogen must be taken (naturally under medical supervision).
Nutrition For Cystitis: General Guidelines
The primary objectives of dietary therapy are to promote the emptying of the bladder, to avoid the stagnation of very concentrated urine that can irritate the bladder and stimulate the proliferation of bacteria, to favor regular intestinal transit, to reduce the number of dangerous bacteria, in preventing irritation of the bladder and in reducing the possibility of harmful (pathogenic) bacteria.
Therefore, based on these assumptions, the power supply must include the following:
- Good daily hydration;
- A reduction in the consumption of simple sugars, which germs feed on
- A reduction in the consumption of saturated fats, which can irritate the bladder
- An increase in the consumption of fiber, which helps regulate the intestine
- Simple cooking methods (without added fat) such as steaming, microwave cooking, on the grill or plate, in a pressure cooker, etc., instead of frying, cooking in a pan, or boiling meat
- A correct distribution of meals, avoiding large dinners
Cystitis: What Foods Should I Avoid?
- Spirits and spirits, including wine and beer, as they are potent irritants of all the mucous membranes of the body, including the bladder
- Coffee, tea, and beverages containing caffeine or other nerve substances (e.g., cola, energy drink, etc.)
- Chili, pepper, curry, paprika, and hot spices in general because they can irritate the mucous membrane of the bladder
- Spicy cheeses
- Sweets and sweets such as chocolate, ice cream, snacks, candies, etc., because simple sugars favor bacterial growth
- Sugary drinks such as tonic water, iced tea, orange soda, etc., but also fruit juices because they naturally contain sugar (fructose) even if they bear the words “no added sugars” on the package;
- Artificial sweeteners (in tablets or included in some yogurts, jams, baked goods, and soft drinks);
- Citrus and strawberry juice, as they can irritate the mucous membrane of the bladder
- Fatty condiments such as butter, lard, lard, margarine, cream, etc., because they can slow down digestion
- Dips and fries;
- Elaborate sauces containing sugar such as mayonnaise, ketchup, mustard, bbq, etc.
- Sausages such as mortadella, sausage, salami, etc.
- Natural and artificial yeasts can favor vaginal infections such as candida and modify the bacterial flora
Cystitis: What Foods Should I Limit?
- Salt. It is good practice to reduce the amount added to dishes during and after cooking and limit the consumption of foods that naturally contain high quantities (canned or brine foods, nuts, meat extracts, soy-type sauces, etc.)
- Meat. It is advisable to favor the one from lean cuts, deprived of visible fat, and cooked with simple cooking methods. Avoid smoked meats
Cystitis: What Can I Eat?
- Unsweetened herbal teas and infusions (e.g., thyme)
- Vegetables. Consume at least one serving of vegetables per meal to ensure the correct intake of vitamins, minerals, antioxidants, and fiber. Choose vegetables low in sodium and potassium, including cauliflower, fennel, carrots, lettuce, broccoli, and spinach. If necessary, supplement your diet with powdered fiber supplements (consult your doctor first)
- Fruit. Consume three fruits daily, preferably with the peel (if edible and well-washed). Vary the quality (colors) as much as possible to properly take in all essential micronutrients. I mainly prefer blueberries, currants, kiwis, and berries because, thanks to the abundant presence of vitamin C, they help strengthen the urinary tract and the immune system. Watermelon and pineapple are fruits indicated in case of cystitis due to their high water intake
- Garlic and onion
- Celery and parsley, by their diuretic action
- Whole grains, preferable to refined ones
- Fresh fish, especially blue fish and salmon, for their high content of Omega-3 polyunsaturated fatty acids
- Fresh cheeses with low-fat content, such as cottage cheese, ricotta, Paciotti, crescenza, etc., or aged cheeses with a lower fat content, such as Grana Padano DOP, which is reduced during processing and therefore is less fat than whole milk with which it is produced. Furthermore, its consumption increases the protein intake at meals ( high biological value proteins, with the nine essential amino acids) and favors the achievement of the daily calcium requirement
- Fermented milk and its derivatives (e.g., yogurt) or lactic ferments in cycles
- Extra virgin olive oil is to be used raw to season dishes and dosed with a teaspoon so as not to exceed in quantities
Cystitis: Practical Advice
- Practice accurate and daily intimate hygiene, to be intensified in women during the menstrual cycle
- The use of linen in synthetic material or trousers that are too tight alters the correct transpiration of the fabrics
- It is advisable to urinate before and especially after sexual intercourse since the urinary flow facilitates the transport to the outside of any bacteria
- Practice regular physical exercise (minimum 150 min per week, optimal 300 min), but avoid activities such as spinning or exercise bikes because they can irritate the bladder mucosa, especially if it is already inflamed
- Do not smoke!
- For dinner, prefer the first course in broth or a vegetable soup, to be flavored to taste with grated Grana Padano PDO
- Timeliness in starting the therapy is essential to accelerate recovery. However, it is necessary to consult the doctor in case the symptoms are doubtful or the treatment does not work
Evaluate with your doctor the possibility of introducing cranberry supplements. Studies have shown that the daily intake of cranberry juice – not to be confused with the more well-known blueberry – can reduce urinary tract infections. However, due to its acidity, this juice is not very pleasant on the palate, and there are no clear indications of the minimum amount of adequate intake. Furthermore, cranberry juice is not recommended for those following anticoagulant therapy with Warfarin or Acenocoumarol due to the risk of interactions.