What are the causes of cystitis?

Cystitis is an inflammation of the urinary tract (the suffix -itis indicates inflammation, such as gastritis, pharyngitis, tonsillitis, etc.). It is an extremely widespread pathology, so much so that it is second only to respiratory infections (which include classic colds and winter flu).

Cystitis affects adults, children and the elderly. In the fertile age, the subjects most affected are women. During early childhood and old age, however, there are no major epidemiological differences between the two sexes. In fact, the immaturity of the urinary tract in children and the increase in prostatic pathologies in the elderly make the probability of developing cystitis similar between males and females.

Cystitis can have various causes . These are the most frequent:

1. Infectious causes (bacteria, viruses or fungi). In this case we are dealing with a urinary tract infection (UTI).
   
   
2. Inflammatory causes. Bacteria are absent; in this case we speak of abacterial cystitis , that is, an inflammation not caused by pathogenic microorganisms, but by factors that irritate the urinary tract: excessive acidity of the urine, irritating foods or drinks, oxalates and crystals in the urine (which scratch the walls of the bladder and urethra), etc.
   
   
3. Then there are cases in which the presence (even massive) of bacteria in the urine is not accompanied by inflammation. In this case we should NOT speak of cystitis, but of asymptomatic bacteriuria , or the presence of harmless bacteria in the urine, not capable of triggering bladder damage, not capable of triggering symptoms and therefore not need to be treated except in rare cases.
   
   
4. The last class of cystitis includes all those pathologies that are mistakenly classified and treated as cystitis, but which, not being so, do not heal with traditional therapies. In this case the bladder has no problem and the urine is perfect. This last category includes vulvar vestibulitis, pelvic muscle contracture, pelvic neuropathy, pudendal neuralgia, chronic pelvic pain, interstitial cystitis. It may seem incredible, but the majority of "cystitis" belongs to this last category. Unfortunately, the failure to diagnose these pathologies (as frequent as they are unknown to classical medicine) subjects women to continuous and useless antibiotic therapies, to dozens of inconclusive medical visits, to the degeneration and chronicization of a problem that if it were recognized immediately would be resolved in a short time.

The classic path of those who suffer from recurrent cystitis is this: onset of the first cystitis, antibiotic, new cystitis, new antibiotic, weakened immune system, destruction of the beneficial intestinal and vaginal bacterial flora, onset of vaginitis and candida, intake of other antibiotics and antifungals, sensitization of the vulvar and vaginal mucosa, pain during sexual intercourse, new cystitis, new antibiotics, wandering between visits, invasive tests, specialist consultations, wasted money, disappointed expectations, increasingly frequent cystitis, to the point of having constant pain even in the presence of sterile urine.

In fact, a vicious circle is established that feeds on itself and cystitis becomes only a symptom of a lost balance.

An area repeatedly affected by inflammation develops new nerve fibers , responsible for detecting sensations of pain, heat, cold, acid. Consequently, even a minimal stimulus is amplified and what would not hurt in a woman with a healthy bladder, causes pain in someone suffering from recurrent cystitis. Consequently, elements that normally would not be irritating become: an acidic food, a food rich in oxalates, waste products eliminated by the kidney, carbonated drinks, alcohol, cold, concentrated urine, a very low bacterial load, etc. It is for this reason that even in the absence of bacteria, the same symptoms of a urinary tract infection can occur.

Repeated pain and the fear of experiencing it again tend to cause the pelvic muscles to contract as a defensive reaction. Just as pain at the end of urination causes the muscles to tighten, interrupting the flow of urine, in the same way, involuntarily and unconsciously, one tends to constantly contract those muscles. The pelvic floor is like a hammock placed horizontally through which pass the urethra (that “little tube” that connects the bladder to the outside), the vaginal canal, the rectum, the nerves, and the blood vessels.