Coping with cystitis

To minimise the risk of infection, cystitis sufferers should avoid tight trousers, choose stockings rather than tights and wear cotton underpants rather than synthetic materials. Anything likely to irritate the skin such as bubble baths, vaginal deodorants and spermicides (usually used together with condoms and the contraceptive diaphragm) should also be avoided

Take showers in preference to baths and steer clear of Jacuzzis, where a type of bacteria called Pseudomonas proliferates. After going to the toilet, wipe your bottom from front to back and use a bidet if available.

Women who tend to develop cystitis after intercourse should wash before sex and encourage their partner to do the same. They should try to drink water before intercourse and urinate soon afterwards. If the vagina is dry, it is more likely to become inflamed as a result of intercourse, so use a non-perfumed lubricant.

Some people are convinced that diet has an effect on cystitis. Nutritional therapists recommend avoiding caffeine, alcohol, spicy foods and sugars, though doctors are generally sceptical. Cranberry juice or cranberry extract supplements alter the pH balance of the urine and seem to prevent bacteria from sticking to the wall of the bladder. There is good evidence that it can reduce the number of attacks but not that it can relieve an existing infection.

If you have pain on passing water, develop a fever or notice blood in your urine, you should visit your GP. You will be asked to give a mid-stream urine sample and if this reveals an infection, you will be prescribed an antibiotic. (NB when prescribed an antibiotic it is a good idea to also take a probiotic supplement containing digestive bacteria; these help to reduce intestinal side effects such as diarrhoea). If the cystitis persistently recurs, you may be referred to a specialist to ensure that there is no underlying kidney problem.

Some complementary therapies may help relieve urinary tract infections, including cystitis. Nutritional therapist Dr Marilyn Glenville suggests supplements of zinc to help fight infection, lactobacillus acidophilus, a probiotic to help restore healthy bacteria and bromelain, an enzyme derived from pineapples that has anti-inflammatory properties. She also advises taking the herbs uva ursi, golden seal and echinacea short-term.

Sipping a teaspoon of bicarbonate of soda in half a litre of warm water throughout the day makes the urine more alkaline, thus relieving the burning sensation (but do not do this if you also have high blood pressure. Shop-bought or home-made barley water (boil 40g barley in 1200ml water for half an hour, strain and flavour with lemon juice and honey) can have the same effect.