Bladder infections can be avoided and their effects reduced if you take this advice, says Barbara Lantin

Around 50 per cent of women suffer from cystitis at some time in their lives and many endure repeated, painful attacks.

Cystitis is an inflammation of the bladder, usually caused by bacteria. The most common symptoms are an overwhelming need to urinate frequently, even when there is very little urine, and an excruciating burning sensation when passing water, which sufferers say feels ‘like passing razor blades’.

Women are more prone than men to the condition because the tube that carries urine from the bladder (the urethra) is much shorter and bacteria do not have so far to travel to get up into the bladder. Also, the opening of the urethra is close to the anus and vagina, where bacteria are present.

Cystitis is not sexually transmitted, but intercourse can provoke an attack by encouraging bacteria to enter the bladder, especially when sexual intercourse if frequent. This is sometimes referred to as 'honeymoon cystitis'. Dehydration is another common cause. ‘If the urine is dilute and the bladder is emptied regularly, bugs are flushed out of the system,’ explains Mrs Helen Parkhouse, a consultant urological surgeon at the London Clinic. ‘But if the urine is concentrated and the bladder is not regularly emptied, it becomes like a stagnant pond and provides the ideal medium for bacteria to proliferate.’

Some women seem more prone to the condition than others and there is evidence that it runs in families. Those who are susceptible can take various precautions. The first and most obvious is to drink plenty of water and urinate regularly. This applies particularly when you are at risk of dehydration – in hot weather, during and after exercise and when travelling on an aeroplane.

‘People do not realise how dehydrating air travel is,’ says Mrs Parkhouse. ‘They tend to avoid drinking on planes because they do not want to go to the toilet, but I advise my patients to take their own bottle of water and to get an aisle seat so that they can keep their system flushed through.’

How to cope

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.