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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 17651
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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Chronic cystitis - Any treatment?

Resolved Question:

Chronic cystitis - Any treatment?
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. D. Love replied 1 year ago.
Hello from JustAnswer.
It will help if you could provide some further information.
How long has this been bothering you?
Do you have the results of the most recent urinalysis and urine culture?
Which antibiotics have been used most recently?
Has there been any evaluation to identify any underlying cause of the problem?
Has there been any interventions to try to prevent infection?
Customer: replied 1 year ago.

About 12 years

Yes , held by GP

Augmentin

Tests show various infections but antibiotics do not clear completly and cystitis recurs within a couple of days

Bladder washouts - bladder does not empty fully - am under a Urologist

Also have heart Condition and on warfarin

Expert:  Dr. D. Love replied 1 year ago.
Thank you for the additional information.

It is good that you have seen a Urologist. When someone is having chronic or recurrent cystitis, the usual first step is to identify any underlying conditions that is predisposing the person to the cystitis. If there is an anatomic problem, then surgery may help to correct the anatomic problem, but this is what would have been considered by the Urologist.

If there is a problem with incomplete emptying of the bladder and there is no surgical correction that would be possible, it may be an option to consider intermittent catheterization to accomplish complete emptying, but that is also something that should be considered by the Urologist.

I also have asked these questions because some people can have chronic cystitis that is not a typical infection, a condition called interstitial cystitis. An evaluation by a Urologist, including cystoscopy, would be the usual process for identifying interstitial cystitis.

If no specific intervention is possible, then the next consideration would be to use interventions to prevent infection. Antibiotics are designed to kill the germs, but germs may become resistant to antibiotics, particularly when there has been frequent need for antibiotics. In that situation, it may be better to try interventions to prevent infection. A common intervention is the use of cranberry juice, which works partly by increasing flow and flushing the system and partly because of the composition of cranberry juice. Another intervention that is not as well known is the use of a supplement, D-mannose. D-mannose is a type of sugar that is not metabolised by humans, so passes into the urine and in the urinary tract appears to interfere with the ability of bacteria to attach to the bladder or other urinary structures. D-mannose has been suggested to be used both for treatment and prevention, but the clinical studies indicate that it is far better at preventing infection.

So, at this point, the next interventions to consider would be cranberry juice and/or D-mannose to try preventing infection.

If I can provide any further information, please let me know.
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 17651
Experience: Family Physician for 10 years; Hospital Medical Director for 10 years.
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