Management of Cystitis in Children - Types and Causes

What Is Cystitis?

A bladder is a muscular and empty organ that stores urine. It keeps on storing the urine; once it is full, it signals the brain to empty it. Some conditions, such as infections or external factors such as medicine or radiation therapy, can cause cystitis or inflammation of the bladder.

Cystitis is a prevalent urinary tract infection affecting the bladder, and it is generally caused by bacterial infection. It can occur in any part of the urinary tract, such as the kidneys, ureters, bladder, and urethra. It is more commonly seen in females than males; almost 60 percent of females suffer from this condition during their lifetime. Usually, the symptoms are gone by themselves within almost three days; however, sometimes, it needs antibiotic therapy.

What Are the Types of Cystitis?

There are commonly two types of cystitis such as:

• Acute Cystitis: It is a type of cystitis that occurs suddenly, causing sudden inflammation of the bladder.It is commonly known as a urinary tract infection.

• Interstitial Cystitis: It is a severe type of cystitis. A person with this condition can feel pressure on the bladder and pain in the stomach and pelvic region.

Cystitis can also be classified based on duration and treatment:

• Complicated Cystitis: Complicated urinary tract infections can occur at any age and gender in individuals who have functional or structural malformations. Urinary tract infections in elderly males are always treated as complicated. Patients with complicated cystitis usually need a longer duration of therapy compared to patients with uncomplicated cystitis.

• Acute Uncomplicated Cystitis: Acute uncomplicated cystitis patients have an infection in the lower urinary tract and occurs commonly in women and children older than age two years. Acute urinary infections in men are always considered complicated infections. Patients are usually treated with a single antimicrobial regimen of a single dose or a three-day therapy.

• Recurrent or Chronic Cystitis: Various factors, like the use of estrogen, antimicrobials, and immunodeficiency, can cause recurrent urinary tract infections. Patients with recurrent cystitis need prolonged antimicrobial therapy for 6 to 12 months.

Cystitis can also be classified according to the causative organisms.

Bacterial:

• E. coli (80 to 85 percent).

• Proteus Mirabilis.

• Enterococcus faecalis.

• Klebsiella.

• Saprophyticus.

• Staphylococcus.

• Group B Streptococci.

• Staphylococcus aureus.

• Lactobacillus.

• Pseudomonas.

Fungal:

• Candida.

Viral:

• HIV.

• Adenovirus.

• Cytomegalovirus.

• Polyomaviruses.

• Parasite.

• Toxoplasma gondii.

What Are the Causes of Cystitis in Children?

There are many etiological factors behind this condition, such as

• Bacterial infection.

• Constantly and prolonged wearing of dirty diapers.

• Urinary tract infection.

• A side effect of a certain medication.

• Radiation therapy.

• Other conditions such as diabetes, spinal injuries, kidney stones, and enlarged prostate.

What Are the Signs and Symptoms of Cystitis?

There are multiple signs and symptoms associated with this condition, such as

• Burning and tingling sensation during urination.

• Frequent urge to urinate.

• Dark and cloudy urine formation.

• Fussy and cranky child due to pain in the lower tummy.

• Frequent bed wetting.

• Reduced appetite.

• Weakness.

• Fever.

• Confused and agitated behavior.

• Shivers or chills.

• Vomiting.

How to Diagnose Cystitis?

There are a few types of diagnosis of cystitis, such as:

• Cystoscopy: A thin tube is inserted into the bladder with a camera light to check the condition of the bladder. This is also used for tasking the biopsy sample for testing tissue.

• Imaging Test: Imaging tests such as X-rays or ultrasounds can be used to rule out the causes of cystitis, such as tumors or structural issues.

• Urinalysis: It is the first diagnostic method that a doctor uses. When there is abnormal urine formation is seen in a child, doctors take urine samples for urinalysis.

• Urine Culture: It evaluates the type of bacteria causing this condition and which medicine is sensitive to this condition.

What Are the Complications Associated With Cystitis?

There are the following complications related to health that are associated with cystitis:

• Pyelonephritis: It is a kidney infection caused by gram-negative bacteria. The infection spreads through the urethra into the bladder and then the kidneys. If the infection lasts longer, it can cause fatal damage to the kidneys.

• Vesicoureteral Reflex: Instead of urine flowing from the kidneys through the ureters and then into the bladder, the urine flows in the reverse direction. It is an abnormal condition that can lead to kidney damage. There are medicines or surgery options available for the treatment of this condition.

• Sclerosis of the Bladder: Sclerosis is the hardening of the tissue by the overgrowth of fibrous tissue. Due to sclerosis, the bladder loses the nerve connection between the bladder and the urinary sphincter that surrounds the opening of the bladder. This can cause several symptoms, such as urine leakage, frequent urge to urinate, or urine urgency. There are some medications available to treat this condition.

• Perforation of the Bladder Wall: Bladder wall perforation is a very common complication in cases of cystitis. Due to this condition, there are a few symptoms seen, such as stomachache, abdominal distention, and inability to distend the bladder.

• Peritonitis: It is the inflammation of the outer layer of the membrane that covers organs of the abdomen. It is a condition caused by a perforated bladder or an infection.

What Are the Preventive Measures in Cystitis?

There are a few preventive measures that parents can keep in mind to prevent cystitis in their children:

• Make sure the diapers are clean and changed regularly.

• Increase the fluid intake in children so the bacteria can be flushed out of the body.

How to Manage Cystitis in Children?

There are a few treatment options available according to the severity and frequency of cystitis, such as

1. If a child is cranky and constantly crying, parents should ask doctors if they can give painkillers.

2. If the pain and change in urine are there, parents should immediately seek medical attention.

3. Doctors may prescribe urine tests to check for any signs of infection and prescribe medicine accordingly.

4. Usually, the symptoms of cystitis go away on their own, so it is better to wait for at least 48 hours.

5. Keep the child hydrated.

There are some medications that doctors can prescribe according to the age and weight of the child. These medications are

• Nitrofurantoin.

• Amoxicillin.

• Cephalosporins.

• Sulfonamides.

Conclusion

Symptoms of cystitis usually disappear on their own. However, in severe conditions, if the symptoms are persistent, it is best to seek medical attention. This condition can cause damage to the kidneys in its severe form. So, parents should keep an eye on maintaining hygiene and keeping their children hydrated.