Chronic urologists and patients cautioned against National Institute for Health and Care (NICE) guidelines that discourage primary care physicians from treating or prescribing medications for patients with “mild cystitis.”
A prominent doctor said that when patients are seen as having “mild cystitis,” they are forced to use ineffective over-the-counter medications to treat it, putting them at risk of developing a chronic urinary tract infection (UTI).
For many patients who develop a UTI, their experience is extremely distressing but short-lived. But for thousands of others, a single acute attack turns into a life-saving, chronic infection that lasts for months or even years.
Bladder infection specialist Dr. Kat Anderson said failure to fully evaluate every patient with symptoms of cystitis — however mild — means that recurrent or chronic bladder infections are “going a step further.”
She said I The terms “cystitis” and “urinary tract infection” usually refer to the same thing: cystitis.
“Mild cystitis” is on the list of conditions doctors can no longer prescribe, along with sunburn, head lice, and motion sickness.
This is due to a revision of NICE guidelines in 2018, which barred patients from receiving prescriptions for over-the-counter medicines for a range of minor health conditions.
Dr. Anderson said that over-the-counter medications for “mild cystitis” include alkaline powders, which make urine that comes in contact with the inflamed bladder surface feel comfortable rather than treat the infection itself.
“I think there is a risk that it will make the patient more comfortable to tolerate their symptoms for longer, giving any bacteria present a greater chance of causing an inherent infection,” she said.
NICE guidelines have also been revised in recent years to advise clinicians to consider a 48-hour delay before prescribing antibiotics to women with UTI symptoms – just in case symptoms develop during that time.
Dr. Anderson described these changes as a “terrible setback” that “resulted in lifelong misery for quite a few patients” who eventually develop chronic infections due to a lack of effective treatment.
What is mild cystitis?
Dr. “Mild cystitis,” Anderson said, might mean “people with little increased frequency and less discomfort.”
However, she added, this is a “complex disease area” and that talk of “mild cystitis” in NICE guidelines is “an oversimplification”.
“By the way, they can’t predict which cases will develop into more severe cases.” [cystitis] Provided in the first place.
Some bladder infections are easily resolved with a three-day course of antibiotics, while others are more difficult and require long-term treatment in a specialist clinic.
Can you get cystitis without a urinary tract infection?
Some experts say you can have cystitis without an infection, while others disagree.
There is a condition called bladder pain syndrome or interstitial cystitis, which in theory is cystitis with no infection.
Key experts, including Dr. However, Anderson argues that interstitial cystitis is less common than previously expected, and that “most cases of chronic cystitis are actually a misdiagnosed infection.”
Leah Herridge, an activist who has suffered from a chronic urinary tract infection, said the inclusion of “mild cystitis” in the list of conditions doctors can’t prescribe “degrades” the disease.
The 35-year-old from London said the terms sounded “really dangerous” as it could lead GPs not to take the condition seriously.
“This could affect the way clinicians respond to women with UTIs, possibly decreasing the likelihood of diagnosis and treatment, while increasing the likelihood of recurrence of infection and thus the percentage of women with chronic UTIs,” she said. I†
Ms Heridge also expressed concern that women who develop a urinary tract infection could self-relieve the condition and not seek appropriate treatment until the infection becomes recurrent or chronic.
As part of her campaign, Ms Heridge is asking the government to take women’s health concerns seriously. She said the revision of NICE’s guidance in 2018 was a “step in the wrong direction”.
A spokesperson for the Department of Health and Social Care said: “We are committed to ensuring that everyone has access to the high-quality care they need, regardless of their gender, and plan to update our Women’s Health Strategy later this year. To address gender inequality in health.†
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