The danger of cystitis lies not only in the painfulness of the symptoms - the lack of appropriate treatment is fraught with complications, especially in women; incorrect selection and use of medications can have life-threatening consequences.
Causes and pathogenesis
A predisposing factor for the development of cystitis in women is the peculiarities of the anatomical structure of their urinary tract - a short, wide urethra, which allows the unhindered penetration of microbes. The anal and vaginal openings located near the urethra increase the risk of infection.
Another physiological feature that influences the frequent development of pathologies in women is a larger bladder volume than in men, which allows them to endure the urge to go to the toilet for a long time. Periodic stagnation of urine leads to the persistence and spread of infection in the organ cavity.
The development of the inflammatory process is promoted by wearing tight or synthetic underwear, which creates the effect of a thermos, as well as lack of personal intimate hygiene and indiscriminateness during sexual intercourse.
Microbes enter the bladder via the ascending (through the urethra) or descending route (through the ureters from the kidneys). Infection with lymph flow from the pelvic organs is possible. Less common, but more likely, is the hematogenous route of infection through distant foci of inflammation - the nasopharynx, carious tooth cavities.
The most common causative agent of the disease is E. coli or streptococci, less often viruses, yeast-like fungi or sexually transmitted infections: gonococci, trichomonas.
Normally, the mucous membrane of the bladder is protected from infection by glycocalyx, a protective substance produced under the influence of female sex hormones. The cavity of a healthy organ is nonsterile - individual cells of pathogenic microflora may be present in it, but the active development of microbes is blocked by the body's immune forces. In addition, the infection is eliminated by periodic flow of urine.
The trigger for the development of acute cystitis can be:
- reduced immunity as a result of hypothermia, ARVI, nervous overstrain, stress, physical fatigue;
- allergies to certain medications;
- Pyelonephritis, urolithiasis, accompanied by impaired urine outflow;
- diabetes mellitus;
- late stages of pregnancy;
- Menopause, a condition of imbalance in female sex hormones.
Cystitis can occur in acute and chronic forms. The latter is the result of improper treatment, persistent renal dysfunction and systemic diseases associated with hormonal imbalance.
Development of acute cystitis
The illness always begins suddenly, most often at night or the next morning after getting wet feet, getting wet in the rain, or sitting on something cold. The symptoms are vivid and painful, you cannot miss them:
- excruciating pain in the lower abdomen above the pubic bone, radiating to the lumbosacral region;
- nocturia – urge to urinate every 10-15 minutes;
- Dysuria – a constant feeling of fullness in the bladder;
- Urine excretion is scanty, difficult, dropwise, accompanied by acute cutting pain, burning and itching;
- the color is cloudy, with flakes, there may be admixtures of pus or blood;
- Weakness, weakness, headache, fever, mild fever or high temperature.
The inflammatory process often affects the urethra and leads to the development of urethritis, in which pain and itching increase.
There can be no question of performance in such a situation. It is best to consult a doctor immediately.
Treatment started in the first hours of the disease increases the chances of getting rid of cystitis forever in a short time.
diagnosis
To treat cystitis, you need to consult a urologist, gynecologist or infectious disease specialist.
A series of tests must be carried out:
- general urinalysis;
- microscopic examination of urine;
- Bacterial culture to determine the sensitivity of the pathogen to antibiotics;
- An ultrasound examination of the bladder is necessary to ensure that there are no changes in the deep submucous and muscular layers of the bladder, polyps and cysts.
Cystitis is indicated by a high leukocyte level – leukocyturia over 2000/ml.
Based on the content of red blood cells and cylindrical formations in the urine, associated problems and factors provoking the development of cystitis can be identified: traumatic kidney damage, urolithiasis, acute and chronic glomerulonephritis, nephropathies, purulent abscesses, toxic lesions of cystitis urinary system, the presenceof viruses.
In addition, a gynecological examination is required - analysis of a vaginal smear for the presence of sexually transmitted infections and pathogenic microflora.
Such a detailed anamnesis helps to reliably identify the causative agent of the inflammation and the degree of damage to the organ tissue.
Treatment with antibiotics
To treat acute infectious cystitis that is not fraught with complications, a course of antibiotics is prescribed for a period of 2 to 7 days. Tetracycline medications based on clavulanic acid from the group of penicillins and fluoroquinolones are used.
The doctor chooses the medication based on the results of pathogen sensitivity tests. Spontaneous taking of medications can only suppress symptoms and contribute to the development of a sluggish inflammatory process. The developed resistance of microbes will complicate further treatment and limit the spectrum of effective drugs.
You cannot independently extend the prescribed duration of taking antibiotics - due to the suppression of the body's normal internal microflora, there is a risk of developing dysbiosis and immunodeficiency states.
In addition to antibiotics, when treating cystitis in women, antispasmodics, analgesics and herbal medicines in tablets and other dosage forms are prescribed to relieve symptoms.
Herbal medicines and nutritional supplements
Complexes based on plant raw materials are non-toxic, have anti-inflammatory, diuretic, choleretic and antimicrobial effects and enhance the effect of antibiotics without disturbing the balance of microflora. They can be taken for a long period of time - from 2 weeks to 1 month during the treatment of acute and chronic cystitis. The selection of funds is quite large:
- Tablets with cranberry extract – a well-known natural antibiotic and diuretic. Cranberry has an astringent and anti-inflammatory effect and accelerates the removal of infections through urine.
- Capsules containing ascorbic acid, cranberry, bearberry and horsetail are intended for the prevention and treatment of cystitis as part of complex therapy;
- herbal remedy for cystitis based on medicinal plants. Available in the form of solutions and dragees with centaury, lovage, rosemary;
- natural complex based on oils from orange, pine, sage and other plants. Available in the form of a thick green paste. Before taking, a small amount of the product should be dissolved in warm water;
- the product, produced in tablet form, contains extracts of hops, peppermint, oregano and fir oil;
- a drug used to treat urolithiasis and prevent cystitis. Contains kidney tea, curly silkworm leaves, papaya, cubeb pepper. Available in capsules and tablets. In addition to its pronounced diuretic effect, the product stops the inflammatory process in the urinary tract, improves its permeability, removes sand and dissolves small kidney stones, and has an antispasmodic and analgesic effect.
Antispasmodics
To relieve pain, relax the smooth muscles of the bladder and facilitate the passage of urine, myotropic antispasmodics are prescribed. The medications relieve severe symptoms and relieve pain and discomfort caused by the contraction of muscle fibers.
A single dose should not exceed 2-3 tablets. An overdose can cause dizziness, drowsiness and reduced blood pressure. Do not forget that an antispasmodic drug only provides temporary relief, but does not cure the disease.
Analgesics
Severe pain, accompanied by fever, fever and weakness, is the reason for prescribing drugs from the group of propionic acid derivatives. The medications used generally have an anti-inflammatory and pain-relieving effect. Side effects are rare but possible. Therefore, before taking any medication, be sure to check its safety by speaking to your doctor. Contraindications to taking products containing propionic acid derivatives are severe renal and liver failure, pregnancy and early childhood under 6 years of age.
Probiotics
To prevent dysbiosis and diseases of the gastrointestinal tract while taking antibiotics, drugs are used that contain natural complexes of lactobacilli and bifidobacteria - probiotics. The products have been proven to protect and restore the microflora of the female genital organs, strengthen local immunity and reduce the undesirable consequences of antibiotic treatment. There are few contraindications to taking probiotics – hypersensitivity to the components of the medication or an allergic reaction.
For uncomplicated acute cystitis, treatment with dry and moist heat is effective. Warm steam and sitz baths with a decoction of St. John's wort or yarrow are useful: For a steam bath, a hot herbal decoction is poured into a basin. You need to squat over the steam coming out and sit for 10-15 minutes. The steam should be warm, but not boiling. With a sitz bath, a decoction of medicinal herbs is added to water at a temperature of around 45 °C.
When resting, you can place a warm heating pad on the lower abdomen - at the location of the bladder.
Thermal treatments stimulate the exchange between the tissues and have a relaxing, pain-relieving and antispasmodic effect.
Warming is permissible only if there are no inflammatory processes in the genital organs, otherwise such treatment can lead to additional damage.
Additional treatments
Bladder massage techniques can be used as additional treatment.
- While lying on your back, bend your knees slightly (you can place a pad or pillow under your back).
- Place the fingertips of both hands on your stomach 2-3 fingers below the navel.
- As you exhale, press gently and deeply on the abdominal wall until you feel a slight pain inside. After a few seconds, release your hands and press your stomach again. Do 5 or 6 reps.
The movements are aimed at eliminating diuresis delays and congestion and accelerating blood circulation in the bladder area. If the massage is done correctly, there will be a strong urge to go to the toilet after the massage is completed.
During treatment for a bladder infection, you will need to drink more fluids than usual to flush the bladder. In addition to clean drinking water, it is useful to drink slightly alkaline mineral water without gas, fruit drinks made from cranberries, black and red currants, cherries, sea buckthorn and other berries. Acidic drinks have an antimicrobial effect, prevent infections from remaining on the organ walls and accelerate the removal of inflammatory products from the bladder cavity.
Decoctions and infusions from seeds and herbs of dill, chamomile, parsley, cranberry leaves and millet have a strong diuretic and anti-inflammatory effect. To prepare it, 2 tablespoons of crushed raw materials are poured into 1 liter of boiling water, simmered in a water bath for 15 minutes and left to stand for about an hour. The liquid is carefully filtered and drunk warm, 1 glass three times a day.
If there is insufficient kidney function, a tendency to high blood pressure or hypotension, diuretic drinks should be used with caution.
During the treatment of cystitis, it is necessary to exclude hot spices, pickled and salty foods, confectionery, carbonated sweet drinks, strong coffee and alcohol from the diet. These products impair the excretory function of the kidneys, promote the accumulation of uric acid and irritate the urinary tract.
Chronic cystitis
Premature initiation or incorrect and negligent treatment of acute cystitis leads to an advanced chronic form with periodic relapses. Chronic cystitis is a long-term illness. Periods of remission or a sluggish inflammatory process, during which the disease is practically not noticeable, alternate with a sharp exacerbation of symptoms.
The danger of chronic cystitis lies not only in the severe discomfort and pain that occurs during exacerbations. A focus of inflammation existing in the bladder for a long time affects the deep layers of the organ and contributes to the formation of stubborn morphological forms of the disease: interstitial, cystic, hemorrhagic, gangrenous cystitis, polypoid growths. The inflammatory process affects not only the mucous membrane, but also the submucosa layer, muscle tissue and the circulatory system of the organ. Gradually, the affected areas are replaced by rough scar tissue, the organ loses its elasticity and can no longer perform its functions properly.
In addition, the inflammatory process can spread to neighboring organs and lead to the development of paracystitis - damage to perivesical tissue, pyelonephritis. The gradual spread of infection can lead to the development of adnexitis, adhesions of the fallopian tubes and subsequent infertility.
In pregnant women, an exacerbation of the chronic process is inevitable, it is influenced by changes in hormonal levels, fluctuations in immunity, compression of internal organs by the growing uterus, which additionally leads to stagnation of urine and an inflammatory process. The most serious complication of cystitis in pregnant women is acute pyelonephritis with severe intoxication of the body and the threat of miscarriage.
Treatment of complicated forms of cystitis takes place in a hospital. In addition to taking medication, the following forms of therapy can be prescribed:
- Instillation - the introduction of medicinal solutions into the bladder cavity that flush out toxins and have an anti-inflammatory effect;
- Physiotherapy – treatment with electrical current pulses, iontophoresis, UHF, mud applications, acupuncture;
- Positional therapy – special poses that help eliminate constipation and restore patency of the urinary tract. The method is suitable for pregnant women;
- surgical treatments – laser cauterization or removal of affected bladder tissue. In severe cases of complete loss of function of the organ, they resort to plastic surgery of the bladder from their own intestinal tissue.
The treatment period for chronic cystitis is several months. The course is aimed at eliminating the inflammatory process, preventing complications, maximizing the restoration of the urinary system and preventing irreversible changes in the structure of organ tissue.
Basic measures to prevent cystitis: maintaining good hygiene, wearing underwear made of natural fabrics, choosing shoes and clothes according to the weather and season, timely treatment of colds and chronic diseases, taking general strengthening vitamin complexes.