Cystitis is inflammation of the bladder. This organ is designed for the accumulation and excretion of urine, but when the lining of the organ is damaged, its function suffers and the person begins to experience uncomfortable symptoms. In most cases, the pathology affects only the mucous membrane, but sometimes the inflammatory process extends to muscle tissue as well. Interstitial cystitis is the most difficult to treat.
The disease mainly affects women, which is related to the anatomical features of the urethra. Inflammation rarely occurs in men, most often acts as a comorbidity against the background of chronic prostatitis.
symptoms
The signs of cystitis are fairly obvious, and it's difficult not to notice them. As a rule, the disease begins acutely, which is why patients pay attention to obvious discomfort in the urinary tract. Among the manifestations of pathology note:
- frequent urge to urinate;
- feeling of incomplete urination;
- cramps and pain when urinating;
- increase in body temperature;
- the appearance of an admixture of blood in the urine;
- cloudy urine (due to the presence of pus);
- Nausea, drawing pains as during menstruation.
Despite the characteristic symptoms, the disease can show different manifestations. Hematuria is not always present, but the intensity of the pain can resemble only a mild discomfort. In any case, if signs of pathology appear, it is necessary to consult a doctor in order to make a diagnosis as early as possible. The disease is best treated early in the acute phase, but the chronic form takes longer to fight.
Forms and types of chronic cystitis
By the nature of the inflammatory process, cystitis is acute and chronic. Depending on the source of its origin, the disease can be primary (an independent disease) or secondary (inflammation spreading from neighboring areas, such as the kidney).
Depending on the area of \u200b\u200bthe damage to the bladder mucosa, cystitis occurs:
- total (general);
- Main emphasis.
The following clinical forms of cystitis are distinguished:
- catarrhal - non-purulent inflammation of the mucous membrane of the bladder;
- phlegmonous - purulent lesion of the submucosal layer;
- granulomatous - accompanied by rashes on the mucous membrane;
- hemorrhagic, which is characterized by the release of blood in the urine;
- interstitial cystitis - inflammation spreads to all layers of the organ.
A number of rare forms are also distinguished: ulcerative, cystic, gangrenous cystitis.
The whole variety of inflammatory diseases of the bladder is summarized in two large groups:
- specific cystitis caused by causative agents of sexual infections: gonococci, ureaplasma, chlamydia.
- nonspecific cystitis - develop through the fault of opportunistic flora, representatives of which do not lead to disease under normal conditions (e. g. E. coli).
Finally, non-infectious cystitis is combined in a separate group. They can appear under the influence of allergic factors, radiation, traumatic, thermal effects, toxins from parasites.
Causes of cystitis
In most cases, damage to the bladder and the development of the inflammatory process is associated with the penetration of an infection, but cystitis can be toxic and allergic. When infection occurs, the disease is transmitted in several ways:
- ascending - from the urethra through the urethra - affects the bladder;
- descending - in this case the infection occurs due to inflammation of the kidneys, reaches the bladder through the ureters;
- lymphogenous - due to the flow of lymph through the pelvic organs in lesions of the genital organs;
- hematogenous - the infection enters with the bloodstream, but this route of spread is the rarest;
- direct - when an abscess ruptures in the bladder and pathogenic microflora penetrates directly into the bladder cavity, this can also occur during catheterization of an organ or infection during surgery.
Most often, E. coli provokes cystitis. It occurs in 80-95% of cases with uncomplicated pathology. This bacterium is usually found in the rectum, but when it penetrates the urethra, it provokes an inflammatory process. Enterobacteria, staph, fungi, and sexually transmitted infections can also cause the disease. Usually, symptoms of vaginitis or bacterial vaginosis precede the onset of symptoms, and you may also notice symptoms of the disease within a day of intercourse (postcoital cystitis).
Factors contributing to the development of cystitis
The body with good immunity can cope with the presence of pathogenic microflora, so the symptoms of cystitis do not appear in the patient. But when exposed to some factors, it manifests itself:
- injury to the mucous membrane of the bladder;
- circulatory disorders of the pelvic organs;
- hypothermia;
- the presence of other foci in the body, such asB. Kidney infections;
- decrease in the body's defenses;
- inflammatory diseases of the genital organs;
- lack of vitamins and minerals in the body;
- hormonal imbalance;
- poor hygiene, wearing synthetic underwear;
- stress and overwork;
- delayed bladder emptying.
In the presence of these factors, cystitis will quickly progress, and chronic pathology will go to the stage of relapse. Therefore, in order to prevent relapses, it is necessary to exclude the influence of provoking factors on the body.
Causes of the transition from acute inflammation to the chronic phase
The inflammatory process in the bladder can be triggered by various pathogens. Most often it is bacterial, but there are cystitis and viral, fungal etiology. If the acute form of the disease is diagnosed in a timely manner, the correct treatment of cystitis is prescribed, and the patient follows all the doctor's recommendations, then the pathological process can be completely eliminated and recovery will come.
But often women postpone visiting the doctor and try to treat cystitis themselves, hoping that everything will go away on its own. This wastes valuable time. Microorganisms are actively multiplying, the intensity of inflammation is increasing. Once fully "seated" in the bladder, microbes will not give up their position easily. The inflammation becomes chronic.
It is also common for a specialist to prescribe a bladder infection, the patient starts taking medication and stops therapy at the moment when she feels relieved. As a result, pathogens are not completely destroyed, and the survivors divide - chronic cystitis develops, resistant to antibiotic therapy.
Finally, the following circumstances contribute to the development of chronic cystitis:
- general decrease in immune defense, hypothermia;
- hormonal changes (pregnancy, menopause);
- neglect of the rules of personal hygiene;
- gynecological diseases;
- chronic diseases of other organs and systems: diabetes mellitus, malignant tumors.
Signs of chronic cystitis
In today's medical community, the term "chronic cystitis" is outdated. It is used "in the old-fashioned way" to improve communication with patients. A sluggish inflammatory process in the bladder is called recurrent cystitis. Its main symptom is developmentof 2 or more exacerbations within 6 months or 3 episodes per year.
The period of exacerbation is accompanied by characteristic symptoms:
- frequent urination;
- pain, burning, painful urination;
- night calls;
- Feeling of incomplete emptying, pain in the lower abdomen.
Exacerbation of the disease can be accompanied by a moderate increase in body temperature, the appearance of blood in the urine and its turbidity.
During the period of remission, the symptoms can be completely smoothed out. But more often, patients suffer from discomfort during urination and periodic moderate pain for years.
The most serious consequence of recurrent cystitis is the development of resistance (resistance) of pathogens to antibacterial drugs and the subsequent degeneration of the bladder mucosa. The mucosal epithelium undergoes cicatricial deformation or is replaced by a stratified squamous epithelium. At this stage, chronic cystitis can no longer be cured with antibiotic therapy alone. It is necessary to carry out special medical procedures.
Acute and chronic cystitis: treatment approaches
Treatment of acute and chronic forms of pathology is different. Usually, acute cystitis is much easier to treat, since the pathology is provoked by microorganisms, against which the doctor prescribes antibiotic therapy. Antibacterial drugs are very different. They quickly help to stop an attack of the disease, and the systematic use of funds leads to a complete cure from cystitis. Fosfomycin-based preparations perfectly cope with inflammation.
Chronic inflammation is more difficult to treat because it is complicated by other disorders. Complex treatment of long-term developing cystitis is carried out using several groups of drugs. Antibiotics remain leaders, but the doctor will also prescribe anti-inflammatory drugs, vitamins and reparants. For the prevention of infection and to consolidate the effect of therapy, the patient is prescribed herbal remedies, courses of physiotherapy.
cystitis in women
Most often, cystitis in women is accompanied by an exacerbation of chronic inflammation, therefore, according to statistics, every second patient twice a year consults a doctor with a recurrent disease.
This speaks not so much of the difficulties in treating the disease as of the need for careful adherence to doctor's prescriptions and elimination of factors provoking the disease.
Cystitis after sexual intercourse
Postcoital cystitis in women is provoked by urogenital anomalies. If it is shifted down and into the external opening of the urethra, it becomes more susceptible to the penetration of pathogenic microflora. Also to blame for postcoital cystitis is an overly flexible urethra, which shifts slightly when the penis is rubbed. In this case, the mucous membrane is easily irritated, and pathogenic microorganisms penetrate into the opening of the urethra. Symptoms and treatment of this form of pathology are interconnected, so doctors approach the issue individually in each clinical case.
Also, the cause of cystitis is the alternation of anal sex with vaginal sex, which is absolutely impossible, since the microflora of the rectum goes directly into the vagina and adjacent urethra. A factor in the development of bacterial infections is the introduction of microbes by hand, insufficient secretion of vaginal mucus, which causes microcracks.
The symptoms of postcoital inflammation do not differ, but the patient can notice their occurrence directly in connection with sexual intercourse - usually discomfort appears already in the first 12 hours.
Treatment of postcoital cystitis is individual, since first of all it is necessary to determine the cause of the disease and precisely target therapy. If there is an abnormality in the urethra, the doctor will suggest plastic surgery, which will make the problem go away. Both surgery and injection of hyaluronic acid are possible. If an STI infection occurred during an intimate relationship, then antibacterial drugs are required, followed by the restoration of the vaginal microflora.
What does blood in the urine say
The appearance of blood in the urine indicates the development of acute hemorrhagic cystitis. It does not appear at the end, but accompanies the entire process of urination. The presence of erythrocytes gives the urine its pink color. Urine can also have the color of "meat shavings", that is, have a brownish color if there are threads of mucus, threads or brown flakes.
Usually, when urinating with blood, there is severe pain, pain in the bladder, and a tightening in the lower back. The appearance of blood in the urine is a compelling reason to consult a doctor.
Cystitis during menstruation
In some women, against the background of hormonal changes during menstruation, there is an exacerbation of cystitis. During menstruation, the pelvic organs are most susceptible to infection, so the following can provoke the disease:
- inflammatory diseases of the female genital organs;
- hormonal fluctuations;
- allergic reaction to intimate hygiene products;
- decrease in the body's defenses;
- non-compliance with personal hygiene;
- non-specific infections, mycoses, sexually transmitted diseases.
Under the influence of these factors, the pathogen penetrates into the urethra and urethra, causing inflammation. Usually exacerbation of the disease occurs during ovulation, as well as 1-2 days before the onset of menstruation. Vaginal discharge becomes an excellent breeding ground for pathogenic microflora. Symptoms of cystitis during menstruation are typical, but are complicated by characteristic manifestations during menstruation - aching and pulling pains in the lower abdomen.
The doctor can determine the cause of the pathology after taking an anamnesis and examining the results of laboratory diagnostics. The treatment regimen is standard, but concomitant treatment of gynecological pathologies may be required if genital infections are diagnosed. It is important to observe personal hygiene, strengthen the immune system.
pregnancy and cystitis
According to the results of the studies, doctors noted that asymptomatic bacteriuria is detected even before pregnancy, therefore the disease manifests itself during pregnancy. The reasons for this are:
- Changes in the hormonal background and the ratio of progesterone and estrogen in the body of the expectant mother;
- Violations of urodynamics with an increase in the size of the uterus;
- Weakening of the ligament apparatus, greater mobility of the organ, but a decrease in its peristalsis and tone;
- Enlargement of the renal pelvis due to increased blood flow in the pelvis.
The latent course of pathology makes early detection difficult. Cystitis during pregnancy can also be treated with antibiotics. The doctor will prescribe the names of drugs and dosages of drugs that are safe for the fetus.
diagnostic methods
The symptoms of cystitis are very characteristic, but the doctor will still prescribe a series of tests to finally find out the causative agent of the pathology and determine the nature of the course of the disease. The specialist takes an anamnesis, analyzes the patient's complaints and performs an external examination with palpation of the bladder zone. The following diagnostic methods are used:
- echoscopy - ultrasound allows you to determine the degree of the inflammatory process and its prevalence, as well as assess the condition of the urinary system and genital organs.
- cystoscopy - examination of the organ with an endoscope, which allows you to assess the condition of the bladder mucosa;
- Cystography - an examination of the bladder using a contrast medium.
In women, treatment should begin with the definition of the causative agent. A set of laboratory tests is mandatory: general urinalysis, Nechiporenko analysis, bacteriological culture, tissue biopsy, polymerase chain reaction (for more accurate determination of the causative agent). To assess the degree of the inflammatory process, doctors can send a blood test. If there is a suspicion of inflammatory diseases of the female genital organs, an examination by a gynecologist and carrying out the tests prescribed by him may be necessary.
treatment methods
With inflammatory diseases of the organ, doctors resort to therapeutic and surgical methods of treating the pathology. In most cases, it is possible to get rid of the disease with properly formulated drug therapy with additional physical therapy.
Drug treatment, depending on the nature of the disease, includes a combination of different groups of effective drugs. The patient can be given:
- anti-inflammatory drugs - serve to relieve swelling of the mucous membrane and eliminate pain, the inflammatory process is reduced;
- Antispasmodics - used to relieve pain symptoms, effectively eliminate spasms of the bladder;
- antibacterial therapy - a group of drugs that act directly on the causative agent of pathology;
- Antifungal drugs - recommended when cystitis is provoked or complicated by a fungus (for example, with a combined course of bacterial-fungal infection);
- Phytopreparations - medicines in tablet and other forms with antimicrobial and anti-inflammatory properties.
In some cases, doctors prescribe instillations of drugs to the patient instead of oral administration. Bladder lavage is performed in the clinic. With the help of a special catheter, the desired concentration of the drug is administered, which cannot be achieved in any other way. Before the procedure, the patient must defecate so that the drug acts on the mucous membrane for as long as possible.
Surgical treatment is used only in rare cases, when the inflammatory process provoked anatomical changes or with severe recurrent infections. In this case, laser correction is performed. For example, for many women with postcoital cystitis, the only treatment option is distal urethral transposition.
Diet in the treatment of cystitis
It is imperative to follow a diet, since spicy and salty foods contribute to the appearance of ulcers on the mucous membrane. Other products are irritants that interfere with recovery:
- foods high in sugar;
- citrus fruits, acidic foods, fermented;
- Spices;
- Tomatoes and all dishes with tomatoes, additives (ketchups, sauces, adjika);
- soy sauce and vinegar;
- nuts and chocolate.
To speed up recovery, the patient is recommended a light and nutritious diet. It is necessary to exclude fried foods, smoked meats, marinades, fatty foods. It is best to steam, stew or boil. Eliminate all foods that can cause allergies.
A cystitis attack can also be provoked by heavy eating, which causes the patient to suffer from constipation. With stagnation of fecal masses, intestinal peristalsis worsens, stagnation occurs in the bladder, as a result of which the mucous membrane becomes irritated again. Due to the high protein content, you should not eat too much meat, fish, beans and cheese. Replace them with high-fiber foods - vegetables and permitted fruits.
During treatment, try to eat at home, cook for yourself and do not add any new food or dishes to the menu. Remember that the diet completely excludes alcoholic beverages, and also limits coffee and tea. Juices, infusions and decoctions of herbs, fruit drinks and compotes are useful. It is better to replace ordinary water with slightly alkaline mineral water.
physical therapy
Among the methods of treating the disease, physiotherapy is widely used. As a rule, it is recommended at the stage of recovery, when acute cystitis is eliminated and there is a positive tendency to recovery. Physiotherapy is also effective for submucosal localization of the causative agent of pathology when antibacterial drugs do not have the right effect. Physiotherapy uses:
- phonophoresis;
- electrophoresis;
- magnetotherapy;
- UHF;
- modulated currents.
The session does not last long, but it takes 10-15 treatments to get the effect. Effective treatment of cystitis in a combined way will help to completely get rid of the disease.
question answer
How long does a bladder infection last?
The duration of cystitis depends on the form of the pathology. The acute one lasts 7-10 days, after which, with proper treatment, recovery occurs, but the chronic form of the disease can last several months, remembering periods of exacerbation.
Is it possible to visit a bath or hot shower with cystitis?
A hot shower or bath really helps with spasms and pain, but these thermal effects are contraindicated in cystitis, as it contributes to the aggravation of the inflammatory process.
Which doctor to contact and which analyzes to submit?
Women with suspected cystitis should contact a family doctor, men a urologist. If necessary, the patient can be referred to a gynecologist for examination. Tests - urinalysis, blood test and ultrasound or cystoscopy.
How does age affect the course of the disease?
Most often, cystitis occurs in women aged 20-45 years, which is associated with active sexual activity, unstable hormonal levels and a higher risk of developing gynecological pathologies. In older women, the pathology occurs less often and is associated with a weakened immune system.
Can chronic cystitis be cured?
Like any other chronic disease, cystitis occurs with periods of exacerbation and remission. It is difficult to completely cure the disease, but with the right treatment, you can achieve stable and very long remission without symptoms of the urinary system.
Do I need a special diet if there are signs of a bladder infection?
Yes, during the period of exacerbation of the disease, patients are recommended to follow a diet with the exception of salty, spicy, irritating foods. Despite frequent urination, you should not restrict yourself to fluid intake. You can drink up to 2 liters of pure water, compote, weak tea. But alcohol and coffee in the acute stage are prohibited.
What features should be considered when choosing a uroseptic?
Let's start with the fact that choosing the drug and appointing a regimen of antibiotics is only a task for a specialist: a urologist, nephrologist, therapist. It is unacceptable to stop treating cystitis on your own or to change the remedy.
The use of tetracyclines, cephalosporins in cystitis quickly leads to resistance of pathogens. Therefore, drugs from these groups are practically not used to treat cystitis. Doctors prescribe ampicillins, fluoroquinolones, and various combinations of uroseptics. Herbal uroseptics are also widespread, the main advantage of which lies in good tolerability and the almost complete absence of contraindications. Preparations from this group can be used to treat pregnant and lactating mothers.
The doctor individually selects a uroseptic and analyzes the data of each clinical case. To determine the sensitivity of pathogens to a specific antibiotic, a special study is carried out - a bacteriological analysis of urine with inoculation on nutrient media.
How to treat cystitis yourself at home and can it be done?
When symptoms of cystitis appear, it is necessary to consult a urologist, nephrologist or family doctor as soon as possible. Only a specialist can correctly assess the features of the clinical picture, conduct a comprehensive examination, make a correct diagnosis and prescribe the necessary treatment.
But patients are often confronted with the fact that a doctor's appointment is scheduled for a certain time and the pain now needs to be relieved. To reduce the progression of the pathological process, observe the drinking regime - drink about 2 liters of water, compotes, fruit drinks. Hypothermia is a common cause of exacerbation of the disease, so it is worth dressing warmly and protecting yourself from drafts.
Also, try to avoid overexertion. Rest (physical and sexual) will help to wait for an appointment with a specialist. It is undesirable to take analgesics and antispasmodics yourself without extreme need - they can "smear" the clinical manifestations of the disease, and it will become more difficult for the doctor to make a correct diagnosis.