The danger of cystitis lies not only in the pain of the symptoms: the lack of adequate treatment is fraught with complications, especially in women; Improper selection and use of medications can have life-threatening consequences.
Causes and pathogenesis.
A predisposing factor in the development of cystitis in women is the peculiarities of the anatomical structure of their urinary tract: a short and wide urethra, which allows access to free penetration of microbes. Anal and vaginal openings located near the urethra increase the risk of infection.
Another physiological characteristic that influences the frequent development of pathology in women is the larger volume of the bladder than in men, which allows them to endure the urge to go to the bathroom for a long time. Periodic stagnation of urine causes the persistence and proliferation of infection in the cavity of the organ.
The development of the inflammatory process is facilitated by the use of tight or synthetic underwear, creating the effect of a thermos, as well as the lack of personal intimate hygiene and the lack of indiscrimination in sexual relations.
Microbes enter the bladder by the ascending (through the urethra) or descending (through the ureters from the kidneys) route. Infection is possible with lymph flow from the pelvic organs. More rare, but probable, is the route of hematogenous infection from distant foci of inflammation: the nasopharynx and dental caries.
The most common causative agent of the disease is E. coli or streptococcus, less often - viruses, yeast-like fungi or sexually transmitted infections - gonococci, trichomonas.
Normally, the mucous membrane of the bladder is protected from infections by the glycocalyx, a protective substance that is produced under the influence of female sex hormones. The cavity of a healthy organ is not sterile: individual cells of pathogenic microflora may be present in it, but the active development of microbes is blocked by the body's immune forces. Additionally, the infection is eliminated by the periodic flow of urine.
The impetus for the development of acute cystitis can be:
- decreased immunity as a result of hypothermia, ARVI, nervous overstrain, stress, physical fatigue;
- allergies to certain medications;
- pyelonephritis, urolithiasis, accompanied by impaired urine flow;
- diabetes;
- late stages of pregnancy;
- menopause, a state of imbalance of female sex hormones.
Cystitis can occur in acute and chronic forms. The latter is the result of inadequate treatment, persistent kidney dysfunction and systemic diseases associated with hormonal imbalance.
Development of acute cystitis.
The illness always begins abruptly, most often at night or the next morning after getting your feet wet, getting wet in the rain, or sitting on something cold. The symptoms are vivid and painful, it is impossible not to notice them:
- persistent pain in the lower abdomen above the pubis, radiating to the lumbosacral region;
- nocturia: need to urinate every 10 to 15 minutes;
- dysuria - a constant feeling of fullness of the bladder;
- urine production is poor, difficult, drop by drop, accompanied by sharp cutting pain, burning and itching;
- the color is cloudy, with scales, there may be mixtures of pus or blood;
- weakness, weakness, headache, fever, low-grade fever, or high temperature.
The inflammatory process often affects the urethra, resulting in the development of urethritis, in which pain and itching intensify.
In such a situation one cannot talk about performance. The best thing you can do is consult a doctor immediately.
Treatment started in the first hours of the disease increases the chances of getting rid of cystitis in a short time forever.
Diagnosis
To treat cystitis, it will be necessary to consult a urologist, gynecologist or infectious disease specialist.
It will be necessary to carry out a series of tests:
- general urine analysis;
- microscopic examination of urine;
- bacterial culture to determine the sensitivity of the pathogen to antibiotics;
- Ultrasound of the bladder is necessary to ensure that there are no changes in the deep submucosal and muscular layers of the bladder, polyps or cysts.
Cystitis is indicated by a high level of leukocytes (leukocyturia greater than 2000/ml).
Depending on the content of red blood cells and cylindrical formations in the urine, it is possible to identify problems and associated factors that provoke the development of cystitis: traumatic kidney damage, urolithiasis, acute and chronic glomerulonephritis, nephropathies, purulent abscesses, toxic lesions of the urine. urinary system, the presence of viruses.
Additionally, a gynecological examination is necessary - analysis of a vaginal smear for the presence of sexually transmitted infections and pathogenic microflora.
Such a detailed history will help to reliably identify the causative agent of inflammation and the degree of damage to the organ tissue.
Antibiotic treatment
For the treatment of uncomplicated acute infectious cystitis, a course of antibiotics is prescribed for a period of 2 to 7 days. Tetracycline drugs based on clavulanic acid, from the group of penicillins and fluoroquinolones, are used.
The choice of the drug is made by the doctor based on the results of tests for sensitivity to pathogens. Spontaneous use of medications can only suppress symptoms and contribute to the development of a slow inflammatory process. The developed resistance of microbes will complicate further treatment, reducing the range of effective drugs.
You cannot independently extend the prescribed period for taking antibiotics; Due to the suppression of the normal internal microflora of the body, there will be a danger of developing dysbacteriosis and immunodeficiency states.
In addition to antibiotics, in the treatment of cystitis in women, antispasmodics, analgesics and herbal medications in tablets and other dosage forms are prescribed to relieve symptoms.
Herbal medicines and dietary supplements.
Complexes based on plant raw materials are non-toxic, have anti-inflammatory, diuretic, choleretic and antimicrobial effects and improve the effect of antibiotics without disturbing the balance of the 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 choice of funds is quite wide:
- tablets containing cranberry extract, a well-known natural antibiotic and diuretic. Cranberry has an astringent and anti-inflammatory effect, accelerating the elimination of infection 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, containing centaury, celery, rosemary;
- Natural complex based on orange, pine, sage and other plant oils. Available in the form of a thick green paste. Before ingestion, a small amount of the product should be dissolved in warm water;
- the product, made in the form of tablets, contains extracts of hops, mint, oregano and fir oil;
- a medicine intended for the treatment of urolithiasis and the prevention of bladder infections. Contains kidney tea, curly silkworm leaves, papaya and cubeba 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 acts as an antispasmodic and analgesic.
Antispasmodics
To relieve pain, relax the smooth muscles of the bladder and facilitate the passage of urine, myotropic antispasmodics are prescribed. The drugs relieve severe symptoms, reduce pain and discomfort caused by contraction of muscle fibers.
A single dose should not exceed 2-3 tablets. An overdose can cause dizziness, drowsiness, and a drop in blood pressure. Do not forget that an antispasmodic provides only 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 drugs used have a general anti-inflammatory and analgesic effect. Side effects are rare but possible, so be sure to check its safety by talking to your doctor before using medications. Contraindications to taking products containing propionic acid derivatives include severe kidney and liver failure, pregnancy, and childhood under 6 years of age.
Probiotics
To prevent dysbacteriosis and disorders of the gastrointestinal tract while taking antibiotics, drugs containing natural complexes of lactobacilli and bifidobacteria (probiotics) are used. The products have proven effective in protecting and restoring the microflora of the female genital organs, strengthening local immunity and reducing the undesirable consequences of antibiotic treatment. There are few contraindications to taking probiotics: hypersensitivity to the components of the drugs or an allergic reaction.
For uncomplicated acute cystitis, dry and moist heat treatment 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 container. You need to crouch over the steam emanating from it and sit for 10 to 15 minutes. The steam should be warm, but not boiling. For sitz baths, a decoction of medicinal herbs is added to the water at a temperature of about 45 °C.
At rest, you can apply a warm heating pad to your lower abdomen at the location of your bladder.
Thermal procedures stimulate the exchange between tissues and have a relaxing, analgesic and antispasmodic effect.
Warming is allowed only in the absence of inflammatory processes in the genital organs; Otherwise, such treatment may cause additional damage.
Additional treatments
Bladder massage techniques can be used as an additional treatment.
- In a reclining position on your back, bend your knees slightly (you can place a cushion or pillow under your back).
- Place the fingertips of both hands on your stomach, 2 or 3 fingers below your navel.
- Exhaling, gently and deeply press the abdominal wall until you feel a slight pain inside, after a few seconds release your hands and press the stomach again. Do 5 or 6 repetitions.
The movements are aimed at eliminating delays in diuresis, congestion and accelerating blood circulation in the bladder area. If the massage is done correctly, once it is finished you will feel a strong urge to go to the bathroom.
During cystitis treatment, it is necessary to drink more fluid than usual to flush the bladder. In addition to drinking water, it is useful to drink still slightly alkaline mineral water, fruit drinks based on cranberries, black and red currants, cherries, sea buckthorn and other berries. Acidic drinks have an antimicrobial effect, prevent infection from persisting in the walls of the organ and accelerate the removal of inflammatory products from the bladder cavity.
Decoctions and infusions of seeds and herbs of dill, chamomile, parsley, lingonberry leaves and millet have a high diuretic and anti-inflammatory effect. To prepare them, 2 tablespoons of crushed raw materials are poured into 1 liter of boiling water, simmered for 15 minutes in a water bath and left for about an hour. The liquid is carefully filtered and consumed warm, 1 glass 3 times a day.
Diuretic drinks should be used with caution in cases of insufficient kidney function, tendency to hypertension or hypotension.
During the treatment of cystitis, it is necessary to exclude spicy seasonings, pickled and salty foods, sweets, sweet carbonated drinks, strong coffee and alcohol from the diet. These products interfere with the excretory function of the kidneys, promote the accumulation of uric acid and irritate the urinary tract.
chronic cystitis
Untimely onset or incorrect and careless treatment of acute cystitis leads to an advanced chronic form with periodic relapses. Chronic cystitis is a long-term disease. Periods of remission or a slow inflammatory process, during which the disease practically does not make itself felt, alternate with a sharp exacerbation of symptoms.
The danger of chronic cystitis lies not only in the intense aches and pains that occur during exacerbations. A long-existing focus of inflammation in the bladder affects the deep layers of the organ, contributing to the formation of untreatable morphological forms of the disease: interstitial, cystic, hemorrhagic, gangrenous cystitis, polypous growths. The inflammation process involves not only the mucous membrane, but also the submucosal 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 ceases to adequately perform its functions.
In addition, the inflammatory process can spread to nearby organs, provoking the development of paracystitis: damage to perivesical tissue, pyelonephritis. The gradual spread of the infection can lead to the development of adnexitis, adhesions of the fallopian tubes and subsequent infertility.
In pregnant women, exacerbation of the chronic process is inevitable, this is influenced by changes in hormonal levels, fluctuations in immunity, compression of internal organs by the growing uterus, which additionally causes stagnation of urine and a process inflammatory. The most serious complication of cystitis in pregnant women is acute pyelonephritis with severe intoxication of the body and threat of miscarriage.
Treatment of complicated forms of cystitis is carried out in a hospital. In addition to taking medications, the following types of therapy may be prescribed:
- instillation - introduction into the bladder cavity of medicinal solutions that eliminate toxins and have an anti-inflammatory effect;
- physiotherapy: treatment with electrical current pulses, iontophoresis, UHF, mud applications, acupuncture;
- Positional therapy - special postures that help eliminate congestion and restore the patency of the urinary tract. The method is suitable for pregnant women;
- Surgical treatments: laser cautery or excision of affected bladder tissue. In severe cases of total loss of organ functions, plastic surgery of the bladder is resorted to from its own intestinal tissue.
The duration of treatment 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 tissues.
Basic measures to prevent cystitis: maintain good hygiene, wear underwear made of natural fabrics, choose footwear and clothing depending on the climate and season, timely treatment of colds and chronic pathologies, take general strengthening vitamin complexes.