Cystitis is an inflammation of the bladder. This organ is intended for the accumulation and excretion of urine, but if the lining of the organ is damaged, its function suffers and the person begins to experience unpleasant symptoms. In most cases, the pathology affects only the mucous membrane, but sometimes the inflammatory process also spreads to muscle tissue. Interstitial cystitis is the most difficult to treat.
The disease mainly affects women, which is associated with the anatomical features of the urethra. Inflammation in men rarely appears, it usually acts as a comorbidity against the background of chronic prostatitis.
Symptoms
The signs of cystitis are quite obvious and it is difficult not to notice them. As a rule, the disease begins acutely, so 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;
- increased 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 give different manifestations. Hematuria is not always present, but the intensity of the pain may only resemble mild discomfort. In any case, if signs of pathology appear, it is necessary to consult a doctor in order to make a diagnosis as soon as possible. The disease in the acute phase at an early stage is better treated, 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 development, the disease can be primary (an independent disease) or secondary (inflammation spreads from adjacent areas, such as the kidney).
Depending on the area of damage to the mucous membrane of the bladder, cystitis occurs:
- Grand Total);
- focal.
The following clinical forms of cystitis are distinguished:
- catarrhal - nonpurulent inflammation of the mucosa of the bladder;
- phlegmonous - purulent lesion of the submucous 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.
Several rare forms are also distinguished: ulcerative, cystic and gangrenous cystitis.
The entire variety of inflammatory diseases of the bladder is grouped into two large groups:
- Specific cystitis, which are caused by pathogens of sexual infections: gonococcus, ureaplasmas, chlamydia.
- nonspecific cystitis - develops due to the fault of opportunistic flora, whose representatives under normal conditions do not lead to disease (for example, E. coli).
Finally, noninfectious cystitis is combined into a separate group. They can occur under the influence of allergic factors, radiation, traumatic, thermal effects, parasite toxins.
Causes of cystitis
In most cases, damage to the bladder and the development of the inflammatory process are associated with the penetration of the infection, however, cystitis can be toxic and allergic in nature. When an infection enters, the disease is transmitted in several ways:
- ascending, from the urethra through the urethra, affects the bladder;
- descending - in this case, the infection appears due to inflammation of the kidneys, through the ureters, it reaches the bladder;
- lymphogenous - by the flow of lymph through the pelvic organs in the presence of lesions of the genital organs;
- hematogenous - the infection enters with the bloodstream, but this route of spread is the most rare;
- direct - if an abscess ruptures inside the bladder, and the pathogenic microflora penetrates directly into the bladder cavity, it can also be during catheterization of an organ, infection during surgery.
Most often, E. coli provokes cystitis. It occurs in 80-95% of cases of uncomplicated pathology. This bacterium is normally found in the rectum, but when it enters the urethra it causes an inflammatory process. Enterobacteriaceae, staphylococci, fungi, and sexually transmitted infections can also cause the disease. It usually precedes the appearance of symptoms of vaginitis or bacterial vaginosis, and symptoms of the disease can also be noticed the day after sexual intercourse (postcoital cystitis).
Factors contributing to the development of cystitis.
The body with good immunity can cope with the presence of pathogenic microflora, so symptoms of cystitis will not appear in the patient. But when exposed to some factors, it manifests:
- lesion of the mucous membrane of the bladder;
- circulatory disorders of the pelvic organs;
- hypothermia;
- the presence of other foci in the body, such as kidney infections;
- decrease in the body's defenses;
- inflammatory diseases of the genital organs;
- lack of vitamins and minerals in the body;
- hormonal imbalance;
- insufficient hygiene, use of synthetic underwear;
- stress and overwork;
- delay in emptying the bladder.
In the presence of these factors, cystitis will progress rapidly, and the chronic pathology will go to the stage of relapse. Therefore, in order to prevent relapse, 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 occur due to various pathogens. Most of the time they are bacteria, but there are cystitis and viral and fungal etiology. If the acute form of the disease is diagnosed in time, 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 a doctor, trying to treat cystitis on their own, hoping that everything will go away on its own. As a result, precious time is wasted. Microorganisms actively multiply, the intensity of inflammation increases. Having completely "settled" in the bladder, the microbes will not leave their positions so easily. The inflammation becomes chronic.
It is also common for a specialist to prescribe a treatment for cystitis, the patient starts taking medication and stops the therapy at her own expense the moment she feels relieved. As a result, the pathogens are not completely destroyed, and the survivors are divided - chronic cystitis is formed, which is resistant to antibiotic therapy.
Finally, the following circumstances contribute to the development of chronic cystitis:
- general decrease in immune defenses, 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 very term "chronic cystitis" is obsolete. It is used "in the old way", for better communication with patients. A slow inflammatory process in the bladder is called recurrent cystitis. Its main symptom is the development of 2 or more exacerbations in six months or 3 episodes per year.
The period of exacerbation is accompanied by characteristic symptoms:
- frequent urination;
- pain, burning, pain when urinating;
- night calls;
- feeling of incomplete emptying, pain in the lower abdomen.
The exacerbation of the disease may be accompanied by a moderate increase in body temperature, the appearance of blood in the urine, its turbidity.
During the period of remission, the symptoms can be completely smoothed out. But more often, patients experience discomfort with urination and periodic mild 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, because the pathology is provoked by microorganisms, against which the doctor will prescribe a course of antibiotic therapy. Antibacterial drugs are quite diverse. They quickly help to stop an attack of the disease, and the systematic use of funds will lead to a complete cure for 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 are still leading, but the doctor will also prescribe anti-inflammatory drugs, vitamins and repairmen. As prevention of infection and to consolidate the effect of therapy, the patient is prescribed herbal remedies, physiotherapy courses.
cystitis in women
In most cases, cystitis in women is accompanied by exacerbations of chronic inflammation, therefore, according to statistics, every second patient consults a doctor with recurrent disease twice a year.
This speaks not so much about the difficulties in treating the disease, but about the need to carefully follow the doctor's prescriptions and eliminate the factors that provoke the disease.
cystitis after intercourse
Postcoital cystitis in women is caused by genitourinary abnormalities. When it moves down and into the external opening of the urethra, it becomes more susceptible to the penetration of pathogenic microflora. Also, the culprit in postcoital cystitis is an overly mobile urethra, which easily shifts when the penis is rubbed. In this case, the mucous membrane is easily irritated, and pathogenic microorganisms penetrate the opening of the urethra. The symptoms and treatment of this form of pathology are interrelated, so doctors approach the problem individually in each clinical case.
Also, the causes of cystitis are the alternation of anal with vaginal sex, which is absolutely impossible to do, because the microflora of the rectum directly enters the vagina and the adjacent urethra. A factor in the development of bacterial infections is the introduction of microbes by hand, insufficient secretion of vaginal mucus, which leads to microcracks.
Symptoms of postcoital inflammation do not differ, but the patient may notice its appearance directly in connection with sexual intercourse; discomfort usually already occurs in the first 12 hours.
Treatment of postcoital cystitis is individual, since it is first necessary to determine the cause of the disease and accurately direct therapy. With an anomaly of the urethra, the doctor will suggest plastic surgery, as a result of which the problem will disappear. Both surgery and hyaluronic acid injections are possible. If an STI infection occurred during an intimate relationship, antibacterial drugs will be required, followed by the restoration of the vaginal microflora.
What does blood in urine say?
The appearance of blood in the urine indicates the development of acute hemorrhagic cystitis. It does not appear at the end, but rather accompanies the entire urination process. The presence of erythrocytes gives the urine its pink color. Also, the urine may be the color of "meat slop, " that is, have a brownish color with the presence of brown mucous strands, threads, or scales.
Usually, when urinating with blood, there is severe pain, pain in the bladder and a feeling of tightness in the lower back. The appearance of blood in the urine is a mandatory reason to see a doctor.
Cystitis during menstruation
In some women, an exacerbation of cystitis occurs against the background of hormonal changes during menstruation. During menstruation, the pelvic organs are more 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;
- nonspecific infections, fungal infections, STDs.
Under the influence of these factors, the pathogen enters the urethra and urethra, causing inflammation. An exacerbation of the disease usually 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 they are complicated by the characteristic manifestations during menstruation - aching pains and tightness in the lower abdomen.
The doctor can identify the cause of the pathology after collecting an anamnesis and studying the results of laboratory diagnostics. The treatment regimen is standard, but simultaneous treatment of gynecological pathologies may be necessary 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 found that asymptomatic bacteriuria is detected even before pregnancy, therefore it is during the gestation period that the disease manifests itself. The reasons for this are:
- changes in the hormonal background and the ratio of progesterone and estrogen in the body of the future mother;
- violations of urodynamics as the size of the uterus increases;
- weakening of the ligamentous apparatus, increased mobility of the organ, but a decrease in its peristalsis and tone;
- expansion of the renal pelvis due to increased blood circulation in the pelvis.
The latent course of the pathology complicates early diagnosis. Treatment of cystitis during pregnancy is possible even with the use of antibiotics. The doctor will prescribe the names of the drugs and the dosages of the 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 in order to finally find out the causative agent of the pathology and determine the nature of the course of the disease. The specialist will collect an anamnesis, analyze the patient's complaints and conduct an external examination with palpation of the bladder area. The following diagnostic methods are used:
- echography - with the use of ultrasound, you can determine the degree of the inflammatory process, its prevalence, as well as assess the state of the urinary system, genital organs;
- cystoscopy - examination of the organ with an endoscope, which allows you to assess the condition of the mucosa of the bladder;
- cystography - an examination of the bladder using a contrast agent.
In women, treatment should begin with the definition of the pathogen. A set of laboratory tests is mandatory: general urinalysis, Nechiporenko analysis, bacteriological culture, tissue biopsy, polymerase chain reaction (for a more accurate determination of the pathogen). To assess the degree of the inflammatory process, doctors can send a blood test. If inflammatory pathologies of the female genital organs are suspected, an examination by a gynecologist and the delivery of the tests prescribed by him may be required.
treatment methods
In inflammatory diseases of the organ, doctors resort to therapeutic and surgical methods to treat pathology. In most cases, it is possible to get rid of the disease with properly formulated drug therapy with the addition of physiotherapy.
Drug treatment includes a combination of different groups of effective drugs, depending on the nature of the disease. The patient may receive:
- anti-inflammatory drugs - they serve to relieve swelling of the mucosa 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 the pathology;
- antifungal drugs - recommended if cystitis is provoked by a fungus or complicated by it (for example, with a combined course of bacterial and fungal infection);
- phytopreparations - drugs in tablets and other forms that have antimicrobial and anti-inflammatory properties.
In some cases, doctors prescribe drug instillations 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 be emptied so that the drug affects the mucosa as long as possible.
Surgical treatment is used only in rare cases, when the inflammatory process caused anatomical changes or in severe recurrent infections. In this case, laser correction is performed. For example, in postcoital cystitis, for many women, the only treatment option is distal urethral transposition.
Diet in the treatment of cystitis.
It is essential to follow a diet, since spicy and salty foods contribute to the appearance of ulcers in the mucosa. Other products are irritants that interfere with recovery:
- high-sugar foods;
- citrus fruits, acidic, fermented foods;
- condiments;
- tomatoes and all tomato dishes, additives (tomato sauces, 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 trigger allergies.
An attack of cystitis can also be provoked by heavy food, in which the patient suffers from constipation. With stagnation of fecal masses, intestinal peristalsis worsens, stagnation occurs in the bladder, as a result of which the mucosa is again irritated. Due to the high protein content, you should not eat too much meat, fish, beans, cheese. Replace them with foods rich in fiber: vegetables and fruits allowed.
During treatment, try to eat at home, cook for yourself, and do not include new foods or dishes on the menu. Please note that the diet completely excludes alcoholic beverages, and also limits coffee and tea. Juices, infusions and decoctions of herbs, fruit drinks and compotes will be useful. It is better to replace ordinary water with slightly alkaline mineral water.
Physiotherapy
Among the methods of treating the disease, physiotherapy is widely used. As a general rule, it is recommended at the recovery stage, when the acute inflammation of the bladder has been eliminated and there has been a positive trend towards recovery. Physiotherapy is also effective for submucosal localization of the causative agent of pathology, when antibacterial drugs do not have the proper effect. How physiotherapy is used:
- phonophoresis;
- electrophoresis;
- magnet therapy;
- ultrahigh frequency;
- modulated currents.
The session does not last long, however, a course of 10-15 procedures is required to obtain the effect. Powerful treatment of cystitis in combined forms will help to completely eliminate the disease.
Question answer
How long does cystitis last?
The duration of cystitis depends on the form of the pathology. The acute lasts 7-10 days, after which, with proper treatment, recovery occurs, but the chronic form of the disease can last for several months, reminiscent of periods of exacerbation.
Is it possible to visit a hot bath or shower with cystitis?
A hot shower or bath really helps relieve spasms and pain, however, these thermal effects are contraindicated in bladder inflammation, since this contributes to the aggravation of the inflammatory process.
Which doctor to go to and what analysis to deliver?
Women with suspected cystitis should contact a general practitioner, men - a urologist. If necessary, the patient can be referred for examination by a gynecologist. Tests: urinalysis, blood tests, 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 an increased risk of developing gynecological pathologies. In older women, the pathology occurs less often and is associated with a weakened immune system.
Is it possible to cure chronic cystitis?
Like any other chronic disease, cystitis presents with periods of exacerbation and remission. It is difficult to completely cure the disease, but with proper treatment, you can achieve a stable and very long remission without any symptoms from the urinary system.
Do I need a special diet for signs of cystitis?
Yes, during the period of exacerbation of the disease, patients are recommended to follow a diet with the exception of salty, spicy and irritating foods. Despite the presence of frequent urination, you should not severely limit your fluid intake. You can drink up to 2 liters of pure water, compote, soft tea. But alcohol and coffee in the acute stage are prohibited.
What characteristics should be taken into account when choosing a uroseptic?
Let's start with the fact that the selection of the drug and the appointment of an antibiotic regimen is a task only for a specialist - a urologist, nephrologist, therapist. It is unacceptable to stop the treatment of cystitis on your own or 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 for the treatment of cystitis. Doctors prescribe ampicillins, fluoroquinolones, and various combinations of uroseptic agents. Herbal uroseptics are also widely used, the main advantage of which is good tolerability and almost complete absence of contraindications. Preparations of this group can be used to treat pregnant and lactating mothers.
The doctor selects a uroseptic individually, analyzing the data of each clinical case. To determine the sensitivity of pathogens to a particular antibiotic, a special study is carried out - a bacteriological analysis of urine with inoculation into nutrient media.
How to treat cystitis yourself at home and can it be done?
If symptoms of cystitis appear, it is necessary to consult a urologist, nephrologist or general practitioner as soon as possible. Only a specialist can correctly assess the features of the clinical picture, conduct a full examination, make a correct diagnosis and prescribe the necessary treatment.
But often patients are faced with the fact that the doctor's appointment is scheduled for a certain time, and the pain needs to be relieved right now. To reduce the rate of progression of the pathological process, observe the drinking regimen: drink about 2 liters of water, compotes, fruit drinks. Hypothermia is a common cause of aggravation of the condition, 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 painkillers and antispasmodics on your own without extreme need; they can "lubricate" the clinical manifestations of the disease and it will be more difficult for the doctor to make a correct diagnosis.