The danger of cystitis does not lie only in the pain of the symptoms - the lack of proper treatment is fraught with complications, especially in women; improper selection and use of medicines can lead to 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 the unhindered penetration of microbes. Anal and vaginal openings located near the urethra increase the risk of infection.
Another physiological feature that affects 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 toilet for a long time. Periodic stagnation of urine provokes persistence and spread of infection in the organ cavity.
The development of the inflammatory process is facilitated by wearing tight or synthetic underwear, creating the thermos effect, as well as the lack of intimate personal hygiene and the lack of discrimination in sexual relations.
Microbes enter the bladder via the ascending (through the urethra) or descending (through the ureters from the kidneys) pathway. Infection with lymphatic drainage from the pelvic organs is possible. Rarer, but possible, is the hematogenous route of infection from distant foci of inflammation - the nasopharynx, carious tooth cavities.
The most common causative agent of the disease is E. coli or streptococcus, less often - viruses, yeast-like fungi or sexually transmitted infections: gonococcus, trichomonas.
Normally, the bladder mucosa 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 nonsterile - single 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 the periodic flow of urine.
The impetus for the development of acute cystitis can be:
- decreased immunity as a result of hypothermia, ARVI, nervous overload, stress, physical fatigue;
- allergy to certain drugs;
- pyelonephritis, urolithiasis, accompanied by impaired urine flow;
- diabetes;
- late stages of pregnancy;
- menopause, a state of female sex hormone imbalance.
Cystitis can occur in acute and chronic forms. The latter is the result of improper treatment, continuous kidney dysfunction and systemic diseases associated with hormonal imbalance.
Development of acute cystitis
The illness always starts suddenly, 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:
- annoying pain in the lower abdomen above the pubis, radiating to the lumbosacral region;
- nocturia - the desire to urinate every 10-15 minutes;
- dysuria - a constant feeling of fullness of the bladder;
- The production of urine is scanty, difficult, drop by drop, accompanied by acute cutting pain, burning, itching;
- the color is cloudy, flaky, there may be admixture of pus or blood;
- weakness, weakness, headache, fever, low temperature or high temperature.
The inflammatory process often affects the urethra, resulting in the development of urethritis, in which pain and itching intensify.
There can be no talk of performance in such a situation. The best thing to do is to 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.
Diagnosing
To treat cystitis, you will need to consult a urologist, gynecologist or infectious disease specialist.
A number of tests will need to be done:
- general analysis of urine;
- 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, cysts.
Cystitis is indicated by a high level of leukocytes - leukocytosis more than 2000/ml.
Based on the content of red blood cells and cylindrical formations in the urine, it is possible to identify associated problems and factors that provoke the development of cystitis: traumatic kidney damage, urolithiasis, acute and chronic glomerulonephritis, nephropathies, purulent abscesses, toxic lesions ofurinary system, the presence of viruses.
In addition, a gynecological examination is necessary - the 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 organ tissue damage.
Treatment with antibiotics
For the treatment of acute infectious cystitis that is not burdened with complications, 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 medication is made by the doctor based on the results of sensitivity tests to the pathogen. Spontaneous use of drugs can only suppress symptoms and contribute to the development of a slow inflammatory process. The developed resistance of microbes will complicate further treatment, narrowing the range of effective drugs.
You cannot independently extend the prescribed period of taking antibiotics - due to the suppression of the normal internal microflora of the body, there will be a risk of developing conditions of dysbacteriosis and lack of immunity.
In addition to antibiotics, during the treatment of cystitis in women, antispasmodics, analgesics and herbal medicines 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, antimicrobial effects, improve the work of antibiotics without disturbing the balance of microflora. They can be taken for a long period - 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. Blueberry has an astringent and anti-inflammatory effect, accelerating the removal 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, lovage herbs, rosemary;
- natural complex based on oils of orange, pine, sage and other plants. Available in the form of a thick green paste. Before swallowing, a small amount of the product should be dissolved in warm water;
- the product, produced in the form of tablets, contains extracts of hops, mint, oregano and fir oil;
- a drug intended for the treatment of urolithiasis and the prevention of bladder infections. Contains kidney tea, silkworm leaves, papaya, cubed pepper. Available in capsules and tablets. In addition to the 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
Myotropic antispasmodics are prescribed to relieve pain, relax the smooth muscles of the bladder and facilitate the passage of urine. Medicines 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. Remember that an antispasmodic only provides temporary relief, but does not cure the disease.
Analgesics
Severe pains, accompanied by fever, fever and weakness, are the reason for prescribing medications 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 their 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 early 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 been proven to protect and restore the microflora of the female genital organs, strengthen local immunity and reduce the unwanted consequences of antibiotic treatment. There are few contraindications for taking probiotics - hypersensitivity to the components of the drug or an allergic reaction.
For uncomplicated acute cystitis, dry and moist heat treatment is effective. Warm steam baths and sitz 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 sit on the steam coming out and sit for 10-15 minutes. The steam should be warm, but not scalding. For sitting baths, a decoction of medicinal plants is added to water at a temperature of about 45 °C.
At rest, you can apply a warm heating pad to the lower abdomen - at the location of the bladder.
Thermal procedures stimulate intertissue exchange and have a relaxing, analgesic and antispasmodic effect.
Heating is allowed only in the absence of inflammatory processes in the genitals, otherwise such treatment can cause additional damage.
Additional treatments
Bladder massage techniques can be used as an additional treatment.
- In a supine position, slightly bend your knees (you can put a support or pillow under your back).
- Place the fingertips of both hands on the stomach 2-3 fingers below the navel.
- Exhaling, press gently and deeply on the abdominal wall until you feel a slight pain inside, after a few seconds, release your hands and press on the stomach again. Do 5 or 6 repetitions.
The movements are aimed at eliminating diuresis delays, congestion and accelerating blood circulation in the bladder area. If the massage is done correctly, after its completion there will be a strong urge to visit the toilet.
During the treatment of cystitis, you should 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, buckthorn and other berries. Acidic drinks have an antimicrobial effect, prevent the extension of the infection in the walls of the organ and accelerate the removal of inflammatory products from the bladder cavity.
Decoctions and infusions of fennel seeds and herbs, chamomile, parsley, blackberry and millet leaves have a high diuretic and anti-inflammatory effect. For their preparation, 2 tablespoons of crushed raw material are poured into 1 liter of boiling water, boiled for 15 minutes in a water bath and left for about an hour. The juice 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, with a tendency to hypertension or hypotension.
During the treatment of cystitis, it is necessary to exclude from the diet hot spices, pickled and salty foods, sweets, sweet carbonated drinks, strong coffee and alcohol. These products interfere with the excretory function of the kidneys, promote the accumulation of uric acid and irritate the urinary tract.
Chronic cystitis
Premature 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 is practically not felt, alternate with a sharp worsening of symptoms.
The danger of chronic cystitis does not lie only in discomfort and severe pain that occur during exacerbations. A focus of inflammation that exists for a long time in the bladder affects the deep layers of the organ, contributing to the formation of untreatable morphological forms of the disease: interstitial cystitis, cystic, hemorrhagic, gangrenous, polyp growth. The process of inflammation includes not only the mucous membrane, but also the submucous 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 cope with its functions properly.
In addition, the inflammatory process can spread to nearby organs, causing the development of paracystitis - damage to the peri-vesical tissue, pyelonephritis. The gradual spread of the infection can cause the development of adnexitis, attachment of the fallopian tubes and subsequent infertility.
In pregnant women, an aggravation 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 also provokes 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 abortion.
Treatment of complicated forms of cystitis is carried out in the hospital. In addition to taking medications, the following types of therapy may be prescribed:
- instillation - introduction into the bladder cavity of medicinal solutions that remove toxins and have an anti-inflammatory effect;
- physiotherapy - treatment with electric current pulses, iontophoresis, UHF, mud applications, acupuncture;
- positional therapy - special poses that help eliminate congestion and restore the patency of the urinary tract. The method is suitable for pregnant women;
- surgical treatments - laser cauterization or removal of the affected bladder tissue. In severe cases of complete loss of organ functions, they resort to plastic surgery of the bladder from its 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 for the prevention of cystitis: maintaining good hygiene, wearing underwear made of natural fabrics, choosing shoes and clothing according to the weather and season, timely treatment of colds and chronic pathologies, taking general strengthening vitamin complexes.