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 mucosa, but sometimes the inflammatory process also extends 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 occurs rarely, it usually acts as a comorbidity against the background of chronic prostatitis.
Symptoms
The signs of cystitis are quite visible and it is difficult not to notice them. As a rule, the disease begins acutely, which is why patients pay attention to visible discomfort in the urinary tract. Among the manifestations of the pathology, note:
- frequent urge to urinate;
- feeling of incomplete urination;
- cramps and pain during urination;
- increase in body temperature;
- the appearance of a mixture of blood in the urine;
- cloudy urine (due to the presence of pus);
- nausea, drawing pains as during menstruation.
Regardless of the characteristic symptoms, the disease can give different manifestations. Hematuria is not always present, but pain in intensity may resemble only mild discomfort. In any case, if signs of pathology appear, it is necessary to consult a doctor to make a diagnosis as soon as possible. The disease in the acute phase at an early stage is best treated, but the chronic form requires more time to fight.
Forms and types of chronic cystitis
According to the nature of the inflammatory process, cystitis is acute and chronic. Depending on the source of development, the disease can be primary (independent disease) or secondary (inflammation spreads from adjacent areas, such as the kidney).
According to the area of damage to the bladder mucosa, cystitis appears:
- total (total);
- focal.
The following clinical forms of cystitis are distinguished:
- catarrhal - non-purulent inflammation of the bladder mucosa;
- phlegmonous - purulent lesion of the submucosal layer;
- granulomatous - accompanied by redness 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.
There are also a number of rare forms: ulcerative, cystic, gangrenous cystitis.
The entire variety of inflammatory diseases of the bladder is combined into two large groups:
- specific cystitis, which are caused by pathogens of sexual infections: gonococci, ureaplasma, chlamydia.
- nonspecific cystitis - develops due to the fault of opportunistic flora, representatives of which under normal conditions do not lead to disease (for example, E. coli).
Finally, non-infectious 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 is associated with the penetration of infection, however, cystitis can be toxic and allergic in nature. When an infection enters, the disease is transmitted in several ways:
- adhesion - from the urethra through the urethra - affects the bladder;
- descending - in this case, the infection occurs due to inflammation of the kidneys, through the ureters, reaches the bladder;
- lymphogenic - from the flow of lymph through the pelvic organs in the presence of lesions of the genital organs;
- hematogenous - the infection enters the bloodstream, but this route of spread is rarer;
- directly - if an abscess ruptures inside the bladder and 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 with uncomplicated pathology. This bacterium is normally found in the rectum, but when it enters the urethra, it provokes an inflammatory process. Enterobacteria, staphylococci, fungi, sexually transmitted infections can also cause the disease. It usually precedes the appearance of symptoms of vaginitis or bacterial vaginosis, and the symptoms of the disease can be noticed within a day after intercourse (postcoital cystitis).
Factors contributing to the development of cystitis
The body with good immunity can withstand the presence of pathogenic microflora, so the symptoms of cystitis in the patient will not appear. But when exposed to certain factors, it manifests itself:
- damage to the bladder mucosa;
- blood circulation disorders of the pelvic organs;
- hypothermia;
- the presence of other foci in the body, such as kidney infections;
- reduction of the body's defenses;
- inflammatory diseases of the genital organs;
- lack of vitamins and minerals in the body;
- hormonal imbalance;
- insufficient hygiene, wearing synthetic underwear;
- stress and overwork;
- delayed bladder emptying.
In the presence of these factors, cystitis will progress rapidly and the chronic pathology will pass into the relapse phase. Therefore, to prevent relapses, it is necessary to exclude the influence of provoking factors on the body.
Causes of the transition of acute inflammation to the chronic phase
The inflammatory process in the bladder can occur due to various pathogens. Most often they are bacteria, but there are cystitis and viral, fungal etiology. If the acute form of the disease is diagnosed in time, the appropriate 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 the visit to the doctor, try to treat the cystitis themselves, hoping that everything will go away by itself. As a result, precious time is wasted. Microorganisms multiply actively, the intensity of inflammation increases. Being completely "set" in the cocoon, the germs will not give up their positions so easily. The inflammation becomes chronic.
It is also common for a specialist to prescribe treatment for cystitis, the patient starts taking drugs and stops the therapy herself when she feels relieved. As a result, the pathogens are not completely destroyed, and the survivors divide - 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 protection, hypothermia;
- hormonal changes (pregnancy, menopause);
- neglecting the rules of personal hygiene;
- gynecological diseases;
- chronic diseases of other organs and systems: diabetes mellitus, malignant tumors.
Signs of chronic cystitis
In the medical community today, the very term "chronic cystitis" is outdated. The "old way" is used, 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 within six months or 3 episodes per year.
The period of deterioration is accompanied by characteristic symptoms:
- frequent urination;
- pain, burning, pain during urination;
- night calls;
- feeling of incomplete emptying, pain in the lower abdomen.
Aggravation of the disease can be accompanied by a moderate increase in body temperature, the appearance of blood in the urine, its turbidity.
During the remission period, the symptoms may completely subside. But more often, patients suffer from discomfort during urination and periodic moderate pain for years.
The most serious consequence of repeated cystitis is the development of resistance (resistance) of pathogens to antibacterial drugs and subsequent degeneration of the bladder mucosa. The mucosal epithelium undergoes cicatricial deformation or is replaced by a stratified squamous. At this stage, chronic cystitis can no longer be cured by antibiotic therapy alone. It is necessary to perform special medical procedures.
Acute and chronic cystitis: treatment approaches
The 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 different. They quickly help to stop an attack of the disease, and the systematic use of funds will lead to a complete cure for cystitis. Preparations based on fosfomycin 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 the mainstay, but the doctor will also prescribe anti-inflammatory drugs, vitamins and restoratives. As a prevention of infections and to consolidate the effect of the therapy, the patient is prescribed herbal medicines and physiotherapy.
cystitis in women
Most often, cystitis in women is associated with exacerbations of chronic inflammation, therefore, according to statistics, every second patient consults a doctor with a recurring 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 provoked by genitourinary abnormalities. When it moves down and inside the external opening of the urethra, it becomes more susceptible to the penetration of pathogenic microflora. Also, the culprit of postcoital cystitis is a very mobile urethra, which is easily displaced when the penis is rubbed. In this case, the mucous membrane is easily irritated, and pathogenic microorganisms penetrate the opening of the urethra. Symptoms and treatment of this form of pathology are interconnected, so doctors approach the problem individually in each clinical case.
Also, the cause of cystitis is the alternation of anal sex 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 causes microcracks.
The symptoms of postcoital inflammation do not change, but the patient can notice their appearance directly in connection with sexual intercourse - usually the discomfort occurs already in the first 12 hours.
The treatment of postcoital cystitis is individual, as it is first necessary to determine the cause of the disease and direct the therapy exactly. 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, then antibacterial drugs will be required, followed by the restoration of the vaginal microflora.
What does blood in urine mean?
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 urine its pink color. Also, urine can be the color of "meat slops", that is, have a brown color with the presence of mucous threads, threads or brown flakes.
Usually, when you urinate with blood, there is severe pain, pain in the bladder and a pulling sensation 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 these can provoke the disease:
- inflammatory diseases of the female genital organs;
- hormonal fluctuations;
- allergic reaction to intimate hygiene products;
- reduction of the body's defenses;
- non-respect of personal hygiene;
- non-specific infections, mycosis, STD.
Under the influence of these factors, the pathogen enters the urethra and urethra, causing inflammation. Usually, an 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. The symptoms of cystitis during menstruation are typical, but they are complicated by the characteristic manifestations during menstruation - pain and pulling pain 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 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 discovered that asymptomatic bacteriuria is detected even before pregnancy, therefore, it is during the period of pregnancy that the disease appears. 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 the increase in the size of the uterus;
- weakening of the ligamentous apparatus, greater mobility of the organ, but a decrease in peristalsis and its 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 also possible with the use of antibiotics. The doctor will prescribe drug names and drug doses that are safe for the fetus.
Diagnostic methods
The symptoms of cystitis are very characteristic, but the doctor will prescribe a series of tests to finally discover 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 perform an external examination with palpation of the bladder area. The following diagnostic methods are used:
- echoscopy - using 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 using an endoscope, which allows you to assess the condition of the bladder mucosa;
- cystography - an examination of the bladder using a contrast agent.
In women, treatment should begin with determining 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 pathology of the female genital organs is suspected, an examination by a gynecologist and the submission of tests prescribed by him may be required.
Methods of Treatment
In inflammatory diseases of the organ, doctors use therapeutic and surgical methods of treating the pathology. In most cases, it is possible to get rid of the disease with a 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 be given:
- anti-inflammatory drugs - serve to relieve the swelling of the mucous membrane and eliminate pain, the inflammatory process decreases;
- antispasmodics - used to relieve pain symptoms, they effectively eliminate bladder spasms;
- 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 a bacterial-fungal infection);
- phytopreparations - drugs in tablets and other forms that have antimicrobial and anti-inflammatory properties.
In some cases, doctors prescribe the patient instillations of drugs instead of oral administration. Bladder lavage is performed in the clinic. With the help of a special catheter, the desired drug concentration is administered, which cannot be achieved in other ways. Before the procedure, the patient must empty himself so that the drug affects the mucosa as long as possible.
Surgical treatment is used only in rare cases, when the inflammatory process provoked 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 transposition of the urethra.
Diet in the treatment of cystitis
It is necessary 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 rich in sugar;
- citrus fruits, sour, fermented foods;
- 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 meat, marinades, fatty foods. It is good to boil, steam. Eliminate all foods that can cause allergies.
An attack of cystitis can also be provoked by heavy food, in which the patient suffers from constipation. With the stagnation of fecal masses, intestinal peristalsis worsens, stagnation occurs in the bladder, as a result of which the mucosa is irritated again. It is because of the high protein content that you should not eat a lot of meat, fish, beans, cheeses. Replace them with foods rich in fiber - vegetables and fruits are allowed.
During treatment, try to eat at home, cook yourself and do not include new foods or dishes in the menu. Keep in mind that the diet completely excludes alcoholic beverages, as well as limits coffee and tea. Juices, infusions and decoctions of plants, fruit drinks and composts will be useful. It is better to replace ordinary water with slightly alkaline mineral water.
Physiotherapy
Among the methods of treatment of the disease, physiotherapy is widely used. As a rule, it is recommended in the recovery phase, when the acute inflammation of the bladder has been removed and there is a positive tendency towards recovery. Physiotherapy is also effective for submucosal localization of the causative agent of the pathology, when antibacterial drugs do not have the proper effect. As physiotherapy is used:
- phonophoresis;
- electrophoresis;
- magnetic therapy;
- UHF;
- modulated currents.
The session does not last long, however, a course of 10-15 procedures is required to get the effect. Powerful treatment of cystitis in combined ways 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 one lasts 7-10 days, after which, with proper treatment, recovery occurs, but the chronic form of the disease can last several months, reminding oneself of the periods of irritation.
Is it possible to visit a bath or a hot shower with cystitis?
A hot shower or a bath really helps to relieve spasm and pain, however, these thermal effects are contraindicated in bladder inflammation, as this contributes to the worsening of the inflammatory process.
Which doctor should we turn to and what tests should we submit?
Women with suspected cyst should contact a general practitioner, men - a urologist. If necessary, the patient can be referred for examination to a gynecologist. Analysis - urine analysis, blood analysis and ultrasound or cystoscopy.
How does age affect the course of the disease?
Most often, cystitis appears in women aged 20-45, 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.
Is it possible to cure chronic cystitis?
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 a stable and very long remission without any symptoms from the urinary system.
Do I need a special diet for cystitis symptoms?
Yes, during the period of exacerbation of the disease, patients are advised to adhere to a diet excluding salty, spicy, irritating foods. Despite the presence of frequent urination, you should not limit yourself to fluid intake. You can drink up to 2 liters of clean water, compote, weak tea. But alcohol and coffee in the acute phase are prohibited.
What characteristics should be considered when choosing a uroseptic?
Let's start with the fact that choosing a drug and prescribing 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 to change the medicine.
The use of tetracyclines, cephalosporins in cystitis quickly leads to the 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 from 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 in 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, perform a comprehensive examination, make an accurate diagnosis and prescribe the necessary treatment.
But often patients are faced with the fact that the appointment with the doctor is scheduled for a certain time and the pain should be relieved right now. To reduce the rate of progression of the pathological process, observe the drinking regimen - drink about 2 liters of water, compote, fruit drinks. Hypothermia is a common cause of worsening 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 you wait for an appointment with a specialist. It is undesirable to take analgesics and antispasmodics yourself without extreme need - they can "lubricate" the clinical manifestations of the disease, and it will be more difficult for the doctor to make an accurate diagnosis.