The danger of cystitis lies not only in the pain of the symptoms - the lack of proper treatment is fraught with danger, especially in women, and incorrect selection and use of drugs can lead to life-threatening consequences.
Causes and pathogenesis
A predisposing factor for the development of cystitis in women is the peculiarities of the anatomical structure of their urinary tract - a short and wide urethra, which allows unhindered 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 pathologies in women is a larger bladder volume than in men, which allows them to endure the urge to go to the toilet for a long time. Periodic stagnation of urine causes the persistence and proliferation of infection in the organ cavity.
The development of the inflammatory process is facilitated by wearing tight or synthetic underwear, creating the effect of a thermos, as well as lack of intimate hygiene and indiscriminateness during sexual intercourse.
Microbes enter the bladder either ascending (through the urethra) or descending (through the ureters from the kidneys). Infection through lymphatic flow from the pelvic organs is possible. More rare, but probable, is the hematogenous route of infection from distant foci of inflammation - the nasopharynx, carious 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 glycocalyx, a protective substance produced under the influence of female sex hormones. The cavity of a healthy organ is not sterile - single cells of pathogenic microflora may be present there, but the active development of microbes is blocked by the body's immune forces. Additionally, the infection is eliminated by periodic discharge of urine.
The impetus for the development of acute cystitis can be:
- decreased immunity due to hypothermia, ARVI, nervous overstrain, stress, physical fatigue;
- allergies to certain medications;
- pyelonephritis, urolithiasis, accompanied by impaired urinary outflow;
- diabetes;
- advanced 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 inappropriate treatment, persistent renal dysfunction and systemic diseases associated with hormonal imbalance.
Development of acute cystitis
The disease always begins suddenly, most often at night or the next morning after wet feet, getting wet in the rain, or sitting on something cold. The symptoms are sharp and painful, it is impossible not to notice them:
- stabbing pain in the lower abdomen, above the pubis, radiating to the lumbosacral region;
- nocturia – urge to urinate every 10 to 15 minutes;
- dysuria – constant feeling of fullness of the bladder;
- urine flow is rare, difficult, drip, accompanied by sharp cutting pain, burning, itching;
- the color is cloudy, with flakes, there may be admixtures of pus or blood;
- weakness, weakness, headache, fever, low-grade fever or high temperature.
The inflammatory process often affects the urethra, leading to the development of urethritis, in which pain and itching intensify.
We cannot talk about performance in such a situation. The best thing to do is to see a doctor immediately.
Treatment started in the first hours of the disease increases the chances of getting rid of cystitis permanently in a short time.
Diagnostic
To treat cystitis, you will need to consult a urologist, gynecologist or infectious disease specialist.
A certain number of tests will have to be carried out:
- 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, cysts.
Cystitis is indicated by a high level of leukocytes - leukocyturia greater than 2000/ml.
Based on the content of red blood cells and cylindrical formations in urine, it is possible to identify associated problems and factors provoking the development of cystitis: traumatic kidney damage, urolithiasis, acute and chronic glomerulonephritis, nephropathy, purulent abscesses, toxic lesions of the 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 organ tissues.
Treatment with antibiotics
For the treatment of acute uncomplicated 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 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 sluggish inflammatory process. The developed resistance of microbes will make it difficult to continue treatment, thereby reducing 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 dysbacteriosis and immunodeficiency states.
In addition to antibiotics, when treating cystitis in women, antispasmodics, analgesics and herbal remedies 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 time - from 2 weeks to 1 month when treating 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. Available in the form of solutions and dragees, based on centaury, lovage, rosemary;
- natural complex based on oils of orange, pine, sage and other plants. Available as a thick green paste. Before ingestion, a small amount of the product should be dissolved in lukewarm water;
- the product, presented in the form of tablets, contains extracts of hops, peppermint, 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 cubeb pepper. Available in capsules and tablets. In addition to its pronounced diuretic effect, the product stops the inflammatory process of 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. Medications relieve severe symptoms, reduce pain and discomfort caused by contraction of muscle fibers.
A single dose should not exceed 2-3 tablets. Overdose may cause dizziness, drowsiness and decreased blood pressure. Remember that an antispasmodic only provides temporary relief, but does not cure the disease.
Painkillers
Severe pain, accompanied by fever, fever and weakness, is the reason why drugs from the group of propionic acid derivatives are prescribed. 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 with your doctor before using any medications. Contraindications to taking products containing propionic acid derivatives include severe renal and hepatic insufficiency, pregnancy and infancy under 6 years of age.
Probiotics
To prevent dysbacteriosis and disorders of the gastrointestinal tract when taking antibiotics, drugs containing natural complexes of lactobacilli and bifidobacteria - probiotics - are used. The products have proven themselves well 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 drug components or allergic reaction.
For acute uncomplicated cystitis, treatment with dry and moist heat is effective. Hot and sitz steam baths with a decoction of St. John's wort or yarrow are useful: for a steam bath, a hot decoction of herbs is poured into a basin. You need to squat over the steam emanating from it and sit for 10-15 minutes. The steam should be lukewarm, but not hot. For sitz baths, a decoction of medicinal herbs is added to water at a temperature of approximately 45 °C.
While resting, 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.
Warming is allowed only in the absence of inflammatory processes in the genitals, otherwise such treatment may cause additional damage.
Additional treatments
Bladder massage techniques can be used as a complementary treatment.
- While lying on your back, bend your knees slightly (you can place a bolster or pillow under your back).
- Place the fingertips of both hands on the stomach, 2 to 3 fingers below the navel.
- While 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 performed correctly, after its completion there will be a strong urge to go to the toilet.
During cystitis treatment, you should drink more fluids than usual to flush the bladder. In addition to drinking water, it is useful to drink slightly alkaline mineral water without gas, fruit drinks based on cranberries, black and red currants, cherries, sea buckthorn and other berries. Acidic drinks have an antimicrobial effect, prevent infection from lingering on the walls of the organ and accelerate the elimination 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 renal insufficiency, a tendency to hypertension or hypotension.
During the treatment of cystitis, it is necessary to exclude hot seasonings, pickled and salty foods, confectionery, 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 initiation or incorrect and careless treatment of acute cystitis leads to an advanced chronic form with periodic relapses. Chronic cystitis is a long-term condition. Periods of remission or a slow inflammatory process, during which the disease is practically not felt, alternate with a sharp exacerbation of symptoms.
The danger of chronic cystitis lies not only in the severe discomfort and pain that occurs during exacerbations. A focus of inflammation that has existed for a long time in the bladder affects the deep layers of the organ, contributing to the formation of intractable morphological forms of the disease: interstitial, cystic, hemorrhagic, gangrenous cystitis, polyp growths. The process of inflammation 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 properly perform its functions.
In addition, the inflammatory process can spread to neighboring organs, provoking the development of paracystitis - damage to the perivesical tissue, pyelonephritis. The gradual spread of infection can cause the development of adnexitis, adhesions of the fallopian tubes and subsequent infertility.
In pregnant women, an exacerbation of the chronic process is inevitable, it is influenced by changes in hormonal levels, fluctuations in immunity, compression of internal organs by the growing uterus, which further causes stagnationurine and an inflammatory process. The most serious complication of cystitis in pregnant women is acute pyelonephritis with severe intoxication of the body and the risk of miscarriage.
Treatment of complicated forms of cystitis is carried out in a hospital setting. In addition to taking medications, the following types of therapies 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 patency of the urinary tract. The method is suitable for pregnant women;
- surgical treatments - laser cauterization or excision of affected bladder tissue. In severe cases of complete loss of organ functions, they resort to plastic surgery of the bladder 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 shoes and clothing depending on the weather and season, timely treat colds and chronic pathologies, takegeneral fortifying vitamin complexes.