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 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 appears rarely, 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, therefore patients pay attention to obvious discomfort in the urinary tract. Among the manifestations of pathology note:
- frequent urination;
- 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 pain in intensity may only feel like 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 acute phase disease 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 kidneys).
Depending on the area of damage to the mucous membrane of the bladder, cystitis occurs:
- total (general);
- 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 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.
There are also a number of rare forms: ulcerative, cystic, gangrenous cystitis.
The whole variety of inflammatory bladder diseases is grouped into two large groups:
- specific cystitis, caused by pathogens of sexual infections: gonococci, ureaplasmas, chlamydia.
- nonspecific cystitis - develops through the fault of opportunistic flora, the representatives of which under normal conditions do not lead to diseases (for example, E. coli).
Finally, non-infectious cystitis is grouped into a separate group. They can occur under the influence of allergic factors, radiation, traumatic, thermal effects, toxins from parasites.
Causes of cystitis
In most cases, damage to the bladder and the development of the inflammatory process are 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:
- 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 reaches the bladder;
- lymphogenous - by the flow of lymph through the pelvic organs in the presence of damage to the genital organs;
- hematogenous - the infection enters with the bloodstream, but this way of spread is the rarest;
- direct - if an abscess breaks inside the bladder, and the pathogenic microflora gets directly into the bladder cavity, then this can also be during catheterization of an organ, infection during surgery.
Most often, E. coli causes 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, sexually transmitted infections can also provoke the disease. Usually precedes the onset of symptoms of vaginitis or bacterial vaginosis, and you may also notice symptoms of the disease within a day of having sex (postcoital cystitis).
Factors contributing to the development of cystitis
The body with good immunity can cope with 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:
- injury to 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, wearing synthetic underwear;
- stress and overwork;
- delayed emptying of the bladder.
In the presence of these factors, cystitis will progress rapidly, and chronic pathology will pass into the stage of relapse. Therefore, in order to prevent relapses, 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 may be due to various pathogens. Most often it is bacteria, but there are cystitis and viral and fungal etiologies. If the acute form of the disease is diagnosed in time, the correct treatment of cystitis is prescribed, and the patient follows all the recommendations of the doctor, then the pathological process can be completely eliminated, and recovery will come.
But often women give up visiting a doctor, try to treat cystitis on their own, hoping that everything will go away on its own. As a result, valuable time is wasted. Microorganisms actively multiply, the intensity of inflammation increases. Having completely "settled" in the bladder, the microbes will not give up their position so easily. The inflammation becomes chronic.
It is also common for a specialist to prescribe treatment for cystitis, the patient starts taking medication and stops the therapy on her own when she feels relief. 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 defences, 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 "old fashioned", 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 exacerbation is accompanied by characteristic symptoms:
- frequent urination;
- pain, burning, pain when urinating;
- night calls;
- feeling of incomplete emptying, pain in the lower abdomen.
Exacerbation of the disease can 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 alleviated. But most often patients suffer from discomfort during urination and periodic moderate 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 scarring deformation or is replaced by stratified squamous epithelium. At this stage, chronic cystitis can no longer be cured by antibiotic therapy alone. It is necessary to carry out special medical procedures.
Acute and chronic cystitis: therapeutic approaches
The treatment of acute and chronic forms of pathology is different. Usually, acute cystitis is much easier to treat, since the pathology is provoked by microorganisms, against which the doctor will prescribe antibiotic treatment. 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 of cystitis. Fosfomycin preparations perfectly resist 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 with the help of several groups of drugs. Antibiotics remain in the lead, but the doctor will also prescribe anti-inflammatories, vitamins and repairers. To prevent infections and consolidate the effect of therapy, the patient is prescribed herbal remedies, physiotherapy courses.
cystitis in women
Most often, cystitis in women is accompanied by exacerbations of chronic inflammation. Therefore, according to statistics, every second patient visits a doctor with a recurrent disease twice a year.
This speaks not so much about the difficulties of treating the disease, as about the need to strictly adhere to the doctor's prescriptions and eliminate the factors that provoke the disease.
cystitis after sex
Postcoital cystitis in women is caused by genitourinary abnormalities. When moved 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 an overly mobile urethra, which moves easily when the penis is rubbed. In this case, the mucous membrane is easily irritated, and pathogenic microorganisms enter the opening of the urethra. 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 intercourse, which is absolutely impossible to do, since the microflora of the rectum penetrates directly into 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 microfissures.
Symptoms of postcoital inflammation do not differ, but the patient can notice their appearance directly in connection with sexual intercourse - usually the discomfort occurs already in the first 12 hours.
Treatment of postcoital cystitis is individual, since first of all it is necessary to determine the cause of the disease and precisely direct the therapy. With an abnormality of the urethra, the doctor will offer plastic surgery, after which the problem will disappear. Surgery and hyaluronic acid injections are possible. If infection with an STI has occurred during an intimate relationship, antibacterial drugs will be required, followed by the restoration of 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 accompanies the whole process of urination. The presence of erythrocytes gives the pink color to the urine. Also, urine may have the color of "meat slops", that is, have a brownish color with the presence of mucous strands, threads or brown flakes.
Usually, when you urinate with blood, you experience severe pain, pain in the bladder, and pulling sensations in your lower back. The appearance of blood in the urine is a mandatory reason for consulting 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 most susceptible to infection, so the following can cause 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;
- non-specific infections, mycoses, STDs.
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. Symptoms of cystitis during menstruation are typical, but are complicated by characteristic manifestations during menstruation - aching, pulling pains 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 studies, doctors found that asymptomatic bacteriuria is detected even before pregnancy, therefore it is during the period of gestation that the disease manifests itself. The reasons 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, greater 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 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
Symptoms of cystitis are very characteristic, but all the same the doctor will prescribe a series of tests 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:
- ultrasound - using ultrasound, you can determine the degree of the inflammatory process, its prevalence, as well as assess the condition of the urinary system, genitals;
- cystoscopy - examination of the organ using an endoscope, which allows you to assess the condition of the bladder mucosa;
- cystography - 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 urine analysis, Nechiporenko analysis, bacteriological culture, tissue biopsy, polymerase chain reaction (for 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 tests prescribed by him may be required.
Treatment methods
In inflammatory diseases of the organ, doctors resort to therapeutic and surgical methods to treat the pathology. In most cases, it is possible to get rid of the disease with properly formulated drug treatment in addition to 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 - serve to relieve swelling of the mucous membrane and eliminate pain, the inflammatory process is reduced;
- 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 caused by a fungus or complicated by it (for example, with a combined course of bacterial and fungal infection);
- phytopreparations - drugs in the form of tablets and other forms with antimicrobial and anti-inflammatory properties.
In some cases, doctors prescribe medication instillations to the patient instead of oral administration. Bladder lavage is performed at the clinic. With the help of a special catheter, the desired concentration of the drug is administered, which cannot be achieved by other means. Before the procedure, the patient must empty himself so that the drug affects the mucous membrane for as long as possible.
Surgical treatment is used only in rare cases, when the inflammatory process has 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 imperative 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 high in sugar;
- citrus fruits, acidic, fermented foods;
- seasonings;
- tomatoes and all tomato-based dishes, additives (ketchups, sauces, adjika);
- soy sauce and vinegar;
- nuts and chocolate.
To speed up recovery, the patient is recommended to follow 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 a heavy diet, 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 mucous membrane is again irritated. It is because of the high protein content that you should not eat too much meat, fish, beans, cheeses. Replace them with foods rich in fiber - vegetables and fruits allowed.
During treatment, try to eat at home, cook yourself, and do not include new foods or menu items. Keep in mind 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 rule, it is recommended at the recovery stage, when the acute inflammation of the bladder has been eliminated and there has been a positive tendency to recovery. Physiotherapy is also effective for the submucosal localization of the causative agent of the pathology, when antibacterial drugs do not have the appropriate 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 achieve the effect. Powerful treatment of cystitis in a combined way will help to completely get rid of the disease.
Question Answer
How long does cystitis last?
The duration of cystitis depends on the form of the pathology. The acute form lasts 7-10 days, after which, with proper treatment, recovery occurs, but the chronic form of the disease can last for several months, remembering periods of exacerbation.
Is it possible to visit a hot bath or shower with cystitis?
A hot shower or bath really helps to relieve spasms and pains, however, these thermal effects are contraindicated in inflammation of the bladder, as it contributes to the aggravation of the inflammatory process.
Which doctor to contact and which analyzes to submit?
Women with suspected cystitis should contact a general practitioner, men - a urologist. If necessary, the patient can be referred for examination to a gynecologist. Tests - urinalysis, blood test and ultrasound or cystoscopy.
How does age affect the course of the disease?
Most often, cystitis occurs in women 20-45 years old, 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 frequently 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 signs of cystitis?
Yes, during the period of exacerbation of the disease, patients are advised to follow a diet except for salty, spicy and irritating foods. Despite the presence of frequent urination, you should not severely limit yourself in fluid intake. You can drink up to 2 liters of pure water, compote, light tea. But alcohol and coffee in the acute stage are prohibited.
What features should be considered 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 for a specialist: urologist, nephrologist, therapist. It is unacceptable to stop the treatment of cystitis on your own or to change the remedy.
The use of tetracyclines, cephalosporins in cystitis quickly leads to the resistance of pathogens. Therefore, drugs of 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 tolerance and the almost complete absence of contraindications. Preparations of this group can be used to treat pregnant and nursing 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 on a nutrient medium.
How to self-treat cystitis 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 comprehensive 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 some time, and the pain should be relieved immediately. To reduce the rate of progression of the pathological process, observe the drinking regime - 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 overwork. Rest (both physical and sexual) will help while waiting for an appointment with a specialist. It is undesirable to take painkillers and antispasmodics without extreme necessity - they can "lubricate" the clinical manifestations of the disease, and it will be more difficult for the doctor to make a correct diagnosis.