The danger of cystitis lies not only in the painfulness of the symptoms - the lack of proper treatment is fraught with complications, especially in women; 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 are the features of the anatomical structure of their urinary tract - a short, wide urethra that allows access for 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 resist the urge to go to the toilet for a long time. Periodic stagnation of urine provokes the persistence and spread of the infection in the cavity of the organ.
The development of the inflammatory process is facilitated by wearing tight or synthetic underwear, creating the effect of a thermos, as well as by not observing personal intimate hygiene and the lack of promiscuity in sexual intercourse.
Microbes enter the bladder by ascending (through the urethra) or descending (through the ureters from the kidneys) route. Infection with lymph flow from the pelvic organs is possible. Less common, but likely, is the hematogenous route of infection from distant foci of inflammation - the nasopharynx, carious dental cavities.
The most common cause of the disease is E. coli or streptococci, less often - viruses, yeast-like fungi or sexually transmitted infections: gonococcus, trichomonas.
Normally, the lining of the bladder is protected from infection by the glycocalyx, a protective substance that is produced under the influence of female sex hormones. The cavity of a healthy organ is non-sterile - individual 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 periodic leakage of urine.
The impetus for the development of acute cystitis can be:
- reduced immunity as a result of hypothermia, ARVI, nervous overstrain, stress, physical fatigue;
- allergies to certain medications;
- pyelonephritis, urolithiasis, accompanied by impaired urine flow;
- diabetes;
- late stages of pregnancy;
- menopause, a state of imbalance of female sex hormones.
Cystitis can occur in acute and chronic form. The latter is the result of incorrect treatment, long-term kidney dysfunction and systemic diseases associated with hormonal imbalance.
Development of acute cystitis
The disease always starts suddenly, most often at night or the next morning after getting wet feet, getting wet in the rain or sitting on something cold. The symptoms are bright and painful, it is impossible not to notice them:
- nagging pain in the lower abdomen above the pubis, radiating to the lumbosacral region;
- nocturia - desire to urinate every 10-15 minutes;
- dysuria - a constant feeling of bladder fullness;
- urination is scanty, difficult, drop by drop, accompanied by sharp cutting pain, burning, itching;
- the color is cloudy, with scales, there may be impurities of pus or blood;
- weakness, weakness, headache, fever, low-grade fever, or high fever.
The inflammatory process often affects the urethra, which leads to the development of urethritis, in which pain and itching intensify.
There can be no talk of performance in such a situation. It is best 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.
Diagnosis
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 muscle layers of the bladder, polyps, cysts.
Cystitis manifests itself with a high level of leukocytes - leukocyturia over 2000/ml.
Based on the content of red blood cells and cylindrical formations in the urine, it is possible to identify related problems and factors provoking the development of cystitis: traumatic kidney damage, urolithiasis, acute and chronic glomerulonephritis, nephropathies, purulent abscesses, toxic lesions of the urinary system, the presence of viruses.
In addition, a gynecological examination is required - 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 cause of inflammation and the degree of organ tissue damage.
Treatment with antibiotics
For the treatment of acute infectious cystitis, which 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 the drug is made by the doctor based on the results of the sensitivity tests of 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 danger of developing dysbacteriosis and immunodeficiency conditions.
In addition to antibiotics, in 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 nutritional supplements
Complexes based on plant raw materials are non-toxic, have anti-inflammatory, diuretic, choleretic, antimicrobial effects, enhance the effect of antibiotics without disturbing the balance of microflora. They can be taken long-term - from 2 weeks to 1 month in the treatment of acute and chronic cystitis. The choice of means is quite wide:
- tablets containing cranberry extract - a well-known natural antibiotic and diuretic. Cranberry has an astringent and anti-inflammatory effect, accelerating the removal of the infection through the urine;
- capsules that contain ascorbic acid, cranberry, gooseberry and horsetail are intended for the prevention and treatment of cystitis as part of complex therapy;
- herbal remedy for cystitis based on medicinal plants. It is available in the form of solutions and dragees containing St. John's wort, hunter's herb, rosemary;
- a natural complex based on oils from orange, pine, sage and other plants. It comes in the form of a thick green paste. Before ingestion, 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, curly silkworm leaves, papaya, black pepper. Available in capsules and tablets. In addition to the pronounced diuretic effect, the product stops the inflammatory process in the urinary tract, improves their permeability, removes sand and dissolves small stones in the kidneys, has an antispasmodic and analgesic effect.
Antispasmodics
To relieve pain, relax the smooth muscles of the bladder and facilitate the passage of urine, myotropic antispasmodics are prescribed. Medicines relieve severe symptoms, reduce pain and discomfort caused by contraction of muscle fibers.
A single dose should not exceed 2-3 tablets. Overdose can cause dizziness, drowsiness and low blood pressure. Remember that an antispasmodic provides only temporary relief, but does not cure the disease.
Analgesics
Severe pain accompanied by fever, chills and weakness is the reason for prescribing drugs 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 for taking products containing propionic acid derivatives are severe kidney and liver failure, pregnancy and early childhood under 6 years of age.
Probiotics
Medicines containing natural complexes of lactobacilli and bifidobacteria - probiotics are used to prevent dysbacteriosis and disorders of the gastrointestinal tract while taking antibiotics. 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 drugs or an allergic reaction.
In uncomplicated acute cystitis, dry and moist heat treatment is effective. Warm steam and sitz baths 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 have to squat over the emanating steam and sit for 10-15 minutes. The steam should be warm but not scalding. For sitz baths, a decoction of medicinal herbs is added to water with a temperature of about 45 °C.
At rest, you can apply a warm heating pad to the lower abdomen - to the location of the bladder.
Thermal procedures stimulate inter-tissue exchange and have a relaxing, analgesic and antispasmodic effect.
Warming is allowed only in the absence of inflammatory processes in the genital organs, otherwise such treatment can cause additional harm.
Additional treatments
Bladder massage techniques can be used as an adjunctive treatment.
- Lying on your back, bend your knees slightly (you can place a pad or pillow under your back).
- Place the fingertips of both hands on the abdomen 2-3 fingers below the navel.
- Exhaling, gently and deeply press the abdominal wall until you feel a slight pain from the inside, after a few seconds relax your hands and press the stomach again. Do 5 or 6 reps.
The movements are aimed at eliminating diuresis delay, congestion and accelerating blood circulation in the bladder area. If the massage is done correctly, after its completion there will be a strong desire to visit the toilet.
During the treatment of cystitis, you should drink more fluids than usual to flush the bladder. In addition to pure drinking water, it is useful to drink slightly alkaline mineral water without gas, fruit drinks from blueberries, blackcurrants, cherries, sea buckthorn and other fruits. Sour drinks have an antimicrobial effect, prevent the retention of infection on the walls of the organ and accelerate the removal of inflammatory products from the bladder cavity.
Decoctions and infusions of seeds and herbs of fennel, chamomile, parsley, lingonberry leaves and millet have a strong diuretic and anti-inflammatory effect. For their preparation, 2 tablespoons of crushed raw materials are poured with 1 liter of boiling water, boiled for 15 minutes in a water bath and left for about an hour. The liquid is carefully filtered and taken warm, 1 cup 3 times a day.
Diuretic drinks should be used with caution in case of insufficient renal function, tendency to hypertension or hypotension.
During the treatment of cystitis, it is necessary to exclude from the diet hot spices, pickled and salty foods, confectionery, carbonated sweet 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
Untimely initiation or incorrect and negligent 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 exacerbation of symptoms.
The danger of chronic cystitis lies not only in the severe discomfort and pain that occur during an exacerbation. The focus of inflammation, which exists 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, polypous formations. The inflammatory process involves 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 a rough scar, 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 perivesical tissue, pyelonephritis. The gradual spread of the infection can cause the development of adnexitis, adhesions of the fallopian tubes and subsequent infertility.
In pregnant women, exacerbation 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 further 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 miscarriage.
Treatment of complicated forms of cystitis is carried out in a hospital. In addition to medication, the following types of therapy may be prescribed:
- instillation - introduction into the bladder cavity of medicinal solutions that expel toxins and have an anti-inflammatory effect;
- physiotherapy - treatment with electric current pulses, iontophoresis, UHF, mud applications, acupuncture;
- positional therapy - special positions that help to remove congestion and restore the patency of the urinary tract. The method is suitable for pregnant women;
- surgical treatments - laser cauterization or excision of the affected bladder tissue. In severe cases of complete loss of the organ's functions, plastic surgery of the bladder from its own intestinal tissue is resorted to.
The duration of treatment of chronic cystitis is several months. The course is aimed at eliminating the inflammatory process, preventing complications, maximizing the recovery of the urinary system and preventing irreversible changes in the structure of organ tissues.
Basic measures to prevent 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.