Cystitis is an inflammation of the bladder. This organ is designed to accumulate and release urine, but if the mucous membrane of the organ is damaged, its function suffers and a person begins to experience unpleasant symptoms. In most cases, the pathology affects only the mucous membrane, but sometimes the inflammatory process extends to the muscle tissue. Interstitial cystitis is the most difficult to deal with.
The disease mainly affects women, which is related to the anatomical features of the urethra. Inflammation in men occurs rarely, it usually acts as a concomitant disease 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, which is why patients pay attention to the obvious discomfort in the urinary tract. Among the manifestations of pathology, note:
- frequent urge to urinate;
- feeling of incomplete urination;
- spasms and pain when urinating;
- increase in body temperature;
- the appearance 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 resemble only mild discomfort. In any case, if signs of pathology appear, it is necessary to consult a doctor in order to make a diagnosis as early as possible. The disease in the acute phase in the early stage is best treated, but the fight against the chronic form takes longer.
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 neighboring areas, for example, the kidneys).
According to the area of damage to the bladder mucosa, cystitis occurs:
- total (total);
- fireplace.
The following clinical forms of cystitis are distinguished:
- catarrhal - non-purulent inflammation of the bladder mucosa;
- phlegmonous - purulent damage to the submucous 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 entire variety of inflammatory diseases of the bladder is combined into two large groups:
- specific cystitis, which is caused by pathogens of sexual infections: gonococci, ureaplasmas, chlamydia.
- non-specific cystitis - develop due to opportunistic flora, whose representatives under normal conditions do not lead to diseases (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, toxins from parasites.
Causes of cystitis
In most cases, damage to the bladder and the development of the inflammatory process is associated with the penetration of infection, but 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 occurs due to inflammation of the kidneys, through the ureters it reaches the bladder;
- lymphogenic - through 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 the rarest;
- directly - if the abscess breaks inside the bladder and the 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 of uncomplicated pathology. This bacterium is usually found in the rectum, but when it gets into 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 you can also notice the symptoms of the disease within a day after intercourse (postcoital cystitis).
Factors contributing to the development of cystitis
A 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 bladder mucosa;
- circulatory 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 stage. Therefore, in order to prevent relapses, it is necessary to exclude the influence of provoking factors on the body.
Reasons for the transition of acute inflammation to chronic phase
The inflammatory process in the bladder can occur due to various pathogens. Most often these are bacteria, but there is cystitis and viral, fungal etiology. If the acute form of the disease is diagnosed in time, the correct 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 a visit to a doctor, try to treat cystitis on their own, hoping that everything will go away by itself. As a result, valuable time is wasted. Microorganisms actively multiply, the intensity of inflammation increases. After completely "settling" in the bladder, the microbes will not give up their positions so easily. The inflammation becomes chronic.
It also often happens that a specialist prescribes treatment for cystitis, the patient starts taking medication and stops the therapy herself the moment 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 reduction of 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 medical circles today, the very term "chronic cystitis" is outdated. It is used "the old way", 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;
- soreness, burning, pain when urinating;
- night talks;
- feeling of incomplete emptying, pain in the lower abdomen.
The 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 remission period, the symptoms can be completely smoothed out. But more often, patients suffer from discomfort during urination and intermittent 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 mucous membrane of the bladder. The mucosal epithelium undergoes cicatricial deformation or is replaced by a stratified squamous cell. At this stage, chronic cystitis can no longer be cured with antibiotic therapy alone. It is necessary to carry out 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, since the pathology is provoked by microorganisms, against which the doctor will prescribe a course of antibiotic therapy. 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. Preparations based on fosfomycin perfectly cope with inflammation.
Chronic inflammation is more difficult to treat because it is complicated by other diseases. Complex treatment of long-term developing cystitis is carried out with the help of several groups of drugs. Antibiotics remain the mainstay, but the doctor will also prescribe anti-inflammatory drugs, vitamins and reparants. As a prevention of infections and to consolidate the effect of the therapy, the patient is prescribed herbal medicines, courses of physiotherapy.
cystitis in women
Most often, cystitis in women is accompanied by an exacerbation of chronic inflammation, therefore, according to statistics, every second patient consults a doctor with a recurrent 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 abnormalities of the genitourinary system. 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 too mobile urethra, which is easily displaced when the penis rubs. In this case, the mucous membrane is easily irritated and pathogenic microorganisms penetrate into 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 causes of cystitis are the alternation of anal sex with vaginal sex, which is absolutely impossible, since the microflora of the rectum enters directly into the vagina and the adjacent urethra. A factor in the development of bacterial infections is the manual introduction of microbes, the insufficient secretion of vaginal mucus, which causes microcracks.
The symptoms of postcoital inflammation do not differ, but the patient can notice their appearance directly in connection with sexual intercourse - usually the discomfort appears already in the first 12 hours.
The treatment of postcoital cystitis is individual, since the cause of the disease must first be established and the therapy directed precisely. In the case of 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 intercourse, then antibacterial drugs will be needed, followed by restoration of the 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 entire process of urination. The presence of erythrocytes gives urine a pink color. Also, the urine can be of "meat slop" color, that is, have a brownish color with the presence of mucous threads, threads or brown scales.
Usually, when urinating 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 for a visit to the doctor.
Cystitis during menstruation
In some women, 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 provoke the disease:
- inflammatory diseases of the female genital organs;
- hormonal fluctuations;
- allergic reaction to products for intimate hygiene;
- reduction of the body's defenses;
- failure to observe personal hygiene;
- non-specific infections, mycoses, sexually transmitted diseases.
Under the influence of these factors, the pathogen enters the urethra and the urethra, causing inflammation. Usually exacerbation of the disease occurs during ovulation, as well as 1-2 days before the start of menstruation. Vaginal discharge becomes an excellent environment for the reproduction of pathogenic microflora. Symptoms of cystitis during menstruation are typical, but they are complicated by characteristic manifestations during menstruation - pains and pulling pains in the lower abdomen.
The doctor can identify the cause of the pathology after taking 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 research, doctors found that asymptomatic bacteriuria is detected even before pregnancy, therefore, during the period of pregnancy, the disease manifests itself. The reasons for this are:
- changes in the hormonal background and the ratio of progesterone and estrogen in the body of the expectant mother;
- disorders of urodynamics with an increase in the size of the uterus;
- weakening of the ligament apparatus, greater mobility of the organ, but a decrease in its peristalsis and tone;
- enlargement 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 possible even with antibiotics. The doctor will prescribe the names of the drugs and the doses of the drugs that are safe for the fetus.
Diagnostic methods
The symptoms of cystitis are very characteristic, but the doctor will still prescribe a series of tests to finally find the cause 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:
- echoscopy - with the help of ultrasound, you can determine the degree of the inflammatory process, its spread, 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 - examination of the bladder with a contrast agent.
In women, treatment should begin with the determination of 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 extent 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 tests prescribed by him may be necessary.
Methods of treatment
In inflammatory diseases of the organ, doctors resort to therapeutic and surgical methods for the treatment of pathology. In most cases, it is possible to get rid of the disease with properly formulated drug therapy with the addition of physical therapy.
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 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 cause of the pathology;
- antifungal drugs - recommended if cystitis is provoked by fungi or complicated by them (for example, with a combined course of bacterial-fungal infection);
- phytopreparations - drugs in tablets and other forms that have antimicrobial and anti-inflammatory properties.
In some cases, doctors prescribe instillations of drugs to the patient instead of oral administration. Bladder lavage is performed in the clinic. With the help of a special catheter, the desired concentration of the drug is administered, which cannot be achieved in other ways. Before the procedure, the patient must defecate so that the medicine acts on the mucous membrane as long as possible.
Surgical treatment is applied only in rare cases, when the inflammatory process is provoked by 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 a distal urethral transposition.
Diet in the treatment of cystitis
It is imperative to follow a diet, as spicy and salty foods contribute to the appearance of mucosal ulcers. Other products are irritants that interfere with recovery:
- foods high in sugar;
- citrus fruits, sour foods, fermented;
- 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 meats, marinades, fatty foods. It is best to steam, stew or boil it. Eliminate all foods that can cause allergies.
An attack of cystitis can also be provoked by a heavy meal, during 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 irritated again. Precisely because of the high protein content, you should not eat a lot of meat, fish, beans, cheese. Replace them with fiber-rich foods - vegetables and permitted fruits.
During the treatment, try to eat at home, cook for yourself and do not include new foods or dishes in the menu. Note 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 treatment of the disease, physiotherapy is widely used. As a rule, it is recommended at the stage of recovery, when the acute inflammation of the bladder has been removed and there is a positive tendency towards recovery. Physiotherapy is also effective in case of submucosal localization of the cause of the pathology, when antibacterial drugs do not have the correct effect. Physiotherapy is used:
- phonophoresis;
- electrophoresis;
- magnetic therapy;
- UHF;
- modulated currents.
The session does not last long, but to achieve an effect, a course of 10-15 procedures is required. The powerful combined treatment of cystitis 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, reminding itself of periods of exacerbation.
Is it possible to visit a bath or hot shower with cystitis?
A hot shower or bath really helps to relieve spasm and soreness, but these thermal effects are contraindicated in bladder inflammation, as it contributes to the worsening of the inflammatory process.
Which doctor should you contact and which tests should you submit?
Women with suspected cystitis should contact a general practitioner, men - a urologist. If necessary, the patient can be referred for examination by a gynecologist. Investigations - urine test, blood test and ultrasound or cystoscopy.
How does age affect the course of the disease?
Most often, cystitis occurs 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 signs of cystitis?
Yes, in 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 severely limit yourself in fluid intake. You can drink up to 2 liters of pure water, compote, weak 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 choice of the drug and the appointment of an antibiotic scheme is the task of a specialist only: a urologist, a nephrologist, a therapist. It is unacceptable to stop the treatment of cystitis yourself or change the medicine.
The use of tetracyclines, cephalosporins in cystitis quickly leads to resistance of pathogens. Therefore, drugs from these groups are practically not used to treat cystitis. Doctors prescribe ampicillin, fluoroquinolones and various combinations of uroseptics. Herb-based uroseptics are also widely used, the main advantage of which is good tolerance and the almost complete absence of contraindications. Preparations from this group can be used to treat pregnant and lactating mothers.
The doctor selects an individual uroseptic by analyzing the data of each clinical case. In order to determine the sensitivity of pathogens to a certain antibiotic, a special study is carried out - bacteriological analysis of urine with inoculation on food 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 characteristics 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 an appointment with a 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 regime - drink about 2 liters of water, compotes, fruit drinks. Hypothermia is a common cause of deterioration, 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 not advisable to take analgesics and antispasmodics alone without extreme necessity - they can "smash" the clinical manifestations of the disease, and it will be more difficult for the doctor to make a correct diagnosis.