The danger of cystitis lies not only in the pain of symptoms - the lack of adequate treatment is fraught with complications, especially in women; improper selection and use of medications can lead to fatal consequences.
Causes and pathogenesis
A predisposing factor for the development of cystitis in women is the peculiarities of the anatomical structure of the urinary tract - a short and wide urethra, which allows access to 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 the larger bladder volume than in men, which allows them to withstand the urge to go to the bathroom 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 the use of tight or synthetic underwear, creating a thermos effect, in addition to the lack of personal intimate hygiene and the lack of discrimination in sexual relations.
Microbes enter the bladder either ascending (through the urethra) or descending (through the ureters from the kidneys). Infection with lymphatic flow from the pelvic organs is possible. More rare, but likely, is the hematogenous route of infection from distant foci of inflammation - the nasopharynx, tooth decay.
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 in it, but the active development of microbes is blocked by the body's immune forces. Furthermore, the infection is eliminated by periodic flow of urine.
The impetus for the development of acute cystitis can be:
- decreased immunity as a result of hypothermia, ARVI, nervous tension, stress, physical fatigue;
- allergies to certain medications;
- pyelonephritis, urolithiasis, accompanied by impaired urinary flow;
- diabetes;
- final stages of pregnancy;
- menopause, a state of imbalance in female sex hormones.
Cystitis can occur in acute and chronic forms. The latter is the result of inadequate treatment, persistent renal dysfunction and systemic diseases associated with hormonal imbalance.
Development of acute cystitis
The illness always begins abruptly, most often at night or the next morning after getting your feet wet, getting wet in the rain, or sitting on something cold. The symptoms are vivid and painful, it is impossible not to notice them:
- dull pain in the lower part of the abdomen, above the pubis, radiating to the lumbosacral region;
- nocturia - urge to urinate every 10-15 minutes;
- dysuria - constant feeling of a full bladder;
- urine production is scanty, difficult, drop by drop, accompanied by sharp cutting pain, burning, itching;
- the color is cloudy, with flakes, there may be impurities of pus or blood;
- weakness, weakness, headache, fever, low fever or high temperature.
The inflammatory process often affects the urethra, resulting in the development of urethritis, in which pain and itching intensify.
There can be no talk of performance in such a situation. The best thing to do is see a doctor immediately.
Treatment started in the first hours of the illness increases the chances of getting rid of cystitis in a short time for good.
Diagnosis
To treat cystitis, you will need to see a urologist, gynecologist, or infectious disease specialist.
Several tests will need to be done:
- 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 submucosal and deep muscular layers of the bladder, polyps, cysts.
Cystitis is indicated by an elevated white blood cell level - leukocyturia greater than 2, 000/ml.
Based on the content of red blood cells and cylindrical formations in the urine, it is possible to identify problems and associated factors that provoke 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.
Additionally, 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 causative agent of inflammation and the degree of damage to the organ tissue.
Antibiotic treatment
For the treatment of acute infectious cystitis that does not have complications, a course of antibiotics is prescribed for a period of 2 to 7 days. Tetracycline medicines based on clavulanic acid, from the group of penicillins and fluoroquinolones, are used.
The choice of medication is made by the doctor based on the results of sensitivity tests for 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 complicate further treatment, narrowing the range of effective drugs.
You cannot independently extend the prescribed period of antibiotic use - due to the suppression of the body's normal internal microflora, there will be a danger of developing dysbiosis and immunodeficiency states.
In addition to antibiotics, in the treatment of cystitis in women, antispasmodics, analgesics and herbal medicines in tablets and other pharmaceutical forms are prescribed to alleviate symptoms.
Herbal medicines and dietary supplements
Complexes based on plant raw materials are non-toxic, have anti-inflammatory, diuretic, choleretic, antimicrobial effects, enhance the work of antibiotics without disturbing the balance of microflora. They can be taken for a long time - from 2 weeks to 1 month during the treatment of 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 infections through the 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 based on medicinal plants. Available in the form of solutions and dragees, containing centaury, lovage herb, rosemary;
- natural complex based on oils of orange, pine, sage and other plants. Available in the form of a thick green paste. Before ingestion, a small amount of the product must be dissolved in warm water;
- the product, produced in tablet form, 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, silkworm leaves, papaya, cubeba pepper. Available in capsules and tablets. In addition to the pronounced diuretic effect, the product stops the inflammatory process in the urinary tract, improves its permeability, removes sand and dissolves small kidney stones, and also 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. An overdose can cause dizziness, drowsiness and low blood pressure. Do not forget 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 for prescribing drugs from the group of propionic acid derivatives. The medicines used have a general anti-inflammatory and analgesic effect. Side effects are rare but possible, so check your safety by talking to your doctor before using medication. Contraindications for taking products containing propionic acid derivatives include severe renal and hepatic impairment, pregnancy and early childhood under 6 years of age.
Probiotics
To prevent dysbiosis and disorders of the gastrointestinal tract while taking antibiotics, drugs containing natural complexes of lactobacilli and bifidobacteria - probiotics are used. The products have proven to protect and restore the microflora of the female genital organs, strengthening local immunity and reducing the undesirable consequences of antibiotic treatment. There are few contraindications to the use of probiotics - hypersensitivity to drug components or an allergic reaction.
For acute uncomplicated cystitis, dry and moist heat treatment is effective. Hot steam and sitz baths with a decoction of St. John's wort or yarrow are useful: for a steam bath, a hot decoction of herbs is placed in a basin. You need to squat over the emanating steam and sit for 10 to 15 minutes. The steam should be hot but not scalding. For sitz baths, a decoction of medicinal herbs is added to water at a temperature of around 45 °C.
At rest, you can apply a warm heating pad to the lower abdomen - at the location of the bladder.
Thermal procedures stimulate intertissue exchanges 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 may cause additional harm.
Additional treatments
Bladder massage techniques can be used as an additional treatment.
- In a reclining position on your back, bend your knees slightly (you can place a cushion or pillow under your back).
- Place the fingertips of both hands on your belly, 2 to 3 fingers below your navel.
- Exhaling, press gently and deeply on the abdominal wall until you feel a slight pain inside, after a few seconds, release your hands and press on your 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 done correctly, after it is finished there will be a strong urge to go to the bathroom.
During cystitis treatment, you need to drink more fluids than usual to flush your bladder. In addition to drinking water, it is useful to drink still slightly alkaline mineral water, fruit juices based on cranberries, black and red currants, cherries, sea buckthorn and other berries. Acidic drinks have an antimicrobial effect, prevent infection from remaining 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 dill, chamomile, parsley, lingonberry and corn leaves 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, boiled 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 insufficient kidney function, tendency to hypertension or hypotension.
During the treatment of cystitis, it is necessary to exclude hot spices, pickled and salty foods, confectionery, carbonated soft 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
Late onset or incorrect and careless 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 practically does not make itself 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 in the bladder for a long time reaches the deep layers of the organ, contributing to the formation of intractable morphological forms of the disease: interstitial, cystitis, hemorrhagic, gangrenous cystitis, polyposis growths. The inflammation process involves not only the mucous membrane, but also the submucosal layer, muscle tissue and the organ's circulatory system. Gradually, the affected areas are replaced by rough scar tissue, the organ loses its elasticity and ceases to adequately fulfill its functions.
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, fallopian tube adhesions and subsequent infertility.
In pregnant women, an exacerbation of the chronic process is inevitable, influenced by changes in hormonal levels, fluctuations in immunity, compression of internal organs by the growing uterus, which additionally 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 setting. In addition to taking medications, the following types of therapy may be prescribed:
- instillation - introduction into the bladder cavity of medicinal solutions that eliminate toxins and have an anti-inflammatory effect;
- physiotherapy – treatment with electric current pulses, iontophoresis, UHF, mud applications, acupuncture;
- positional therapy - special postures that help eliminate congestion and restore patency of the urinary tract. The method is recommended for pregnant women;
- surgical treatments - laser cauterization or excision of the affected bladder tissue. In severe cases of total loss of the organ's functions, they resort to bladder plastic surgery using the intestinal tissue itself.
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 from natural fabrics, choose shoes and clothes according to the climate and season, treat colds and chronic pathologies in a timely manner, take general strengthening vitamin complexes.