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 deal with.
The disease mainly affects women, which is associated with the anatomical characteristics of the urethra. Inflammation in men rarely appears, it usually acts as a comorbidity in the context of chronic prostatitis.
Symptoms
The signs of cystitis are pretty obvious and it's hard not to notice them. As a rule, the disease begins acutely, which is why patients pay attention to obvious discomfort in the urinary tract. Among the manifestations of the pathology, note:
- frequent urge to urinate;
- sensation of incomplete urination;
- cramping and pain when urinating;
- increase in body temperature;
- the appearance of a mixture 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 present different manifestations. Hematuria is not always present, but the intensity of pain can only resemble mild discomfort. In any case, if signs of pathology occur, it is necessary to consult a doctor to make a diagnosis as soon as possible. Early-stage acute-phase disease is best treated, but the chronic form takes longer to combat.
Forms and types of chronic cystitis
By the nature of the inflammatory process, cystitis is both 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 kidney).
According to the area of damage to the mucous membrane of the bladder, cystitis occurs:
- Grand total);
- 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, characterized by the release of blood in the urine;
- interstitial cystitis - inflammation spreads to all layers of the organ.
Several rare forms are also distinguished: ulcerative, cystic and gangrenous cystitis.
The whole variety of inflammatory bladder diseases is combined into two large groups:
- specific cystitis, which are caused by pathogens of sexual infections: gonococci, ureaplasmas, chlamydia.
- nonspecific cystitis - develops as a result of opportunistic flora, whose representatives under normal conditions do not lead to diseases (eg 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, parasite toxins.
causes of cystitis
In most cases, damage to the bladder and the development of the inflammatory process are associated with the penetration of the infection, however, cystitis can be toxic and allergic in nature. Once an infection enters, the disease is spread 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, it reaches the bladder;
- lymphogenic - by the flow of lymph through Organs pelvic organs in the presence of lesions of Organs genital organs;
- hematogenous - the infection enters the bloodstream, but this route of spread is the rarest;
- direct - if an abscess ruptures inside the bladder and pathogenic microflora penetrates directly into the bladder cavity, it can also be during catheterization of an organ, infection during surgery.
Most of the time, E. coli causes cystitis. It occurs in 80-95% of cases of uncomplicated pathology. This bacteria 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 cause the disease. It usually precedes the appearance of symptoms of vaginitis or bacterial vaginosis, and you may also notice symptoms of the disease within a day after sexual intercourse (post-coital cystitis).
Factors that contribute to the development of cystitis
The body with good immunity can cope with the presence of pathogenic microflora, so that the symptoms of cystitis in the patient do not appear. But when exposed to some factors, it manifests itself:
- damage to the mucous membrane of the bladder;
- circulatory disorders of Organs pelvic organs;
- hypothermia;
- the presence of other foci in the body, such as kidney infections;
- decrease in the body's defenses;
- inflammatory diseases of Organs 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 the chronic pathology will move into the relapse stage. Therefore, in order to avoid relapses, it is necessary to exclude the influence of provoking factors on the body.
Causes of transition from acute inflammation to the chronic phase
The inflammatory process in the bladder can occur due to various pathogens. Most often they are bacteria, but there is cystitis and viral and 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 put off visiting the doctor, try to treat cystitis on their own, hoping that everything will go away by itself. As a result, precious time is wasted. Microorganisms actively multiply, the intensity of inflammation increases. Having completely "established" in the bladder, the microbes will not give up their positions so easily. Inflammation becomes chronic.
It is also common for a specialist to prescribe treatment for cystitis, the patient starts taking medication and stops therapy on their own the moment they feel relieved. As a result, pathogens are not completely destroyed, and survivors are divided - chronic cystitis is formed, resistant to antibiotic therapy.
Finally, the following circumstances contribute to the development of chronic cystitis:
- general decrease in immune defense, hypothermia;
- hormonal changes (pregnancy, menopause);
- negligence of personal hygiene rules;
- 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 "the old fashioned 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 in 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 lower abdomen.
Exacerbation of the disease may be accompanied by a moderate increase in body temperature, the appearance of blood in the urine, its turbidity.
During the period of remission, symptoms can be completely alleviated. But more 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 scar deformation or is replaced by a squamous layer. At this stage, chronic cystitis can no longer be cured with antibiotic therapy alone. Special medical procedures are required.
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, because the pathology is caused by microorganisms, against which the doctor will prescribe a course of antibiotic therapy. Antibacterial drugs are quite diverse. They quickly help to prevent an attack of the disease, and the systematic use of funds will lead to a complete cure of cystitis. Fosfomycin-based preparations perfectly cope with 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 using several groups of drugs. Antibiotics continue to lead, but the doctor also prescribes anti-inflammatories, vitamins and repairers. In order to prevent infections and to consolidate the effect of the therapy, the patient is given 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 sees a doctor with a recurring illness twice a year.
This speaks not so much of the difficulties in treating the disease, but of the need for careful adherence to medical prescriptions and the elimination of the factors that cause the disease.
cystitis after intercourse
Postcoital cystitis in women is caused by genitourinary abnormalities. When displaced downwards and into the external opening of the urethra, it becomes more susceptible to penetration by pathogenic microflora. Also, the culprit of post-coital cystitis is a very mobile urethra, which is easily displaced when the penis is rubbed. In this case, the mucous membrane is easily irritated, and pathogenic microorganisms penetrate the opening of the urethra. Symptoms and treatment of this form of pathology are intertwined, so doctors approach the problem individually in each clinical case.
In addition, the causes of cystitis are the alternation of anal and vaginal sex, which is absolutely impossible to do, because the microflora of the rectum directly enters the vagina and the adjacent urethra. A factor in the development of bacterial infections is the introduction of microbes manually, insufficient secretion of vaginal mucus, which causes microcracks.
The symptoms of post-coital inflammation do not differ, but the patient can notice their appearance directly in relation to sexual intercourse - usually the discomfort occurs within the first 12 hours.
The treatment of post-coital cystitis is individual, as it is first necessary to determine the cause of the disease and precisely target therapy. With an abnormality of the urethra, the doctor will suggest plastic surgery, whereby the problem will disappear. Both surgery and hyaluronic acid injections are possible. If an STD infection has occurred during an intimate relationship, antibacterial medication will be required, followed by restoration of vaginal microflora.
What does the blood in the 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 urination process. The presence of erythrocytes gives the urine a pink color. In addition, the urine may have the color of "flesh stains", that is, it may present a brownish color with the presence of threads of mucus, threads or brown flakes.
Normally, when urinating with blood, there is severe pain, bladder pain, and pulling sensations in the lower back. The appearance of blood in the urine is a mandatory reason to see 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 more susceptible to infection, so the following can trigger the condition:
- 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 start 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 and pulling pains in the lower abdomen.
The doctor can identify the cause of the pathology after taking a history and studying the results of laboratory diagnoses. The treatment regimen is standard, but simultaneous treatment of gynecological pathologies may be necessary if genital infections are diagnosed. It is important to observe personal hygiene, strengthen the immune system.
pregnancy and cystitis
According to the results of the studies, doctors have found that asymptomatic bacteriuria is detected even before pregnancy, therefore, it is during the period of gestation that the disease manifests itself. The reasons for this are:
- changes in the hormonal background and in the proportion of progesterone and estrogen in the body of the expectant mother;
- violations of urodynamics as the size of the uterus increases;
- weakening of the ligament apparatus, greater mobility of the organ, but decreased peristalsis and tone;
- expansion 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 the use of antibiotics. The doctor will prescribe the drug names and dosages of 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 out the causative agent of the pathology and determine the nature of the course of the disease. The specialist will take an anamnesis, analyze the patient's complaints and perform 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 - an examination of the bladder using a contrast agent.
In women, treatment should begin with defining 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 degree of the inflammatory process, doctors may send a blood test. If inflammatory pathologies of the female genital organs are suspected, an examination by a gynecologist and delivery of tests prescribed by him may be necessary.
treatment methods
In inflammatory diseases of the organ, doctors resort to therapeutic and surgical methods of treating pathology. In most cases, it is possible to get rid of the disease with a 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 receive:
- anti-inflammatories - serve to relieve swelling of the mucosa and eliminate pain, the inflammatory process is reduced;
- antispasmodics - used to relieve pain symptoms, effectively eliminate bladder spasms;
- antibacterial therapy - a group of drugs that act directly on the causative agent of the pathology;
- antifungal drugs - recommended if the cystitis is caused by or complicated by a fungus (for example, with a combined course of a bacterial-fungal infection);
- phytopreparations - medicines in tablets and other forms that have antimicrobial and anti-inflammatory properties.
In some cases, doctors prescribe drug instillations 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 needs to empty himself so that the drug affects the mucosa for as long as possible.
Surgical treatment is used only in rare cases, when the inflammatory process has caused anatomical changes or in recurrent severe infections. In this case, laser correction is performed. For example, in post-coital 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, as 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;
- spices;
- tomatoes and all dishes with tomato, 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. Eliminate all foods that can trigger allergies.
An attack of cystitis can also be provoked by heavy food, in which the patient suffers from constipation. With the stagnation of fecal masses, intestinal peristalsis worsens, stagnation in the bladder occurs, as a result of irritation of the mucosa again. It is because of the high protein content that you should not eat too much meat, fish, beans, cheeses. Replace them with fiber-rich foods - vegetables and fruits allowed.
During treatment, try to eat at home, cook alone and not include new foods or dishes on the menu. Remember that the diet completely excludes alcoholic beverages and also limits coffee and tea. Juices, herbal infusions and decoctions, fruit drinks and jams will come in handy. It is better to replace regular water with slightly alkaline mineral water.
Physiotherapy
Among the methods of treating the disease, physical therapy is widely used. As a rule, it is recommended in the recovery phase, when the acute inflammation of the bladder has been removed and there has been a positive trend towards recovery. Physiotherapy is also effective for the submucosal localization of the causative agent of the pathology, when antibacterial drugs do not have an adequate effect. How physical therapy is used:
- phonophoresis;
- electrophoresis;
- magnetotherapy;
- 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 combined ways 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 lasts from 7 to 10 days, after which, with proper treatment, recovery occurs, but the chronic form of the disease can last several months, resembling periods of exacerbation.
Is it possible to visit a bath or a hot bath with cystitis?
A hot bath or bath really helps to relieve the spasm and pain, however, these thermal effects are contraindicated in bladder inflammation as this contributes to the worsening of the inflammatory process.
Which doctor to go to and which tests to deliver?
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 aged 20 to 45 years, associated with active sexual activity, unstable hormone levels and an increased 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 get a very long and stable remission without any urinary system symptoms.
Do I need a special diet for signs of cystitis?
Yes, during the period of exacerbation of the disease, patients are advised to adhere to a diet with the exception of salty, spicy and irritating foods. Despite the presence of frequent urination, you should not severely limit your fluid intake. You can drink up to 2 liters of pure water, compote, weak tea. But alcohol and coffee in the acute phase are prohibited.
What characteristics 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 only for one specialist: urologist, nephrologist, therapist. It is unacceptable to stop the treatment of cystitis on your own or to 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 for the treatment of cystitis. Doctors prescribe ampicillins, fluoroquinolones, and various combinations of uroseptic agents. Plant-based uroseptics are also widely used, the main advantage of which is good tolerability and the almost total absence of contraindications. Preparations from this group can be used to treat pregnant and lactating mothers.
The doctor selects a uroseptic individually, analyzing the data of each clinical case. To determine the sensitivity of pathogens to a specific antibiotic, a special study is carried out - a bacteriological analysis of urine with inoculation in nutrient medium.
How to 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, carry out 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 a certain time and the pain needs to be relieved immediately. To reduce the rate of progression of the pathological process, observe the intake regime - drink about 2 liters of water, compotes, fruit drinks. Hypothermia is a common cause of the condition worsening, so it pays to dress well and protect yourself from drafts.
Also try to avoid overexertion. Rest (physical and sexual) will help to wait for an appointment with a specialist. It is undesirable to take painkillers and antispasmodics on their own without extreme need - they can "lubricate" the clinical manifestations of the disease, and it will be more difficult for the doctor to make a correct diagnosis.