Cystitis is an inflammation of the bladder. This organ is designed for the collection and excretion of urine, but if the mucous membrane of the organ is damaged, its function is impaired and the person begins to experience unpleasant symptoms. In most cases, the pathology affects only the mucous membrane, but sometimes the inflammatory process spreads to the muscle tissue. Interstitial cystitis is the most difficult to fight.
The disease mainly affects women, which is related to the anatomical features of the urethra. In men, inflammation appears rarely, it usually acts as a comorbidity against the background of chronic prostatitis.
Symptoms
The symptoms of cystitis are quite obvious and it is difficult not to see them. As a rule, the disease begins acutely, so patients pay attention to obvious discomfort in the urinary tract. Among the manifestations of pathology, note:
- frequent urge to urinate;
- incomplete urination;
- cramps and pain during urination;
- increase in body temperature;
- the appearance of blood in the urine;
- cloudy urine (due to the presence of pus);
- nausea, drawing pains as during menses.
Despite the characteristic symptoms, the disease can have different manifestations. Hematuria is not always present, but the pain in intensity resembles only mild discomfort. In any case, if symptoms of pathology occur, it is necessary to consult a doctor to make a diagnosis as early as possible. The disease in the acute stage in the early stage is best treated, but the fight against the chronic form takes longer.
Forms and types of chronic cystitis
According to the nature of the inflammatory process, cystitis is acute and chronic. Depending on the source of development, the disease can be primary (independent disease) or secondary (inflammation spreads from neighboring areas, for example, the kidney).
Cystitis occurs depending on the area of damage to the mucous membrane of the bladder:
- general (general);
- focus.
The following clinical forms of cystitis are distinguished:
- catarrh - non-purulent inflammation of the mucous membrane of the bladder;
- phlegmonosis - purulent damage of the submucosal layer;
- granulomatosis - 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 body.
A number of rare forms are also distinguished: ulcerative, cystic, gangrenous cystitis.
All different inflammatory diseases of the bladder are combined into two large groups:
- specific cystitis caused by pathogens of sexual infections: gonococci, ureaplasmas, chlamydia.
- non-specific cystitis - develops due to the fault of opportunistic flora, whose representatives do not cause diseases under normal conditions (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 of 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, 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 appears due to inflammation of the kidneys, reaches the bladder through the ureters;
- lymphogenic - with the flow of lymph through the pelvic organs in case of genital lesions;
- hematogenous - the infection enters the bloodstream, but this way of spreading is the rarest;
- directly - if an abscess breaks inside the bladder and pathogenic microflora penetrates directly into the bladder cavity, it can also occur during catheterization of the organ, infection during surgery.
E. coli often causes cystitis. It occurs in 80-95% of uncomplicated pathological cases. This bacterium is normally found in the rectum, but when it enters the urethra, it provokes an inflammatory process. Enterobacteria, staphylococci, fungi, sexually transmitted infections can also cause the disease. It usually occurs before the appearance of symptoms of vaginitis or bacterial vaginosis, and you can also see 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 patient will not show symptoms of cystitis. However, when exposed to some factors, it manifests itself:
- damage to the mucous membrane of the bladder;
- blood circulation disorders of the pelvic organs;
- hypothermia;
- the presence of other foci in the body, for example, kidney infections;
- decrease in the body's defense ability;
- inflammatory diseases of 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 go into relapse stage. Therefore, in order to prevent relapses, it is necessary to exclude the influence of provoking factors on the body.
Causes of transition of acute inflammation to chronic phase
The inflammatory process in the bladder can occur due to various pathogens. Most often, it is bacterial, but there are cystitis and viral, fungal etiology. If the acute form of the disease is detected in time, if the correct treatment of cystitis is prescribed and the patient follows all the recommendations of the doctor, the pathological process can be completely eliminated and recovery will come.
But often women postpone a visit to the doctor, hoping that everything will go away on its own, and try to treat cystitis on their own. As a result, valuable time is wasted. Microorganisms multiply actively, the intensity of inflammation increases. Microbes that are completely "settled" in the bladder will not leave their position easily. Inflammation is chronic.
It is also common for a specialist to prescribe the treatment of cystitis, the patient starts taking the medicine as soon as he feels comfortable and stops the therapy. As a result, the pathogens are not completely destroyed, and the survivors are divided - chronic cystitis is formed, which is resistant to antibiotic therapy.
Finally, the following conditions contribute to the development of chronic cystitis:
- general decrease in immune defense, hypothermia;
- hormonal changes (pregnancy, menopause);
- neglecting the rules of personal hygiene;
- gynecological diseases;
- chronic diseases of other organs and systems: diabetes mellitus, malignant tumors.
Symptoms of chronic cystitis
Today, the term "chronic cystitis" is outdated in the medical community. The "old way" is used 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 6 months or 3 episodes per year.
The exacerbation period is accompanied by characteristic symptoms:
- frequent urination;
- pain, burning, pain during urination;
- night calls;
- feeling of incomplete ejaculation, pain in the lower abdomen.
Aggravation 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, the symptoms can be completely corrected. 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 mucous membrane of the bladder. The epithelium of the mucous membrane undergoes cicatricial deformation or is replaced by stratified squamous. At this stage, chronic cystitis can no longer be treated with antibiotic therapy alone. It is necessary to carry out special medical procedures.
Acute and chronic cystitis: treatment approaches
Treatment of acute and chronic forms of pathology is different. Usually, the treatment of acute cystitis is easier, because the pathology is provoked by microorganisms, against which the doctor will prescribe a course of antibiotic therapy. Antibacterial drugs are quite diverse. They help to quickly stop the attack of the disease, and the systematic use of the funds will lead to a complete cure for cystitis. Fosfomycin-based preparations perfectly fight 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 several groups of drugs. Antibiotics remain the mainstay, but the doctor will also prescribe anti-inflammatory drugs, vitamins and reparatives. To prevent infections and strengthen the effect of therapy, the patient is prescribed herbal medicines, physiotherapy courses.
cystitis in women
Often, cystitis in women is accompanied by an exacerbation of chronic inflammation, therefore, according to statistics, every second patient consults a doctor with a recurring disease twice a year.
This does not speak of difficulties in the treatment of the disease, but of the need to carefully follow the doctor's prescriptions and eliminate the factors that cause the disease.
cystitis after intercourse
Postcoital cystitis in women is provoked by genitourinary abnormalities. When it slides down and inside the external opening of the urethra, the pathogen becomes more susceptible to the penetration of microflora. Also, the culprit of postcoital cystitis is a very mobile urethra that 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. The symptoms and treatment of this form of pathology are interconnected, so doctors approach the problem individually in each clinical situation.
Also, the causes of cystitis are the change of anal sex with vaginal sex, which is absolutely impossible, because the microflora of the rectum directly enters the vagina and the adjacent urethra. Factors in the development of bacterial infections are the introduction of microbes by hand, insufficient secretion of vaginal mucus, which causes microcracks.
The symptoms of postcoital inflammation do not differ, but the patient can notice their appearance with direct intercourse - usually discomfort occurs during the first 12 hours.
The treatment of postcoital cystitis is individual, because first of all it is necessary to determine the cause of the disease and to direct the therapy precisely. With abnormalities of the urethra, the doctor will suggest plastic surgery, as a result of which the problem will disappear. Both surgery and hyaluronic acid injection are possible. If the STI infection occurred during intimate intercourse, then antibacterial drugs will be required, 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 is not visible at the end, but accompanies the entire urination process. The presence of erythrocytes gives the urine a pink color. Also, the urine can be the color of "meat slopes", that is, it has a brown color with the presence of mucous threads, threads or brown flakes.
Usually, there is severe pain when urinating with blood, pain in the bladder, and pulling sensations in the lower back. The appearance of blood in the urine is a mandatory reason to consult a 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 cause the disease:
- inflammatory diseases of female genital organs;
- hormonal changes;
- allergic reaction to intimate hygiene products;
- decrease in the body's defense ability;
- non-compliance with personal hygiene rules;
- non-specific infections, mycoses, STDs.
Under the influence of these factors, the pathogen enters the urethra and urethra and causes inflammation. Usually, exacerbation of the disease occurs during ovulation, as well as 1-2 days before the onset of menstruation. Vaginal discharge is an excellent ground for the development of pathogenic microflora. The symptoms of cystitis during menstruation are typical, but they are complicated by the characteristic manifestations during menstruation - pain in the lower abdomen and pulling pains.
The doctor can determine the cause of the pathology after taking an anamnesis and studying the results of laboratory diagnostics. The treatment regimen is standard, but if genital infections are detected, simultaneous treatment of gynecological pathologies may be required. It is important to observe personal hygiene and strengthen the immune system.
Pregnancy and cystitis
According to the results of the research, doctors found that asymptomatic bacteriuria was detected even before pregnancy, so it was during pregnancy that the disease manifested 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;
- violation 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 hidden course of the pathology makes early diagnosis difficult. Treatment of cystitis during pregnancy is possible even with the use of antibiotics. The doctor will determine 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 finally prescribe a series of tests to find the cause of the pathology and determine the nature of the course of the disease. The specialist will collect anamnesis, analyze the patient's complaints and conduct an external examination with palpation of the bladder area. The following diagnostic methods are used:
- echoscopy - using ultrasound, you can determine the degree and spread of the inflammatory process, as well as evaluate the state of the urinary system and genitals;
- cystoscopy - examination of the organ using an endoscope, which allows assessing the condition of the mucous membrane of the bladder;
- cystography - examination of the bladder using a contrast agent.
In women, treatment should begin with the definition of the pathogen. A number of laboratory tests are mandatory: general urinalysis, Nechiporenko analysis, bacteriological culture, tissue biopsy, polymerase chain reaction (for a more accurate identification of the pathogen). To assess the degree of the inflammatory process, doctors can send a blood test. If you suspect inflammatory pathologies of the female genital organs, you may need to be examined by a gynecologist and have tests prescribed by him.
Treatment methods
In inflammatory diseases of organs, doctors resort to therapeutic and surgical methods in the treatment of pathology. In most cases, it is possible to get rid of the disease with properly designed drug treatment with the addition of physiotherapy.
Drug treatment includes a combination of different groups of effective drugs depending on the nature of the disease. The patient can be given:
- anti-inflammatory drugs - serve to relieve swelling of the mucous membrane and relieve pain, the inflammatory process decreases;
- antispasmodics - used to relieve pain symptoms, they effectively relieve bladder spasms;
- antibacterial therapy - a group of drugs that act directly on the causative agent of the pathology;
- antifungal drugs - recommended when cystitis is provoked by a fungus or aggravated by it (for example, with a combined course of bacterial-fungal infection);
- phytopreparations - medicines in tablets and other forms with antimicrobial and anti-inflammatory properties.
In some cases, doctors prescribe instillation 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 controlled, which cannot be achieved by other means. Before the procedure, the patient should empty himself, so that the drug affects the mucosa as long as possible.
Surgical treatment is used only in rare cases, when the inflammatory process causes anatomical changes or in severe recurrent infections. At this time, laser correction is performed. For example, in postcoital cystitis, the only treatment for many women is transposition of the distal urethra.
Diet in the treatment of cystitis
It is important to follow the diet because spicy and salty foods contribute to the formation of ulcers on the mucous membrane. Other products are irritants that prevent recovery:
- high sugar foods;
- citrus fruits, sour foods, fermented;
- spices;
- tomatoes and all dishes with tomatoes, additives (ketchups, sauces, adjika);
- soy sauce and vinegar;
- nuts and chocolate.
A light and nutritious diet is recommended to the patient to speed up recovery. It is necessary to exclude fried foods, smoked meats, marinades, fatty foods. It is better to steam, bake or boil. Eliminate all foods that can cause allergies.
An attack of cystitis can also be provoked by heavy food in which the patient suffers from constipation. Intestinal peristalsis deteriorates due to stagnation of faecal masses, stagnation occurs in the bladder, as a result of which the mucosa is irritated again. Because of the high protein content, you should not eat too much meat, fish, beans, and cheese. Replace them with fiber-rich foods - vegetables and permitted fruits.
During treatment, try to eat at home, cook yourself and do not introduce new foods and dishes to the menu. Remember 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 in the recovery phase, when the acute inflammation of the bladder is eliminated and a positive trend towards recovery is observed. Physiotherapy is also effective for submucosal localization of the causative agent of the pathology, when antibacterial drugs do not have the necessary effect. It is used as physiotherapy:
- phonophoresis;
- electrophoresis;
- magnetotherapy;
- UHF;
- modulated currents.
The session does not last long, but 10-15 procedures are required to achieve the effect. Strong treatment of cystitis with combined methods will help to get rid of the disease completely.
Question and answer
How long does cystitis last?
The duration of cystitis depends on the form of the pathology. Acute lasts 7-10 days, after which recovery occurs with proper treatment, but the chronic form of the disease can last for several months, reminiscent of periods of exacerbation.
Is it possible to visit a bath or a hot shower with cystitis?
A hot shower or bath really helps to relieve spasm and pain, but these thermal effects are contraindicated in inflammation of the bladder, because it contributes to the aggravation of the inflammatory process.
Which doctor should I consult and which tests should I submit?
Women who suspect cystitis should contact a general practitioner, men - a urologist. If necessary, the patient can be referred to a gynecologist for examination. Tests - urinalysis, blood test and ultrasound or cystoscopy.
How does age affect the course of the disease?
Most often, cystitis occurs in women aged 20-45, which is associated with active sexual activity, unstable hormonal levels and a high risk of developing gynecological pathologies. Pathology occurs less often in older women and is associated with a weakened immune system.
Is it possible to treat 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 proper treatment, you can achieve a stable and very long remission without any symptoms from the urinary system.
Do I need a special diet for cystitis symptoms?
Yes, during the exacerbation of the disease, patients are advised to follow a diet excluding salty, spicy and irritating foods. Despite frequent urination, you should not severely limit yourself with fluid intake. You can drink up to 2 liters of clean water, compote, weak tea. However, alcohol and coffee are prohibited in the acute phase.
What features should be considered when choosing a uroseptic?
The choice of drugs and the appointment of an antibiotic regimen is a task only for a specialist: a urologist, a nephrologist, a therapist. Stopping the treatment of cystitis yourself or changing the remedy is unacceptable.
The use of tetracyclines and 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 various combinations of ampicillins, fluoroquinolones and uroseptic agents. Herbal uroseptics are also widely used, their main advantage is good tolerance and almost complete absence of contraindications. Preparations from this group can be used to treat pregnant and lactating mothers.
The doctor, analyzing the data of each clinical situation, selects a uroseptic individually. To determine the sensitivity of pathogens to a certain antibiotic, a special study is carried out - bacteriological analysis of urine with inoculation in a food medium.
How to treat cystitis yourself at home and is it possible to do it?
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 thorough examination, make a correct diagnosis and prescribe the necessary treatment.
However, patients often find that a doctor's appointment is scheduled for a certain period of time and the pain is relieved immediately. To reduce the rate of development of the pathological process, follow the drinking regime - drink about 2 liters of water, compotes, fruit drinks. Hypothermia is a common cause of exacerbation of the condition, so it is worth dressing warmly and protecting 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 analgesics 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.