The danger of cystitis is not only in the pain of the symptoms - the lack of proper treatment is full of complications, especially in women, improper selection and use of drugs can lead to life-threatening consequences.
Causes and pathogenesis
A predisposing factor for the occurrence of cystitis in women are the peculiarities of the anatomical structure of their urinary tract - a short, wide urethra, which provides access to the unhindered penetration of microbes. Anal and vaginal openings located near the urethra increase the risk of infection.
Another physiological characteristic that affects the frequent development of pathology in women is the larger volume of the bladder than in men, which allows them to endure the urge to go to the toilet for a long time. Periodic stagnation of urine causes persistence and proliferation of infection in the organ cavity.
The development of the inflammatory process facilitates the wearing of tight or synthetic underwear, creating a thermos effect, as well as the lack of personal intimate hygiene and the lack of indiscriminateness in sexual relations.
Microbes enter the bladder by ascending (through the urethra) or descending (through the ureters from the kidneys) route. Infection is possible through the flow of lymph from the pelvic organs. Less common, but more 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 streptococcus, 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 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 immune forces of the body. In addition, the infection is eliminated by the periodic flow of urine.
The stimulus 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 disturbed urine outflow;
- diabetes;
- late stages of pregnancy;
- menopause, a state of imbalance of female sex hormones.
Cystitis can occur in acute and chronic forms. The latter is the result of improper treatment, persistent renal dysfunction and systemic diseases associated with hormonal imbalance.
Development of acute cystitis
The disease always starts suddenly, usually in the evening or the next morning after wet feet, rain or sitting on something cold. The symptoms are vivid and painful, it is impossible not to notice them:
- agonizing pain in the lower abdomen above the pubis, spreading to the lumbosacral region;
- nocturia - urge to urinate every 10-15 minutes;
- dysuria - constant feeling of bladder fullness;
- urine output is scarce, difficult, drop by drop, followed by acute cut, burning, itching;
- the color is cloudy, with flakes, there may be an admixture of pus or blood;
- weakness, weakness, headache, fever, low fever or high fever.
The inflammatory process often affects the urethra, which results in the development of urethritis, in which pain and itching increase.
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 forever in a short time.
Diagnostics
For the treatment of cystitis, you will need to consult a urologist, gynecologist or infectious disease specialist.
It is necessary to perform a series of tests:
- general urinalysis;
- microscopic examination of urine;
- bacterial culture to determine the sensitivity of pathogens 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 is indicated by a high level of leukocytes - leukocyturia more than 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 that cause cystitis: traumatic kidney damage, urolithiasis, acute and chronic glomerulonephritis, nephropathy, purulent abscesses, toxic lesions of the urinary system, the presence of viruses.
In addition, a gynecological examination is necessary - analysis of a vaginal swab for the presence of sexually transmitted infections and pathogenic microflora.
Such a detailed anamnesis 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 that is not burdened with complications, a course of antibiotics is prescribed for a duration of 2 to 7 days. Tetracycline drugs based on clavulanic acid from the group of penicillins and fluoroquinolones are used.
The choice of medicine is made by the doctor based on the results of sensitivity tests to pathogens. Spontaneous use of drugs can only suppress symptoms and contribute to the development of a sluggish inflammatory process. Developed microbial resistance 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 a state of immunodeficiency.
In addition to antibiotics, in the treatment of cystitis in women, spasmolytics, analgesics and herbal medicines in tablets and other forms are also prescribed to relieve symptoms.
Herbal medicines and food 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 longer - 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 removal of infection through 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 herbs. Available in the form of a solution and dragee, which contains cattle, violet plant, rosemary;
- natural complex based on oil of orange, pine, sage and other plants. Available as a thick green paste. Before swallowing, a small amount of the product should be dissolved in warm water;
- the product, produced in the form of tablets, contains extracts of hops, peppermint, 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, cubed 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, acts as an antispasmodic and analgesic.
Antispasmodics
Myotropic antispasmodics are prescribed to relieve pain, relax the smooth muscles of the bladder and facilitate the passage of urine. 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 drop in blood pressure. Remember that an antispasmodic provides only temporary relief, but does not cure the disease.
Analgesics
Severe pain, accompanied by fever, fever 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 the medication. 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 drug components or an allergic reaction.
For uncomplicated acute cystitis, dry and moist heat treatment is effective. Warm steam and sitting baths with a decoction of St. John's wort or St. John's wort are useful: for a steam bath, a hot herbal decoction is poured into the basin. You have to crouch over the steam coming out and sit for 10-15 minutes. The steam should be warm, but not scalding. For sitting baths, a decoction of medicinal plants is added to the water at a temperature of around 45 °C.
At rest, you can put a warm heating pad on the lower part of the abdomen - in place of the bladder.
Thermal procedures stimulate inter-tissue exchange and have a relaxing, analgesic and antispasmodic effect.
Heating is allowed only in the absence of inflammatory processes in the genital organs, otherwise such treatment can cause additional damage.
Additional treatments
Bladder massage techniques can be used as an additional treatment.
- In a lying position on your back, bend your knees slightly (you can put a support or a pillow under your back).
- Place the fingertips of both hands on the stomach 2-3 fingers below the navel.
- Exhaling, gently and deeply press the abdominal wall until you feel a slight pain inside, after a few seconds release your hands and press the stomach again. Do 5 or 6 reps.
The movements are aimed at eliminating delayed diuresis, congestion and speeding up 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 need to drink more fluids than usual to flush the bladder. In addition to clean drinking water, it is useful to drink slightly alkaline mineral water without gas, fruit drinks made from cranberries, black and red currants, cherries, sea buckthorn and other berries. Sour drinks have an antimicrobial effect, prevent the retention of infection on the walls of the organs and accelerate the removal of inflammatory products from the bladder cavity.
Decoctions and infusions of seeds and herbs of dill, chamomile, parsley, cranberry leaves and millet have a high diuretic and anti-inflammatory effect. For their preparation, 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 renal function, tendency to hypertension or hypotension.
During the treatment of cystitis, it is necessary to exclude hot spices, sour and salty foods, confectionery products, carbonated sweet drinks, strong coffee and alcohol from the diet. These products interfere with the excretory function of the kidneys, encourage the accumulation of uric acid and irritate the urinary tract.
Chronic cystitis
Untimely initiation or improper 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 slowed inflammatory process, during which the disease is practically not felt, alternate with a sharp worsening of symptoms.
The danger of chronic cystitis lies not only in severe discomfort and pain that occurs during exacerbations. The focus of inflammation that has existed for a long time in the urinary bladder affects the deep layers of the organs, contributing to the emergence of difficult-to-resolve morphological forms of the disease: interstitial, cystic, hemorrhagic, gangrenous cystitis, polypous growths. The inflammatory process involves not only the mucosa, but also the submucosal layer, muscle tissue and the circulatory system of the organ. Gradually, the affected areas are replaced by rough scar tissue, 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, fallopian tube adhesions and subsequent infertility.
In pregnant women, worsening 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 additionally causes stagnation of urine and the 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 cavity of the bladder of medicinal solutions that flush out toxins and have an anti-inflammatory effect;
- physiotherapy - treatment with pulses of electric current, iontophoresis, UHF, mud applications, acupuncture;
- positional therapy - special poses that help 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 organ function, they resort to plastic surgery of the bladder from their own intestinal tissue.
The duration of treatment of chronic cystitis is several months. The course is aimed at eliminating the inflammatory process, preventing complications, maximally restoring the urinary system and preventing irreversible changes in the structure of organ tissues.
Basic measures for the prevention of cystitis: maintaining hygiene, wearing underwear made of natural fabrics, choosing shoes and clothes according to the weather and season, timely treatment of colds and chronic pathologies, taking vitamin complexes for general strengthening.