Cystitis is an inflammation of the urinary bladder. This organ is intended for the accumulation and excretion of urine, but if the mucous membrane of the organ is damaged, its function suffers and the person begins to feel 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 affects mostly women, which is related to the anatomical characteristics of the urethra. Inflammation rarely occurs in men, it usually acts as a comorbidity against the background of chronic prostatitis.
Symptoms
The signs of cystitis are quite obvious and hard not to notice. 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, we note:
- frequent urge to urinate;
- feeling of incomplete urination;
- cramps and pain when urinating;
- increase in body temperature;
- appearance of admixture of blood in the urine;
- cloudy urine (due to the presence of pus);
- nausea, pulling pains as during menstruation.
Despite the characteristic symptoms, the disease can present different manifestations. Hematuria is not always present, but the intensity of pain may only resemble mild discomfort. In any case, if signs of pathology appear, it is necessary to consult a doctor in order to make a diagnosis as soon as possible. The disease in the acute phase in the early stage is best treated, but it takes longer to fight the chronic form.
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 (independent disease) or secondary (inflammation spreads from neighboring areas, such as the kidney).
According to the area of damage to the bladder mucosa, cystitis occurs:
- total (in general);
- 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 a rash 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 numerous rare forms: ulcerative, cystic, gangrenous cystitis.
A whole series of inflammatory diseases of the urinary bladder are grouped into two large groups:
- specific cystitis, which are caused by causative agents of sexual infections: gonococci, ureaplasma, chlamydia.
- non-specific cystitis - develop due to the fault of opportunistic flora, whose representatives under normal conditions do not lead to disease (for example, E. coli).
Finally, non-infectious cystitis is grouped into a separate group. They can arise 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 infection, however, cystitis can be toxic and allergic in nature. Once the 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 - by 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 way of spreading is the rarest;
- directly - if the abscess bursts inside the bladder, and the pathogenic microflora penetrates directly into the bladder cavity, it can also be during organ catheterization, infection during surgery.
Most commonly, E. coli causes cystitis. It occurs in 80-95% of cases of uncomplicated pathology. This bacterium is normally found in the rectum, but when it enters the urethra, it causes an inflammatory process. The cause of the disease can also be enterobacteria, staphylococci, fungi, and sexually transmitted infections. It usually precedes the appearance of symptoms of vaginitis or bacterial vaginosis, and you can notice the symptoms of the disease within a day after intercourse (post-coital cystitis).
Factors that contribute to the development of cystitis
A body with good immunity can cope with the presence of pathogenic microflora, so the symptoms of cystitis will not appear in the patient. But when it is exposed to some factors, it manifests itself:
- bladder mucosa injury;
- pelvic organ circulation disorders;
- hypothermia;
- the presence of other foci in the body, such as kidney infections;
- reduction of the body's defense forces;
- 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 emptying of the bladder.
In the presence of these factors, cystitis will progress rapidly, and the chronic pathology will pass into the relapse phase. Therefore, in order to prevent relapses, it is necessary to exclude the influence of provoking factors on the body.
Causes of the transition of acute inflammation to the chronic phase
The inflammatory process in the bladder can be caused by various pathogens. Most often it is about bacteria, but there are 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 occur.
But often women postpone a visit to the doctor, try to treat cystitis on their own, hoping that everything will pass by itself. As a result, valuable time is wasted. Microorganisms actively reproduce, the intensity of inflammation increases. Once they have completely "settled" in the bladder, the microbes will not give up their positions so easily. The inflammation becomes chronic.
It is also common for a specialist to prescribe treatment for cystitis, the patient starts taking medication and stops the treatment herself when she feels relief. As a result, the pathogens are not completely destroyed, and the survivors divide - a chronic cystitis that is resistant to antibiotic therapy occurs.
Finally, the following circumstances 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.
Signs of chronic cystitis
In the medical community today, the very term "chronic cystitis" is outdated. 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 within six 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 emptying, pain in the lower abdomen.
Aggravation of the disease can be accompanied by a moderate increase in body temperature, the appearance of blood in the urine, and its turbidity.
During the remission period, the symptoms may completely disappear. 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 pathogen resistance to antibacterial drugs and subsequent degeneration of the bladder mucosa. The mucosal epithelium undergoes cicatricial deformation or is replaced by layered squamous. At this stage, chronic cystitis can no longer be cured by 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, 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 stop the attack of the disease, and the systematic use of the means will lead to a complete cure of cystitis. Preparations based on fosfomycin cope perfectly with inflammation.
Chronic inflammation is more difficult to treat because it is complicated by other disorders. Complex treatment of cystitis that develops over a long period of time is carried out using several groups of drugs. Antibiotics are still leading, but the doctor will also prescribe anti-inflammatory drugs, vitamins and reparants. To prevent infections and to consolidate the effect of therapy, the patient is prescribed herbal medicines, physiotherapy courses.
cystitis in women
Most often, cystitis in women is accompanied by exacerbation of chronic inflammation, so, according to statistics, every second patient consults a doctor twice a year with a recurrent disease.
This does not speak 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 cause the disease.
cystitis after sexual intercourse
Postcoital cystitis in women is provoked by genitourinary anomalies. 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 an overly mobile urethra, which is easily moved 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 case.
Also, the causes of cystitis are the exchange of anal sex with vaginal sex, which is absolutely impossible to do, because the microflora of the rectum enters directly into the vagina and the adjacent urethra. A factor in the development of bacterial infections is manual introduction of microbes, 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 - discomfort usually occurs already in the first 12 hours.
The treatment of postcoital cystitis is individual, because it is first necessary to determine the cause of the disease and precisely direct the therapy. In the case of an anomaly of the urethra, the doctor will suggest plastic surgery, as a result of which the problem will disappear. Surgery and hyaluronic acid injections are also possible. If the infection with sexually transmitted infections occurred during an intimate relationship, then antibacterial drugs will be needed, followed by the 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 follows the entire process of urination. The presence of erythrocytes gives the urine a pink color. Also, urine can be the color of "meat scraps", that is, brownish in 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 going to the doctor.
Cystitis during menstruation
In some women, cystitis worsens against the background of hormonal changes during menstruation. During menstruation, the pelvic organs are most susceptible to infections, so the disease can cause:
- inflammatory diseases of female genital organs;
- hormonal fluctuations;
- allergic reaction to products for intimate hygiene;
- reduction of the body's defense forces;
- failure to observe personal hygiene;
- non-specific infections, mycosis, sexually transmitted diseases.
Under the influence of these factors, the pathogen enters the urethra and urethra, causing inflammation. Usually, the aggravation of the disease occurs during ovulation, as well as 1-2 days before the onset of menstruation. Vaginal discharge becomes an excellent place for the reproduction of pathogenic microflora. Symptoms of cystitis during menstruation are typical, but they are complicated by characteristic manifestations during menstruation - painful and pulling pains in the lower abdomen.
The doctor can identify the cause of the pathology after collecting the medical history and studying the results of laboratory diagnostics. 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, to strengthen the immune system.
Pregnancy and cystitis
According to the results of the study, doctors discovered that asymptomatic bacteriuria is detected even before pregnancy, so the disease manifests itself during the gestation period. The reasons for this are:
- changes in the hormonal background and the ratio 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 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 makes early diagnosis difficult. Treatment of cystitis during pregnancy is possible even with the use of antibiotics. The doctor will prescribe drug names and doses 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 in order to finally discover the cause of the pathology and determine the nature of the course of the disease. The specialist will collect the medical history, analyze the patient's complaints and conduct an external examination by palpation of the bladder area. The following diagnostic methods are used:
- echoscopy - using ultrasound, you can determine the degree of the inflammatory process, its prevalence, as well as assess the state of the urinary system, genital organs;
- cystoscopy - examination of organs using an endoscope, which allows you to assess the state of the bladder mucosa;
- cystography - examination of the bladder using 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 more precise determination of pathogens). To assess the degree 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 the delivery of tests prescribed by him may be necessary.
Treatment methods
In case of inflammatory diseases of the organs, doctors resort to therapeutic and surgical methods of treating the pathology. In most cases, it is possible to get rid of the disease with properly formulated drug therapy 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 may be given:
- anti-inflammatory drugs - they are used to relieve swelling of the mucous membrane and remove pain, the inflammatory process is reduced;
- antispasmodics - used to relieve pain symptoms, effectively remove bladder spasms;
- antibacterial therapy - a group of drugs that act directly on the cause of the pathology;
- antifungal drugs - recommended if cystitis is caused by a fungus or is complicated (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 the patient instillations of drugs instead of oral administration. Bladder flushing is done in the outpatient clinic. With the help of a special catheter, the desired concentration of the drug is applied, which cannot be achieved in other ways. Before the procedure, the patient should empty himself so that the medicine can work on the mucous membrane as long as possible.
Surgical treatment is applied only in rare cases, when the inflammatory process has caused anatomical changes or in severe recurrent infections. In that case, laser correction is done. For example, in postcoital cystitis, for many women, the only treatment option is transposition of the distal urethra.
Diet in the treatment of cystitis
It is necessary to follow a diet, because spicy and salty food contributes to the appearance of ulcers on the mucous membrane. Other products are irritants that hinder recovery:
- foods rich in sugar;
- citrus fruits, sour food, fermented;
- spices;
- tomatoes and all dishes with tomatoes, additives (ketchups, sauces, adjika);
- soy sauce and vinegar;
- nuts and chocolate.
In order to speed up the recovery, the patient is recommended a light and nutritious diet. It is necessary to exclude fried food, smoked meat, marinades, fatty food. It is best to steam, stew or boil. Eliminate all foods that can cause allergies.
An attack of cystitis can also be caused by heavy food, in which the patient suffers from constipation. Stagnation of faecal masses worsens intestinal peristalsis, stagnation occurs in the bladder, due to which the mucous membrane is irritated again. Precisely because of the high protein content, one should not eat too much meat, fish, beans, and cheese. Replace them with foods rich in fiber - vegetables and permitted fruits.
During the treatment, try to eat at home, cook for yourself and do not introduce new foods or dishes to 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 treating diseases, physiotherapy is widely used. As a rule, it is recommended in the recovery phase, when the acute inflammation of the urinary bladder has been eliminated and when there is a positive recovery trend. Physiotherapy is also effective for submucosal localization of the causative agent of the pathology, when antibacterial drugs do not have an adequate effect. As physiotherapy is used:
- phonophoresis;
- electrophoresis;
- magnetotherapy;
- UHF;
- modulated currents.
The session does not last long, however, to achieve the effect, a course of 10-15 procedures is required. Strong treatment of cystitis in combined ways will help to get rid of the disease completely.
The answer to the question
How long does cystitis last?
The duration of cystitis depends on the form of the pathology. The acute lasts 7-10 days, after which recovery occurs with proper treatment, while the chronic form of the disease can last for several months, reminiscent of periods of deterioration.
Is it possible to visit a bath or a warm shower with cystitis?
A warm shower or bath really helps to relieve cramps and pain, however, these thermal effects are contraindicated in cystitis, as it contributes to the worsening of the inflammatory process.
Which doctor should I contact and which tests should I submit?
Women with suspicion of cystitis should consult a general practitioner, men - a urologist. If necessary, the patient can be referred to a gynecologist. Tests - urine analysis, blood analysis and ultrasound or cystoscopy.
How does age affect the course of the disease?
Most often, cystitis occurs in women aged 20 to 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 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 signs of cystitis?
Yes, during the period of exacerbation of the disease, patients are advised to follow a diet with the exception of salty, spicy, irritating foods. Despite frequent urination, you should not strictly 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 taken into account when choosing a uroseptic?
Let's start with the fact that choosing a drug and prescribing an antibiotic regimen is a task only for specialists: urologists, nephrologists, therapists. It is unacceptable to independently stop the treatment of cystitis or change the drug.
The use of tetracyclines, cephalosporins in cystitis quickly leads to pathogen resistance. Therefore, drugs from these groups are practically not used to treat cystitis. Doctors prescribe ampicillins, fluoroquinolones and various combinations of uroseptics. Herbal uroseptics are also widely used, the main advantage of which is good tolerability and almost complete absence of contraindications. Preparations from this group can be used for the treatment of pregnant and lactating women.
The doctor selects the uroseptic individually, 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 nutrient media.
How to treat cystitis yourself at home and can it be done?
If symptoms of cystitis appear, it is necessary to visit 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 the correct diagnosis and prescribe the necessary treatment.
But often patients are faced with the fact that a doctor's appointment is scheduled for a certain time, and the pain needs to be alleviated immediately. To reduce the speed of progression of the pathological process, adhere to the drinking regime - drink about 2 liters of water, compote, fruit drinks. Hypothermia is a frequent cause of deterioration 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 you wait for an appointment with a specialist. It is undesirable to independently take analgesics and antispasmodics without extreme need - they can "lubricate" the clinical manifestations of the disease, and it will be more difficult for the doctor to make the correct diagnosis.