Pain in the lower abdomen, worsening with urination, frequent urge to urinate, blood in the urine and unusual color - all these signs, of course, alarm any person. In most cases, behind these manifestations lies such an unpleasant disease as cystitis.
What is cystitis?
Cystitis is an inflammatory process in the lining of the bladder. It most commonly occurs due to a bacterial infection. Despite the favorable prognosis in most cases, the disease can be severe, often accompanied by painful symptoms.
Who is affected?
Studies have shown that 50% of women have had cystitis at least once in their lives. The fact that this disease usually affects women, however, does not mean that men are immune to it. In addition, the disease can develop in children, including infants.
cystitis in adults
This disease is more common in women. It is due to the physiological characteristics of the female body. The main reason is that the urethra is shorter and wider, and opening the urethra in women closer to the anus makes it easier for intestinal bacteria from feces to enter the urethra.
The clinical picture of cystitis in women and men is also different. With pathology in men, frequent urination is characteristic. In addition, acute cystitis when sexual intercourse is stronger, accompanied by pain extending to the external genitalia, fever, hyperthermia, and signs of general intoxication. At the same time, men are at a much higher risk of developing chronic cystitis than women without severe symptoms.
cystitis in childhood
It occurs with almost equal frequency in boys and girls, although it is most common in girls aged 4 to 12 years.
Among the common causes of cystitis in children are:
- anatomical and structural anomalies of the external genitalia, eg stenosis of the foreskin in boys;
- pathology of the structure of the internal organs of the genitourinary system;
- inadequate hygiene of the genitals, in infants - untimely diaper changes;
- beriberi and other conditions and diseases that lower immunity;
- Hypothermia;
- drug therapy with the use of several groups of drugs, especially sulfonamides;
- genetic predisposition.
The initial diagnosis in young children is difficult because the child cannot speak and has difficulty controlling the frequency of urination. Among the signs of cystitis, one may notice dark, cloudy urine and urinary incontinence during the day.
In case of illness in children under one year of age, treatment is carried out in a hospital. The therapeutic program in childhood is developed taking into account the organism's sensitivity to the drug, and antibiotic therapy should be avoided if possible.
Signs of a bladder infection
In most cases, with cystitis, symptoms include:
- Frequent urge to urinate with a small amount of fluid secreted;
- burning in the urethra during urine excretion;
- discomfort, pain in the pelvis, pubic bone, lower abdomen, genitals (in men);
- hyperthermia under fever or fever (depending on the acuteness of the disease), general malaise, symptoms of intoxication of the body.
Signs of cystitis include changes in the color of urine. Visible to the naked eye the liquid is dark, turbid, with sediment, pus in it. In the severe stage, hematuria is noted, the presence of blood in the urine.
Sometimes the pathological process moves to the kidneys. In this case, the manifestation of the characteristic symptoms of nephritis: low back pain, high fever, nausea, vomiting.
Classification of cystitis
Depending on the severity of symptoms, the disease is divided into chronic and acute cystitis. The chronic form of cystitis can be asymptomatic, however, periodically with this form, exacerbations are observed. Acute cystitis usually develops when the infection first enters the urinary tract.
Acute cystitis
According to the results of analysis of the nature and extent of damage to the bladder wall, several forms of cystitis are classified. The most common are the catarrhal, hemorrhagic, and ulcerative forms.
Acute cystitis is more common in the catarrhal form, in which the upper layers of the bladder's mucous membranes are affected, leading to swelling and hyperthermia. The first stage of this form is serous, the second stage, which develops with rapidly or untreated, purulent infectious lesions, is characterized by increased inflammation of the mucosa and the presence of impurities. pus in the urine.
In acute hemorrhagic cystitis, the process of blood infiltration into the urine is observed. This form occurs due to the spread of the inflammatory process to the site of the blood vessels.
Signs of ulcerative cystitis are ulceration of the membranes of the bladder, the penetration of inflammation into the muscular tissues of the organs and their necrosis.
Symptoms of acute cystitis
In acute cystitis, pain, burning, cramps during urination are pronounced.
The general condition of the patient is unsatisfactory: symptoms of intoxication of the body are observed against the background of an increased body temperature (headache, nausea, vomiting, myalgia, asthenia).
In the excretory urine, purulent impurities can be noticed, with the hemorrhagic form, the presence of blood is determined with the naked eye by a change in color: from pink to burgundy-brown.
Chronic cystitis
A common reason for the development of the chronic form is the incomplete course of treatment for acute cystitis. If the patient stops taking the drug as soon as the severe symptoms pass, the body not only retains the infectious agent, but also becomes resistant to the antibiotics used and the bladder lining does not return to its original state.
Such negligence leads to the development of a chronic, difficult-to-treat form of cystitis. Exacerbations of chronic cystitis occur on the basis of minor provoking factors, which leads to an increase in the symptoms of an unpleasant disease. To avoid such consequences and cure cystitis, with a diagnosis of acute cystitis, antibiotic therapy should be continued until clinical signs of recovery are detected, regardless of the absence of symptoms. unpleasant symptoms.
The second most common cause of the development of an inflammatory process in the bladder wall is the presence of undiagnosed or untreated diseases in the urogenital region. Vaginitis, urethritis, pyelonephritis, infections of the organs of the reproductive and urinary systems, sexually transmitted diseases are breeding grounds for pathogenic microorganisms, associated withorgans and surrounding tissues during inflammation.
Immune disorders and deficiencies, pathologies of the structure of the genital organs, due to a violation of the flow of urine or a decrease in the body's resistance, can also provoke the development of a form of cystitischronic.
In some cases, specialists diagnose an interstitial form, which currently has an unexplained cause.
Symptoms of Chronic Cystitis
In the chronic form, the clinical picture of the disease may be characterized by the absence of any symptoms (usually occurring in men) and present only on laboratory and instrumental examinations of the disease. core.
There is a chronic form of the disease with frequent episodes of acute cystitis (from 2 times a year), rare (1 or less exacerbations per year) and periods of remission.
The interstitial form is marked by instability of the alternation of exacerbations and remissions, the unpredictability of the course, the body's response.
The general symptoms of the chronic form are not manifested beyond exacerbations, where the clinical picture corresponds to acute episodes of cystitis.
Reasons for developing cystitis
Thus, we have learned how the symptoms of cystitis are. But what causes this disease? The most common cause of cystitis is infection. Pathogens can be bacteria, less often viruses or other microorganisms. However, there are also cases of non-infectious inflammation. According to these criteria, all cases were divided into two main groups.
Ways of infecting bacterial cystitis
If a person has bacterial cystitis, the cause always lies in the infection of the bladder membrane. This is the most common cause of cystitis. The most common infectious agents that cause cystitis are E. coli (Escherichia coli, E. coli), staphylococcus (Staphylococcus) and the group of streptococcus (Streptococcus).
Among other pathogens of the bacterial form, there are:
- Klebsiella (Klebsiella);
- proteas (Proteus);
- Koch bacillus, tuberculosis (Mycobacterium tuberculosis);
- pale treponema (Treponema pallidum);
- Streptococcus (Neisseria gonorrhoeae);
- Trichomonas vaginalis (Trichomonas vaginalis);
- mycoplasma (Mycoplasma), v. v.
The development of an inflammatory process of bacterial etiology occurs against the background of the presence of conditions suitable for the reproduction of microorganisms, in which local immunity cannot cope withthe number or growth rate of a colony of bacteria. This occurs when the protective force decreases (eg, hypothermia) or increases the number of infectious agents, the introduction of varieties that violate the local flora (frequent sexual intercourse). sex, changing sexual partners, poor hygiene, urinary catheterization, etc. ). In such cases, the infection is considered ascending, penetrating the bladder through the urethra.
Increases the likelihood of inflammatory processes in the membranes in patients with diabetes, since an increased amount of sugar in the urine creates favorable conditions for the reproduction of most pathogenic organisms.
However, the bacterial form can also have a diminished character, so that, during a kidney infection, the bacteria can travel down the bladder through the ureter.
Bacterial entry into the bladder cavity is also possible from inflammation in the lymph nodes. The blood-borne route of infection is noted when the pathogen enters the bladder cavity through the blood, which occurs when there is an infectious process in the body.
Viral form of the disease
The viral form is a consequence of a general decrease in immunity. Injury to the membranes of the bladder can occur in the context of an existing viral disease or caused by a latent virus in the body in a dormant stage.
Viral diseases such as influenza, parainfluenza, herpes, adenovirus, cytomegalovirus infection often cause cystitis. Acute viral cystitis is characterized by the presence of blood in the urine. There is also a change in the blood supply to the walls of the bladder under the influence of the virus. Usually, with viral cystitis, a secondary bacterial form develops due to a weakening of the local immunity.
mushroom form
The most common causative agent of this form is the fungus Candida. Usually, the infectious process is progressive, the fungus enters the bladder through the urethra, but a descending form can be observed: with oral candidiasis, the infection enters the gastrointestinal tract and urinary system, as well as direct infection when using a contaminated catheter. .
parasitic form
The parasitic form is rare, as its causative agent, Schistosoma hematobium, does not live everywhere. Infection occurs when swimming in tropical reservoirs infected with this fluke, schistosomiasis, can spread to the bladder wall.
Non-communicable diseases
Not in all cases, the pathology is caused by some type of infection. Non-infectious cystitis is usually as progressive as infectious diseases and has its own therapeutic features. The most common of non-infectious cystitis are drug, allergic, and interstitial.
Pharmaceutical form
The drug form occurs after treatment for other conditions with certain drugs that irritate the bladder wall. It can be cytostatic drugs, some groups of antibiotics, sulfonamides.
allergic type
Allergic reactions can affect not only the outer mucous membranes and skin, but also many internal organs, such as the bladder. The allergic form develops as a result of the body's reaction to the allergens that have entered it. As a result, eosinophilic infiltrates can form on the inner mucosa of the bladder, manifested by the appearance of symptoms of allergic cystitis.
Interstitial cystitis
The pathogenesis of this form has not been determined, there are hypotheses about the influence of autoimmune, neurological, neuropathic factors, inflammatory processes in other organs, disorders of nitric oxide metabolism. , . . . In this form, the symptoms of cystitis are not accompanied by an inflammatory process in the membrane, which complicates the diagnosis and treatment of the disease.
Other non-infectious forms
Other non-infectious forms include:
- radiation,
- chemistry,
- pain,
- heat.
This form of radiation can develop as a result of irradiation of the pelvic area, often during cancer treatment. The chemical form is a bladder burn when caustic substances enter its cavity.
The form of trauma occurs after trauma to the organs of the genitourinary system. If surgical intervention leads to this form, then it is indicated as a form of postoperative cystitis. The heat form occurs from prolonged exposure to high or low temperatures on the pelvic region.
Diagnose
If you suspect you have it, you should contact a urologist. Diagnosis is made by collecting the patient's medical history, clinical picture, blood and urine tests. Instrumental research methods can be used: ultrasound, cystoscopy, endoscopy.
Treatment of cystitis
What should I do if I have a bladder infection? Like any other disease, it must be treated. It should be remembered that effective treatment is not possible without an accurate diagnosis of the cause of cystitis.
It is known that with cystitis, the main treatment method is drug treatment. Within its framework, the patient is prescribed effective drugs, the type of which depends on the nature of the disease. With bacterial pathogens, antibiotics are prescribed, with fungal processes - fungicides, with allergic processes - antihistamines. In addition, in acute cystitis, antispasmodics, analgesics, non-steroidal anti-inflammatory drugs are prescribed. If necessary, additional therapy is carried out to improve the immune status. Herbal preparations have also been shown to be highly effective in chronic cystitis. Folk methods and decoctions of herbs with anti-inflammatory and antibacterial effects are also popular.
Part of cystitis therapy is a diet that limits foods that irritate the lining of the bladder (spicy, salty, sour, smoked foods). A warm drink is prescribed: fruit drinks, herbal teas, tinctures.
For the treatment of chronic cystitis, physiotherapeutic methods should be used: electrophoresis, electrophoresis, induction and hyperthermia, EHF therapy, ultrasound therapy, laser therapy.
In acute cystitis, it is important not to limit antibiotic therapy until signs of disease have disappeared. Acute cystitis that is not treated with high frequency will turn into a chronic form, manifested by frequent recurrences and threaten the general health of the patient.