Cystitis: symptoms and treatment
Cystitis is a fairly common disease that occurs as a result of inflammation of the mucous membrane of the bladder. Cystitis, the symptoms of which in the overwhelming majority of cases experienced by a representative of the weaker sex between the ages of 16 to 65 years, can be diagnosed in men — in this case, the disease most often develops in individuals 40 years and older.
As already noted, the disease, although it occurs in patients of both sexes, but women, nevertheless, are more predisposed to it. Moreover, on the basis of WHO data, it is known that at least once in a lifetime each patient had to suffer this disease, while every eighth person suffers from chronic cystitis, that is, throughout life.
The predisposition of women to cystitis is explained by the anatomical features characteristic of the structure of the urethra, which is somewhat shorter in them, which in turn is a predisposing factor for the quickest entry into the body of the infection. This infection, which is already noted, proceeds in conjunction with inflammation, which is subject to the mucosa of the bladder, with a violation of its inherent functions and with certain changes to which the urine sediment is exposed. A significant role is also given to the location of the urethra with respect to the anus.
In most cases, cystitis is a disease of an infectious nature, that is, it is provoked by microorganisms that enter the bladder cavity through the urethra. These microorganisms belong to the group of conditionally pathogenic ones, which determines the necessity of influencing certain additional factors for the development of inflammation, against which, in turn, the condition under consideration is determined. In the overwhelming majority of cases, the intestinal rod (from 70 to 95%) acts as such microorganisms, then saprophytic staphylococcus is released (within 5-20%), as well as some other forms of pathogenic microorganisms (which, according to this frequency, is much less frequent) .
It is possible to provoke inflammation during the introduction of certain therapeutic measures (including for instrumental diagnostics), and mechanical damage is considered as a method of infection. Symptoms in cystitis can be caused not only by the effects of infections, but also by fungi, mycoplasma, trichomonas, chlamydia, viruses, etc.
In women during pregnancy and after childbirth, the actual decrease in muscle tone also becomes a provoking factor in the development of an inherent inflammatory cyst.
As the causes of cystitis in men, we can distinguish, for example, inflammation of the prostate, seminal vesicles, epididymis or urethra, but, as already noted, infection of the bladder does not occur so often.
Let us highlight other possible causes that cause cystitis:
- Diseases of the upper respiratory tract (influenza, sinusitis, etc.). The relationship of the respiratory system to the bladder in this case is understandable: blood circulation occurs throughout the body, therefore, pathogens can easily be found by Transfer of blood by a current in those or other organs, actually, the bladder in this scheme is not an exception.
- Inflammatory processes associated with the intestine. The connection between the bladder and the intestine is quite close, and therefore the presence of any pathological inflammatory process in the latter can cause cystitis.
- Constipation. Their frequent appearance can also lead to the development of cystitis, which, again, is dictated by the close connection of the intestine with the bladder.
- Improper purification of the anal area during defecation. Movement is performed during cleansing from the front and back (or from the bottom to the top).
- Low immunity. The changed state of immunity can be triggered by various factors, for example, actual diabetes, pregnancy, immunosuppressive drugs, etc.
- Violation of the use of pads and tampons during menstruation. When menstruating to women, it is important to remember that the replacement of gaskets should be made at least every 4 hours, and the replacement of swabs — at least every 2-3 hours.
- The onset of sexual activity. This is accompanied by the ingress of many alien bacteria, against which the inflammation develops, and, accordingly, cystitis.
- Prolonged wearing of tight clothing. In this case, the bladder is squeezed, against which cystitis develops.
Significantly less cystitis develops with pyelonephritis, which is accompanied by infection through the flow of urine from the kidneys to the bladder. Also, cystitis can trigger a number of factors that are practically standard for the development of many diseases, and this is hypothermia, chronic overfatigue and being in a state of chronic stress, lack of vitamins, etc.
Types of cystitis
In accordance with the form of the course of the disease, cystitis can manifest itself in the form of acute or chronic. The emergence of cystitis in acute form is characterized by suddenness, as well as the appearance of severe soreness with urination, itching and burning, and in some cases — by temperature. As for the chronic form, it, first of all, is recurrent, which means that the disease periodically makes itself felt again. The periodicity of manifestations is strictly individual, it is determined by the influence of provoking factors. As for the peculiarities of occurrence, chronic cystitis mainly develops against the background of an acute form of the disease. In this case, we consider situations with improper treatment, an underserved condition, etc.
Unfortunately, in these variants, the varieties of cystitis do not end, further separation is made based on an account of the causes that triggered cystitis.
For example, infectious cystitis is a form of the disease in which inflammation of the bladder mucosa develops as a result of the entry of pathogenic microorganisms.
The next type of cystitis is traumatic cystitis. Its development is dictated by situations in which this or that scale is traumatized. It should be noted that even the appearance of a microcrack can serve as the basis for creating an ideal environment for bacteria, which, accordingly, determines the possibility of their further reproduction and development of cystitis. You can get a trauma of the mucous membrane by, for example, a catheter or a cystoscope.
Radiation cystitis arises against the background of radiation therapy to patients, which is particularly important in the presence of a tumor disease. Chemical cystitis develops as a result of the ingestion of toxic substances directly onto the mucosa of the bladder, which also leads to inflammation. This form of the disease in practice is extremely rare.
Allergic cystitis is the result of an irritating effect on the mucous membrane of certain substances acting as allergens, which, again, causes an inflammatory process.
Hypercalcuric cystitis. This form of cystitis is relevant in some types of kidney disease, in which they produce a significant amount of salt crystals, as a result of which the bladder undergoes trauma and, in fact, develops cystitis.
Parasitic cystitis appears as a result of the action of a particular type of worm, it is the causative agent of schistosomatosis. This kind of parasites is «imported», because the environment of its typical habitat is the tropics.
There are also two other forms of cystitis, which stand somewhat apart in considering its varieties, in particular, it is interstitial cystitis, as well as the so-called «honeymoon» cystitis.
In the first case, which is marked with interstitial cystitis , a rather rare form of this disease is considered. Moreover, the determination of its nature has not yet been determined. It is assumed that the origin of the disease is a congenital anomaly in development, and it can correspond to different degrees of severity. Along with the definition of the nature of interstitial cystitis, its treatment is also at least complicated.
As for the second form, which we have allocated cystitis «honeymoon» , in this case, this kind of inflammatory process is implied, in which the bladder is affected from For defloration (loss of virginity). Accordingly, this cystitis, the symptoms of which are relevant for women, it occurs because of the entry into the vagina at this point in the mass of various bacteria, foreign to the body. Subsequently, these bacteria enter the bladder when they are spread to the urethra, which is why irritation begins with the subsequent inflammatory process.
Acute cystitis: symptoms
The main signs of cystitis are the following:
- increased frequency of urination
- the appearance of severe pain when urinating
- the appearance of gravity in the lower abdomen;
- burning, general discomfort, arising in the area of the urethra;
- the appearance of festering or bloody discharge.
In many cases, prior to the development of acute cystitis, subcooling becomes a factor, followed by a characteristic symptomatology.
The first symptom of cystitis, as, indeed, is indicated in the list we have selected, is the increased frequency of urination. If it is a serious form of acute cystitis, then the urge to urinate in this case can be observed at intervals of almost a few minutes. As a result, according to the frequency of urination, a figure can be identified within 100 calls to it per day, while the volume of urine output is practically insignificant — about 10-20 ml each. In addition, the possibility of the appearance of nocturnal urge to urinate, which is defined as nocturia, is not excluded. In this case, the possibility of voluntary retention of urine sharply decreases, which means that patients can lose control of their own bladder, a condition that can achieve even incontinence (ie enuresis) in some patients.
Ignoring the need for treatment leads to the fact that the rest of the symptomatology of cystitis begins to manifest itself. There is already pain and difficulty urinating, and this symptomatology is extremely difficult to tolerate. Sensations that arise when urinating, very clearly confirm this. So, often patients give an analogy of urination with passing through the urethra of broken glass. Cystitis in men, and symptoms associated with urination in particular, often manifests itself in combination with pain that occurs at the very base of the penis (which is defined as strangury).
In addition to this symptomatology, in almost all patients with acute cystitis, there is a marked soreness in the lower abdomen, as well as in the lumbar region. The possibility of urinary retention in the urinary bladder is not excluded (which in particular is often a complaint among elderly patients).
Symptoms of cystitis also in most cases are combined with general worsening of the condition of patients, sometimes — in elevated temperature (up to 38 degrees), as well as in the appearance of nausea, vomiting and chills. Palpation (feeling) of the abdomen allows you to determine some soreness in the area above the bosom.
The course of the disease can accompany the appearance of blood in the urine. Blood in the urine with cystitis is noted by its small amount (on the order of a few drops), blood can also appear after urination. With a significant amount of blood in combination with the symptomatology, which indicates exactly the relevance of cystitis, it can be assumed that hemorrhagic cystitis began, in which the bladder wall is destroyed before the blood vessels. Also, such a course allows one to make an assumption about a possible transition of the acute form of the disease into a chronic one when the disease spreads to the kidneys. In general, if we are not talking about the transition to the chronic form of cystitis, the symptomatology peculiar to it manifests itself during 7-10 days, then the condition improves (all this, naturally, is achieved with appropriate treatment of the disease and directly approach to treatment with Side of the patient).
Chronic cystitis: symptoms
As for the symptoms that are relevant for the chronic form of the course of cystitis, it is determined by the phase of this disease. So, for example, the phase in which the exacerbation of cystitis occurs, the symptoms here are similar to those listed in acute cystitis (possibly in a slightly less pronounced form). The phase of remission, in which the disease subsides, the course of chronic cystitis is characterized by a practical absence of symptoms, and only the rapid urination can become the only manifestation that is relevant for patients.
Given the fact that chronic cystitis occurs often with untreated acute cystitis or in the absence of treatment as such, the timing for it can be determined by a wide variety. That is, chronic (recurrent) cystitis can last for many years, without manifestation of any symptomatology (before the onset of exacerbations in its current).
Special attention should be paid during the course of cystitis to the interruption of the course prescribed by the doctor for therapy, as well as to the question of self-medication. Cystitis, the treatment of folk remedies in which patients begin without specifying the specific course of the disease specifically in their case, and also, not less critical, treatment with drugs widely advertised in the media and on television — all this can only exacerbate the condition. And, of course, the transition to a chronic course of the disease in this case is considered as one of the possible outcomes.
Chronic course, as well as deterioration of the condition, can lead to premature interruption of treatment due to a gradual relaxation of symptoms and even with its disappearance. In this case, patients reliably know about what symptoms of cystitis occur, because, in their absence, believe that with their disappearance, the disease itself disappeared. Nevertheless, the improvement of the condition during treatment is not a reason to stop it, it is important to follow the course until the appointed time for its completion.
Cystitis in pregnancy: symptoms
Cystitis, unfortunately, does not exclude the possibility of its occurrence in pregnant women, moreover, they are in a kind of risk group. And it’s not just that the basis for the development of this disease is that the female body is most susceptible to it, but also that in this period there are large-scale hormonal changes in it along with physiological changes. Statistics on the prevalence of cystitis in pregnant women indicate that this disease occurs in almost every tenth case.
Cystitis in the early stages of pregnancy in some way can be considered as a regularity. The fact that often patients learn about their own pregnancy in a random way, it is when addressing a doctor because of the exacerbation of cystitis. For this reason, cystitis is conditionally referred by specialists to signs of pregnancy within the initial terms of its onset. So, what is the reason for this?
Pregnant women often face the fact that cystitis develops in them in view of the changes already noted by us at the hormonal level, and also due to the development of immunosuppression. Immunosuppression is defined as a condition in which the immune system of the future mother is naturally depressed, but it is necessary to ensure that the embryo does not reject its activity. The reverse side of these processes is that the weakened state of the immune system provides an opportunity and active reproduction of various infections, they also appear in the environment of the bladder, provoke the development of the inflammatory process in it.
To top it off, the first days of pregnancy are accompanied by the activation of past, existing in the patient’s history, diseases. For this reason, it should be borne in mind that if a history of cystitis is chronic, then during pregnancy, its symptoms may appear again, as a relapse of the disease.
Cystitis in pregnant women can correspond to acute or chronic form of the course. The acute form is characterized by a standard «set» of symptoms, and this is:
- more frequent urination and soreness
- the appearance of soreness in the lower abdomen (it can appear with varying degrees of intensity and have a different character, manifesting, for example, in the form of drawing pains arising in this area and in an easy form of soreness completing the act of urination or, conversely, Debilitating and severe form of pain while losing the opportunity to retain urine)
- appearance in the urine of blood
- Temperature may increase in some cases.
As for the chronic form of cystitis and its aggravation in particular, the symptomatology here is less pronounced and is determined on the basis of the reasons that this form of the disease provoked.
Often, the symptoms of cystitis are similar to the symptoms of another type of disease, therefore, in any case, you should consult a doctor to avoid complications. It should be noted that complications of cystitis in pregnant women can be extremely serious. So, self-medication of this disease, as well as ignoring the need for its treatment, may develop pyelonephritis (a disease in which kidney infection occurs). Also, cystitis can cause premature birth of a complicated nature or cause the birth of a baby with a low weight. It is also important to remember that any treatment and in any condition should only be prescribed by a doctor.
Preventive maintenance of a cystitis during pregnancy demands observance of some rules which, in the light of possible consequences of this disease, difficult precisely it is impossible to name. They are as follows:
- it is necessary to listen to all, even minor, manifestations that adversely affect the general state of health, because the disease, whether it is cystitis or not, is easier to prevent than to treat it
- avoid supercooling;
- Regularly discharge the bladder, do not tolerate it when there is an acute need for it;
- use liquid in sufficient quantity, if, of course, there are no contraindications to this account
- perform certain physical exercises, if, again, there are no contraindications relating to this item.
Cystitis in men: symptoms
As we have already noted, cystitis in men is mainly manifested at the age of 40 years, and the incidence of cystitis in general for urology is 0.5%. The fact that men develop cystitis is not so often, due to the features, the reverse, by which it develops in women. Thus, the male urethra has a narrow and long urethra, moreover, it has a curved shape, which in most cases provides a sufficient obstacle to prevent entry into the bladder infection. At the same time, the development of men in the disease under consideration occurs in most cases against the background of intravesical obstruction, which consists in squeezing the urinary tract under the bladder (i.e., compression occurs within the neck of the bladder or within the urethra), as a result of which the free Outflow of urine.
Depending on the etiological factors, cystitis may be primary or secondary. Primary cystitis in men manifests itself in the form of acute damage to the bladder or chronic damage. Acute cystitis can have an infectious nature (specific or nonspecific), it is provoked by chemical, thermal, nutritional, toxic and medicinal effects. Chronic cystitis of the primary form can be posttraumatic, infectious or parasitic.
Meanwhile, mainly in men, cystitis manifests itself in a secondary chronic form, which arises from the urgency of urological pathology, which can be localized in the region of the bladder or beyond. Depending on the extent of the current spread in the urinary bladder, the cystitis may be diffuse, focal or cervical.
Urologic pathologies that cause cystitis, as we have identified, are the main causes contributing to the development of cystitis, and this type of pathology is mainly accompanied by stagnation of urine and intravesical obstruction. As a mechanical obstacle that contributes to the violation of urinary outflow, stones of the bladder and foreign bodies, tumor formations, prostate adenoma, As well as stricture of the urethra. Cystitis in boys often accompanies such a pathology as phimosis, in which the narrowing of the foreskin, as well as neurogenic dysfunction of the bladder occurs.
The development of an infectious form of cystitis is accompanied by the presence of such diseases as prostatitis, orchitis, epididymitis, vesiculitis, etc. Similarly to cystitis in women, this disease in men mainly occurs when exposed to E. coli. Specific forms of the disease are provoked by chlamydia, gonococcus, trichomonads, mycoplasmas, etc. As a rare form of cystitis, men develop schistosomiasis, actinomycosis, etc.
In identifying the factors of development of the pathology of interest to us, spinal trauma, stress, diabetes, transurethral operations, abuse of spicy food and alcohol, hypothermia can be indicated.
As for the symptoms themselves, the leading manifestation of acute cystitis is the increased frequency of urination (here also includes nocturia), difficulty and soreness of urination, turbidity of urine. In addition, as a concomitant manifestation may be chills, fever, reduced ability to work.
Pain sensations during urination, especially within the initial stage of the disease and the final stage, are accompanied by burning and cutting in the urethra. In addition to the manifestation of symptoms during urination, soreness also occurs outside this action, it focuses on the penis, groin, scrotum, and suprapubic region. The released volume of urine is reduced, similar to the course of the disease in women, up to 10-20 ml, the possibility of urinary incontinence is not ruled out.
Severe forms of cystitis are accompanied by intoxication, which occurs due to elevated body temperature and oliguria (a reduction in the daily volume of urine segregated by the skin). The urine becomes turbid, it has a rotten smell, an admixture of blood is noted.
In the chronic form of the course, cystitis occurs with rather poor manifestations of the symptomatology, the course of the disease can be either wave-like or stable-continuous. In this form, urination is not so painful, rapid and painful, as in an acute form.
Cystitis in children: symptoms
Symptomatic disease in children is determined by the form of the disease, as well as the age of the child. So, children of the early age group can not always be expressed and generally recognized those complaints that accompany their condition in the disease, which is not to say about older children.
Symptoms of cystitis in children under the age of one year are manifested in increased anxiety and crying, dark urine appears (this can be determined by examining the diaper). There is also a temperature increase of up to 39 degrees.
As for pre-school children, as well as in adolescents, the symptoms of cystitis are manifested in the following:
- frequent urination (within 3 times per hour)
- urinary incontinence (in particular, this is the case when there is no such problem in children before)
- pain in the perineal region, as well as in the rectal area
- lower abdominal pain, increased pain when urinating
- urine turbidity, an admixture of blood in it (an analogy of color with «meat slops»)
Chronic cystitis in children is characterized by a mild symptomatology with its amplification only with exacerbation of the disease. Exacerbation of cystitis in children in this form is characterized by symptoms that are relevant in the acute form of cystitis.
Confirmation of the diagnosis of «acute cystitis» is made on the basis of two main criteria: the typical symptoms of symptoms characteristic of cystitis and the rapid improvement of the general condition of the patient with the use of antibiotics. In the absence of effectiveness in the treatment of the disease, its transition to a chronic form takes place, that is, it becomes lingering during. In this case, it is very important to determine, in connection with which it happens, it is equally important to differentiate chronic cystitis from other types of pathological conditions (cancer of the bladder or prostate gland, schistosomiasis, tuberculosis, etc.). Due to this, it will be possible to appoint a suitable treatment if the situation with the deterioration of the state is not based on the choice of incorrect tactics.
In the diagnosis of cystitis repulse from the received anamnestic data, as well as from the characteristic symptomatology, as already noted, and from the results of the laboratory urine (micro- and macroscopic). In addition, the basis for diagnosis is cystoscopy data (obtained after actual acute inflammation is somewhat weakened in intrinsic intensity), bacteriological examination data, as well as data obtained as a result of functional research on the state of the urinary tract. Women are strongly recommended in this case a gynecological examination, within which a gynecological disease can be determined against which cystitis develops.
Treatment of cystitis is carried out at home, if the patients comply with bed rest. A diet is prescribed (except for salted and spicy dishes, alcohol, etc.), as well as a plentiful drink. Reduce pain in cystitis can be due to heaters, bathtubs. Are shown to application broth of herbs with a diuretic effect. A sharply expressed form of soreness determines the need for using the means by which it is possible to relieve muscular spasm in the musculature of the bladder (preparations papaverine, drotaverin, etc.). Used and antibacterial drugs prescribed by a doctor.
In the treatment of chronic cystitis, it is important, first of all, to restore the normal current of urine, which is achieved in the treatment of concomitant disease (narrowing of the urethra, prostate adenoma, etc.). Mandatory detection of actual foci of infection in the body with subsequent treatment. Antibiotics for chronic cystitis are prescribed only after urinalysis, the determination of a particular pathogen against which the infection developed, and also after determining its sensitivity to antibiotics.
If there is a symptomatic characteristic of cystitis, you need to contact the treating pediatrician (children) or the therapist, in addition to this, you may need to consult a gynecologist and urologist.