Pain in the lower abdomen, aggravated by urination, frequent urge to urinate, blood in the urine and its unusual color - all these signs, of course, worry every person. In most cases, behind these manifestations is 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 a favorable prognosis in most cases, the disease can take a serious course, usually accompanied by painful symptoms.
Who is affected?
Studies have shown that 50% of women have had cystitis at least once in their lives. However, the fact that this disease commonly affects women does not mean that men are immune to it. The disease can also develop in children, including infants.
cystitis in adults
The disease is much more common in women. This is due to the physiological characteristics of the structure of the female body. The most important are the shorter and wider urethra and the fact that the opening of the urethra in women is closer to the anus, which facilitates the passage of intestinal bacteria from the stool into the urethra.
The clinical picture of cystitis also differs in women and men. In the disease in men, frequent urination is characteristic. In addition, acute cystitis in the stronger sex is accompanied by pain that also extends to the external genitals, feverish overheating and general symptoms of intoxication. At the same time, men suffer from chronic cystitis much more often than women, which is not accompanied by severe symptoms.
Childhood cystitis
The disease occurs almost equally in boys and girls, but is most common in girls between the ages of 4 and 12.
The most common causes of bladder infections in children include:
- anatomical pathologies and anomalies in the structure of the external genital organs, for example, narrowing of the foreskin in boys;
- pathology of the structure of the internal organs of the genitourinary system;
- insufficient hygiene of the genital organs in infants - untimely replacement of diapers;
- beriberi and other conditions and diseases that provoke a sharp decrease in immunity;
- hypothermia;
- drug therapy using certain groups of drugs, especially sulfonamides;
- genetic predisposition.
Primary diagnosis in young children is difficult due to the lack of speech and the difficulty in controlling urinary frequency. Among the signs of cystitis, one can note the darkening of urine, the presence of sediment and involuntary urination during the day.
In the case of illnesses in children under the age of one year, treatment is carried out in a hospital. The therapeutic regimen in childhood is built taking into account the sensitivity of the body to drugs, it is recommended to avoid antibiotic therapy if possible.
signs of bladder infection
In most cases, when cystitis occurs, symptoms include the following:
- frequent, strong urge to urinate with little fluid output;
- burning in the urethra during urination;
- Discomfort, pain in the pelvis, pubis, lower abdomen, genitals (in men);
- subfebrile or febrile hyperthermia (depending on how acute the disease is), general malaise, signs of intoxication of the body.
Also among the signs of cystitis is such a phenomenon as a change in the color of urine. The liquid darkens, turbidity, the presence of sediment, lumps of pus can be visually detected in it. In the severe stage, hematuria is noted, the presence of blood in the urine.
Sometimes the pathological process passes to the kidneys. In this case, manifestations of symptoms of kidney inflammation are characteristic: lower back pain, high fever, nausea, vomiting.
Classification of cystitis
Depending on the severity of the symptoms, the disease is divided into chronic and acute cystitis. The chronic form of cystitis can be asymptomatic, however, with this form, periods of exacerbation are periodically observed. Acute cystitis usually develops when the infection first enters the urinary tract.
Acute cystitis
According to the results of the analysis of the nature and degree of damage to the walls of the bladder, various forms of cystitis are classified. The most common are catarrhal, hemorrhagic and ulcerative forms.
Acute cystitis is more common in the catarrhal form, in which the upper layers of the mucous membrane of the bladder are affected, causing swelling and hyperthermia. The first stage of this form is serous, the second, developing with a rapid infectious lesion or without treatment, is purulent, characterized by increased inflammation of the mucous membrane and the presence of purulent inclusions in the urine.
With hemorrhagic acute cystitis, the process of penetration of blood into the urine is observed. This form occurs due to the spread of the inflammatory process to the site of blood vessels.
Signs of ulcerative cystitis are ulceration of the bladder membranes, penetration of inflammation into the muscle tissue of the organ and their necrosis.
Symptoms of acute cystitis
With acute cystitis, pain, burning and cramps when urinating acquire a pronounced character.
The general condition of the patient is unsatisfactory: symptoms of intoxication of the body are observed against the background of an increase in body temperature (headache, nausea, vomiting, muscle pain, weakness).
In the excreted urine, purulent inclusions are noticeable, with a hemorrhagic form, the presence of blood is visually determined by a change in color: from a pink hue to burgundy-brown.
Chronic inflammation of the bladder
A common reason for the development of the chronic form is the incompleteness of the course of treatment of acute cystitis. If the patient stops taking the medication once the severe symptoms have passed, the body not only retains the infectious agent, it also develops resistance to the antibiotic used and the bladder mucosa 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 against the background of minor provoking factors, which leads to an increase in the symptoms of an unpleasant disease. In order to avoid such consequences and cure cystitis, when diagnosing acute cystitis, it is necessary to continue the course of antibiotic therapy until clinical signs of recovery are observed, regardless of whether unpleasant symptoms appear.
The second most common cause of the development of an inflammatory process in the walls of the bladder is the presence of undiagnosed or untreated diseases of the genitourinary tract. Vulvovaginitis, urethritis, pyelonephritis, infections of the organs of the reproductive and urinary systems, sexually transmitted diseases are a breeding ground for pathogenic microorganisms that involve the surrounding organs and tissues in the inflammatory process.
Immune disorders and deficiencies, pathologies of the structure of the genital organs, due to a violation of the outflow of urine or a decrease in the body's resistance can also provoke the development of a chronic form of cystitis.
In some cases, specialists diagnose the interstitial form, which currently has an unexplained etiology.
Symptoms of chronic cystitis
In the chronic form, the clinical picture of the disease can be characterized by the absence of any symptoms (more often in men) and appear only during laboratory tests and instrumental examination of the patient.
There is a chronic form of the disease with frequent episodes of acute cystitis (from 2 times a year), with rare (1 or less exacerbations per year) and a stage of remission.
The interstitial form is characterized by the instability of the alternation of exacerbations and remissions, the unpredictability of the course, the reaction of the body.
The general symptoms of the chronic form are not expressed outside of periods of exacerbation, when the clinical picture corresponds to the acute stages of cystitis.
Reasons for the development of cystitis
So we figured out how cystitis manifests itself. But what causes this disease? The most common cause of a bladder infection is an infection. The pathogens can be bacteria, more rarely viruses or other microorganisms. However, there are also cases of non-infectious inflammation. According to these criteria, all cases are divided into two main groups.
Routes of infection with bacterial cystitis
When a person develops bacterial cystitis, the causes always lie in the infection of the bladder membranes. This circumstance is the most common cause of cystitis. The most common infectious agents that cause inflammation in the bladder are E. coli (Escherichia coli, E. coli), staphylococci (Staphylococcus) and the group of streptococci (Streptococcus).
Among other pathogens of the bacterial form there are:
- Klebsiella (Klebsiella);
- proteas (Proteus);
- Koch bacillus, Mycobacterium tuberculosis (Mycobacterium tuberculosis);
- pale treponema (Treponema pallidum);
- gonococcus (Neisseria gonorrhoeae);
- Trichomonas vaginalis (Trichomonas vaginalis);
- Mycoplasma (mycoplasma), etc.
The development of an inflammatory process of bacterial etiology occurs against the background of the presence of suitable conditions for the reproduction of microorganisms, in which local immunity cannot cope with the number or growth rate of a bacterial colony. This happens with a decrease in protective forces (for example, with hypothermia of the body) or an increased number of infectious agents, the introduction of varieties that violate the local flora (with frequent sexual intercourse, changing partners, poor hygiene, catheterization of the urinary tract, etc. ). In such cases, the infection is considered ascending and enters the bladder through the urethra.
In patients with diabetes mellitus, there is an increased likelihood of inflammatory processes in the membranes, since an increased amount of sugar in the urine creates favorable conditions for the reproduction of most pathogenic organisms.
But the bacterial form can also have a descending character, so that with infectious processes in the kidneys, bacteria can descend through the ureters into the bladder.
The penetration of bacteria into the bladder cavity is also possible from the foci of inflammation in the lymph nodes. The hematogenous route of infection is established when the pathogen enters the cavity of the bladder through the blood, which happens with septic processes in the body.
Viral form of the disease
The viral form is a consequence of a decrease in general immunity. Damage to the bladder membranes can occur against the background of a current disease of viral etiology or provoked by latent viruses that were in the body in an inactive 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. Under the influence of viruses, there is also a change in the blood supply to the walls of the bladder. With cystitis of viral etiology, a secondary bacterial form often develops due to weakening of local immunity.
mushroom shape
The most common cause of this form is the fungus Candida. Most often, the infectious process is ascending, the fungus penetrates through the urethra into the bladder, but a descending form can be observed: with oral candidiasis, the infection enters the gastrointestinal tract and urinary system, as well as when using a contaminated catheter - onedirect infection.
parasitic form
The parasitic form is rare because its causative agent, Schistosoma hematobium, is not found everywhere. Infection occurs when swimming in tropical reservoirs contaminated with this type of trematode, schistosomiasis develops, which can spread to the walls of the bladder.
Non-infectious forms of the disease
Not in all cases the pathology is caused by some kind of infection. Non-infectious cystitis is usually no less severe than infectious and has its own characteristics of treatment. The most common non-infectious cystitis are drug-induced, allergic, and interstitial cystitis.
Pharmaceutical form
The drug form appears after treating some other diseases with certain types of drugs that have an irritating effect on the bladder walls. This can be cytostatics, some groups of antibiotics, sulfonamides.
allergic form
Allergic reactions can affect not only the outer mucous membranes and the skin, but also many internal organs, such as the bladder. The allergic form develops due to the body's reaction to the penetrated allergens. As a result, eosinophilic infiltrates can form on the inner wall of the bladder, which is manifested by the appearance of symptoms of allergic cystitis.
Interstitial cystitis
The pathogenesis of this form has not been identified, there are speculations about the influence of autoimmune, neurogenic factors, neuropathies, inflammatory processes in other organs, metabolic disorders of nitric oxide, etc. In this form, the symptoms of cystitis are not accompanied by an inflammatory process in the membranes, which complicates the diagnosis and treatment of the disease .
Other non-infectious forms
Other non-infectious forms include:
- Radiation,
- chemical,
- traumatic,
- Thermal.
The beam form can be caused by irradiation of the pelvic area, mostly in cancer therapy. The chemical form is a blister burn when corrosive substances enter its cavity.
The traumatic form occurs after trauma to the organs of the genitourinary system. When surgical intervention leads to this form, it is called the postoperative form of cystitis. The thermal form occurs due to prolonged exposure to high or low temperatures in the pelvic area.
diagnosis
If you suspect a disease, you should contact a urologist. The diagnosis is made by collecting anamnesis, clinical picture, laboratory tests of blood and urine of the patient. Instrumental research methods can be used: ultrasound, cystoscopy, endoscopy.
treatment of cystitis
What to do if you have a bladder infection? Like any other disease, it needs to be treated. It should be remembered that effective treatment is impossible without an accurate diagnosis of the cause of cystitis.
It is known that with cystitis, drug therapy is the main method of treatment. Within its framework, the patient is prescribed effective drugs, the type of which depends on the nature of the disease. With a bacterial pathogen, antibiotics are prescribed, with a fungal process - fungicides, with an allergic process - antihistamines. Also, with acute cystitis, antispasmodics, analgesics, nonsteroidal anti-inflammatory drugs are prescribed. If necessary, additional therapy is carried out to improve the immune status. Herbal supplements have also shown high effectiveness in chronic cystitis. Folk remedies and herbal decoctions with anti-inflammatory and antibacterial effects are also popular.
Part of therapy for cystitis is a diet that limits foods that irritate the lining of the bladder (spicy, salty, pickled, smoked foods). A plentiful warm drink is prescribed: fruit drinks, herbal teas, compotes.
To treat chronic cystitis, it is recommended to involve physiotherapeutic methods: magnetophoresis, electrophoresis, induction and hyperthermia, EHF therapy, ultrasound treatment, laser therapy.
With acute cystitis, it is important not to limit the course of antibiotic therapy to the moment when the signs of the disease disappear. Untreated acute cystitis with a high frequency turns into a chronic form, which is manifested by frequent relapses and threatens the general health of a person.