Pain in the lower abdomen, increased urination, frequent urination, blood in the urine and its unusual color - all these signs of course alarm anyone. In most cases, behind these manifestations lies an unpleasant disease such as cystitis.
What is cystitis?
Cystitis is an inflammatory process of the lining of the bladder. It most commonly occurs due to bacterial infection. Although the prognosis is good in most cases, the disease can be severe, often with painful symptoms.
Who is affected?
Studies show that 50% of women will experience cystitis at least once in their lifetime. However, the fact that the disease often affects women does not mean that men are immune to it. Also, the disease can develop in children, including infants.
Cystitis in adults
The disease is more common in women. This is due to the physiological characteristics of the female body structure. The main reason is that the urethra becomes shorter and wider. In women, the opening of the urethra is closer to the anus, which makes it easier for intestinal bacteria in the stool to enter the urethra.
The clinical presentation of cystitis in women and men also differs. For men's disease, frequent urination is characteristic. In addition, acute cystitis during intense sex is accompanied by pain that also extends to the external genitalia, high fever, and signs of systemic toxicity. At the same time, men are more likely than women to develop chronic cystitis, which is not accompanied by severe symptoms.
cystitis in childhood
The disease occurs almost equally in boys and girls, but is most common in girls between the ages of 4 and 12.
Common causes of cystitis in children are as follows:
- Anatomic pathology and abnormalities of the structures of the external reproductive organs, such as narrowing of the foreskin in boys;
- Pathology of visceral structures of the genitourinary system;
- Inadequate genital hygiene of infants - not changing diapers in time;
- Beriberi and other conditions and diseases that cause a sharp decline in immunity;
- low temperature;
- Use of medications from certain drug groups, especially sulfonamides;
- Genetic susceptibility.
Initial diagnosis in young children is difficult due to lack of speech and difficulty controlling urination frequency. Among the signs of cystitis, one can notice darkened urine, the presence of sediment in the urine, and involuntary urination during the day.
If a child under one year of age becomes ill, it is treated in the hospital. Considering the body's susceptibility to the drug, a treatment regimen in childhood is established and antibiotic therapy is recommended to be avoided whenever possible.
signs of cystitis
In most cases, when cystitis occurs, symptoms include:
- frequent, strong urges to urinate and release small amounts of fluid;
- burning in the urethra during urine excretion;
- Discomfort, pain in pelvis, pubic bone, lower abdomen, genitals (men);
- Low-grade or high-grade fever (depending on the severity of the disease), general malaise, symptoms of bodily poisoning.
Signs of cystitis also include changes in the color of urine. The fluid is darkened, cloudy, and the presence of sediment, in which pus clots can be detected with the naked eye. In severe stages, hematuria, the presence of blood in the urine, is noted.
Sometimes, pathological processes pass to the kidneys. In this case, the manifestations of symptoms of kidney inflammation are characteristic: pain in the lower back, high fever, nausea, vomiting.
Classification of cystitis
According to the severity of symptoms, the disease is divided into chronic cystitis and acute cystitis. The chronic form of cystitis may be asymptomatic, however, in this form, periods of exacerbation are periodically observed. Acute cystitis usually occurs when the infection first enters the urinary tract.
acute cystitis
Cystitis is divided into several forms based on the results of the analysis of the nature and extent of bladder wall damage. The most common are catarrhal, hemorrhagic and ulcerative forms.
Acute cystitis is more common in the catarrhal form, in which the upper layer of the bladder mucosa is affected, causing it to become swollen and hyperthermic. The first stage of this form is serous, and the second stage, which develops with rapidly infectious lesions or without treatment, is purulent, characterized by increased mucosal inflammation and the presence of purulent inclusions in the urine.
In hemorrhagic acute cystitis, the process of bleeding into the urine is observed. This form occurs due to the spread of the inflammatory process to the site of the blood vessels.
Ulcerative cystitis is a sign of ulceration of the bladder membrane, inflammation that penetrates the muscle tissue of the organ and its necrosis.
symptoms of acute cystitis
In acute cystitis, pain, burning, cramps during urination reach distinct features.
The general condition of the patient is unsatisfactory: symptoms of bodily intoxication (headache, nausea, vomiting, muscle aches, weakness) are observed on the background of elevated body temperature.
In the excreted urine, purulent inclusions are evident, with a hemorrhagic form, the presence of blood is visually determined by a color change: from pink to burgundy.
chronic inflammation of the bladder
A common cause of developing the chronic form is an incomplete course of treatment for acute cystitis. If a patient stops taking the medication immediately after developing severe symptoms, the body not only retains the infectious agent, but also becomes resistant to the antibiotics used, and the lining of the bladder does not return to its original state.
This neglect leads to the development of chronic, difficult-to-treat cystitis. The exacerbation of chronic cystitis occurs on the background of mild irritants, which lead to an increase in the symptoms of an unpleasant disease. To avoid this consequence and cure cystitis, after a diagnosis of acute cystitis, antibiotic therapy must be continued, with or without unpleasant symptoms, until signs of clinical recovery are detected.
The second most common reason for the development of an inflammatory process in the bladder wall is the presence of undiagnosed or untreated disease in the urogenital region. Vulvovaginitis, urethritis, pyelonephritis, infections of reproductive and urinary organs, sexually transmitted diseases are breeding grounds for pathogenic microorganisms, and inflammatory processes involve surrounding organs and tissues.
Immune diseases and deficiencies due to the flow of urine or a decrease in the body's resistance, lesions of the structures of the reproductive organs, can also trigger the development of chronic cystitis.
In some cases, specialists diagnose the interstitial form, the cause of which is currently unknown.
Symptoms of Chronic Cystitis
In the chronic form, the clinical manifestations of the disease may be characterized by the absence of any symptoms (more common in men) and appear only during laboratory and instrumental examination of the patient.
There is a chronic form of the disease with frequent episodes of acute cystitis (twice per year), rare (exacerbations of 1 or less per year) and remission phases.
Interstitial forms are characterized by alternating instability of exacerbation and relief, unpredictability of the process, and the body's response.
The general symptoms of the chronic form do not manifest outside the exacerbation phase, where the clinical manifestations correspond to the acute phase of cystitis.
causes of cystitis
So, we figured out how cystitis manifests. But what causes the disease? The most common cause of cystitis is infection. Pathogens can be bacteria, less commonly viruses or other microorganisms. However, there are also cases of non-infectious inflammation. Based on these criteria, all cases were divided into two broad categories.
Infection routes of bacterial cystitis
If a person develops bacterial cystitis, the cause is always an infection of the bladder membrane. This condition is the most common cause of cystitis. The most common infectious agents that cause bladder inflammation are Escherichia coli (E. coli), Staphylococcus, and Streptococcus.
Among other pathogens in bacterial form, there are:
- Klebsiella (Klebsiella);
- Proteas (Proteus);
- Kochella, Mycobacterium tuberculosis;
- Treponema pallidum (Treponema pallidum);
- Neisseria gonorrhoeae (Neisseria gonorrhoeae);
- Trichomonas vaginalis (Trichomonas vaginalis);
- Mycoplasma, etc.
The development of inflammatory processes of bacterial etiology occurs in the presence of appropriate conditions for microbial reproduction, in which local immunity is unable to cope with the number or growth rate of bacterial colonies. This occurs with reduced protection (eg, body hypothermia) or increased number of infectious agents, introduction of species that violate the local flora (frequent sexual intercourse, changing partners, poor hygiene, catheterization of the urethra, etc. ). In this case, the infection is thought to be ascending, through the urethra and into the bladder.
The likelihood of inflammatory processes in cell membranes is increased in diabetic patients because the increased sugar content in the urine creates favorable conditions for the proliferation of most pathogenic microorganisms.
However, bacterial forms can also have descending characteristics, so, during a kidney infection, the bacteria can descend through the ureter into the bladder.
Bacteria may also infiltrate the bladder cavity from inflammatory foci of lymph nodes. The hematogenous route of infection is noted when pathogens pass through the bloodstream into the bladder cavity, which occurs in the presence of a septic process in the body.
viral form of disease
The viral form is the result of a general decline in immunity. Damage to the bladder membrane may occur in the context of a disease of current viral etiology or by a latent virus in an inactive phase in the body.
Influenza, parainfluenza, herpes, adenovirus, cytomegalovirus infection and other viral diseases often cause bladder inflammation. Acute viral cystitis is characterized by the presence of blood in the urine. Under the influence of the virus, the blood supply to the bladder wall also changes. Often, due to viral cystitis, secondary bacterial forms occur due to weakened local immunity.
fungal form
The most common pathogen of this form is the fungus Candida. In most cases, the infection process is ascending and the fungus enters the bladder through the urethra, but descending forms can be observed: oral candidiasis, infection into the gastrointestinal tract and urinary system, and direct infection when a contaminated catheter is used.
Parasitic form
This form of parasitism is rare because its causative agent, Schistosoma schistosome, is not ubiquitous. Infection occurs when swimming in tropical reservoirs contaminated with this fluke, schistosomiasis develops, and it can spread to the bladder wall.
non-infectious forms of the disease
In not all cases, the pathology is caused by some kind of infection. Noninfectious cystitis is usually no less severe than infectious cystitis and has its own treatment characteristics. The most common noninfectious cystitis are drug-induced, allergic, and interstitial.
drug form
The drug form occurs after certain other conditions are treated with certain types of drugs that have an irritating effect on the bladder wall. These can be cytostatic drugs, certain groups of antibiotics, sulfonamides.
allergic form
Allergic reactions can affect not only the external mucous membranes and skin, but also many internal organs, such as the bladder. The allergic form develops due to the body's reaction to the allergen that enters it. As a result, an eosinophilic infiltrate may form in the lining of the bladder, manifesting as symptoms of allergic cystitis.
interstitial cystitis
The pathogenesis of this form has not been established, and there are hypotheses regarding the influence of autoimmunity, neurogenic factors, neuropathy, inflammatory processes in other organs, disturbances in nitric oxide metabolism, etc. In this form, the symptoms of cystitis are not accompanied by inflammatory processes in the membranes, complicating the diagnosis and treatment of the disease.
Other non-infectious forms
Other non-infectious forms include:
- radiation,
- Chemical,
- traumatic,
- hot.
Radiation forms can develop as a result of radiation to the pelvic area, often in cancer treatment. When corrosive substances enter its cavity, the chemical form is bladder burns.
The traumatic form occurs after trauma to the organs of the genitourinary system. If surgical intervention results in this form, then it is designated the postoperative form of cystitis. The thermal form occurs due to prolonged exposure of the pelvic region to high or low temperatures.
diagnosis
If you suspect a disease, you should contact a urologist. Diagnosis is made by collecting medical history, clinical pictures, and laboratory tests of the patient's blood and urine. Applicable instrumentation methods: ultrasound, cystoscopy, endoscopy.
Treatment of cystitis
What should I do about cystitis? Like any other disease, it must be treated. It should be remembered that without an accurate diagnosis of the cause of cystitis, effective treatment is impossible.
As we all know, the main treatment for cystitis is drug therapy. Within its framework, patients are prescribed effective drugs, the type of which depends on the nature of the disease. For bacterial pathogens, prescription antibiotics, fungal processes - fungicides, allergic processes - antihistamines. In addition, in acute cystitis, antispasmodics, analgesics, non-steroidal anti-inflammatory drugs are prescribed. If necessary, additional therapy is administered to improve immune status. Herbal preparations have also been shown to be highly effective in chronic cystitis. Folk remedies and herbal soups with anti-inflammatory and antibacterial properties are also popular.
Part of cystitis treatment is to limit the diet of foods that irritate the bladder lining (spicy, salty, pickled, smoked foods). An abundance of hot drinks is prescribed: fruit juice drinks, herbal teas, preserves.
For the treatment of chronic cystitis, it is recommended to involve physical therapy methods: magnetophoresis, electrophoresis, induction and hyperthermia, EHF therapy, ultrasound therapy, laser therapy.
In acute cystitis, it is important not to limit the course of antibiotic therapy to the moment the signs of disease disappear. Untreated, high-frequency acute cystitis transforms into a chronic form that presents with frequent recurrences and threatens a person's overall health.