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, alarm everyone. In most cases, behind these manifestations lies such an unpleasant disease as cystitis.
What is cystitis?
Cystitis is an inflammatory process in the mucous membrane of the bladder. It is most often caused by a bacterial infection. In most cases, despite the favorable prognosis, the disease can be severe, usually accompanied by painful symptoms.
Who does it affect?
Studies have shown that 50% of women have had cystitis at least once in their lifetime. The fact that this disease often affects women does not mean that men are immune to it. In addition, the disease can 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 in women the opening of the urethra is closer to the anus, which makes it easier for intestinal bacteria from feces to enter the urethra.
The clinical picture of cystitis is different in women and men. Frequent urination is characteristic of men's disease. In addition, in the stronger sex, acute cystitis is accompanied by pain extending to the external genitalia, febrile hyperthermia and signs of general intoxication. At the same time, men are much more likely than women to suffer from chronic cystitis, which is not accompanied by severe symptoms.
cystitis in childhood
The disease occurs with almost equal frequency in boys and girls, although it occurs most often in girls aged 4-12 years.
The most common causes of cystitis in children include:
- anatomical pathologies and anomalies in the structure of the external genitalia, for example, narrowing of the foreskin in boys;
- pathology of the structure of the internal organs of the urogenital system;
- insufficient hygiene of the genitals, in babies - premature change of diapers;
- beriberi and other conditions and diseases that cause 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 lack of speech and difficulty controlling urinary frequency. Signs of cystitis include darkening of the urine, the presence of sediment, and involuntary urination during the day.
Children under one year old are treated in a hospital. The scheme of therapy for children is built taking into account the body's sensitivity to drugs, preferably avoid antibiotic therapy.
Signs of cystitis
In most cases, when cystitis occurs, the symptoms are as follows:
- frequent, strong urge to urinate with the release of a small amount of fluid;
- burning sensation in the urethra during urination;
- discomfort, pain in the pelvis, vulva, lower abdomen, genitals (in men);
- subfebrile or febrile hyperthermia (depending on how acute the disease is), general malaise, symptoms of body poisoning.
Signs of cystitis include a phenomenon such 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 a severe stage, hematuria is observed, the presence of blood in the urine.
Sometimes the pathological process passes to the kidneys. In this case, the manifestations of the symptoms of nephritis are typical: pain in the lower back, 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, periodic periods of exacerbation can be 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 extent of damage to the walls of the bladder, many forms of cystitis are classified. The most common are catarrhal, hemorrhagic and ulcerative forms.
Acute cystitis occurs more often in a catarrhal form, in which the upper layers of the mucous membrane of the bladder are affected, which leads to swelling and hyperthermia. The first stage of this form is serous, the second, which develops with a rapid infectious change or without treatment, is purulent, characterized by increased inflammation of the mucous membrane and the presence of purulent inclusions in the urine.
In hemorrhagic acute cystitis, the process of blood entering the urine can be observed. This form occurs due to the spread of the inflammatory process to the place of blood vessels.
The signs of ulcerative cystitis are the ulceration of the bladder membrane, the penetration of inflammation into the muscle tissues of the organ and their death.
Symptoms of acute cystitis
In acute cystitis, the pain, burning sensation, and cramps during urination are pronounced.
The patient's general condition is unsatisfactory: symptoms of body intoxication are observed against the background of an increase in body temperature (headache, nausea, vomiting, muscle pain, weakness).
Purulent inclusions can be detected in the selected urine, in hemorrhagic form, the presence of blood is visually determined by the color change: from pink to burgundy-brown.
Chronic inflammation of the bladder
A common reason for the development of the chronic form is the lack of treatment of acute cystitis. If the patient stops taking the drugs as soon as the severe symptoms have passed, the body not only retains the infectious agent, but also develops resistance to the antibiotic used, and the lining of the bladder does not return to its original state.
Such carelessness leads to the development of a chronic form of cystitis that is difficult to treat. Aggravation of chronic cystitis occurs 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 to cure cystitis, with the diagnosis of acute cystitis, antibiotic therapy should be continued until clinical signs of recovery are observed, regardless of the absence of unpleasant symptoms.
The second most common cause of the inflammatory process in the bladder wall is the presence of undiagnosed or untreated diseases of the urogenital area. Vulvovaginitis, urethritis, pyelonephritis, infections of the reproductive and urinary organs, sexually transmitted diseases are a breeding ground for pathogenic microorganisms, which involve the surrounding organs and tissues in the inflammatory process.
Disorders and deficiencies of the immune system, 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 its chronic form, the clinical picture of the disease can be characterized by the absence of symptoms (more often in men), and it appears only during laboratory tests and instrumental examination of the patient.
There is a chronic form of the disease, with frequent episodes of acute cystitis (twice a year), rare (with 1 or less exacerbations per year) and remission stage.
The interstitial form is characterized by the instability of alternating exacerbation and remission, the unpredictability of the course, the body's reaction.
The general symptoms of the chronic form are not expressed except during periods of exacerbations, in which the clinical picture corresponds to the acute stages of cystitis.
Causes of cystitis
So, we figured out how cystitis manifests itself. But what causes this disease? The most common cause of cystitis is an 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 can be divided into two main groups.
Ways of infection of bacterial cystitis
If someone 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 causing inflammation of the bladder are E. coli (Escherichia coli, E. coli), staphylococcus (Staphylococcus) and streptococcus group (Streptococcus).
Other pathogens of the bacterial form include:
- Klebsiella (Klebsiella);
- proteas (Proteus);
- Koch's bacillus, mycobacterium tuberculosis (Mycobacterium tuberculosis);
- pale treponema (Treponema pallidum);
- gonococcus (Neisseria gonorrhoeae);
- Trichomonas vaginalis (Trichomonas vaginalis);
- mycoplasma (Mycoplasma), etc.
The development of the inflammatory process of bacterial etiology occurs in the presence of suitable conditions for the reproduction of microorganisms, in which the local immunity is unable to cope with the number or growth rate of the bacterial colony. This occurs with a decrease in protective forces (for example, hypothermia of the body) or an increase in the number of infectious agents, the introduction of species that harm the local flora (frequent sexual intercourse, changing partners, poor hygiene, catheterization). urethra etc. ). In such cases, the infection is considered ascending, entering the bladder through the urethra.
In patients with diabetes, the likelihood of inflammatory processes in the membranes is increased, since the increased amount of sugar in the urine creates favorable conditions for the reproduction of most pathogenic organisms.
However, the bacterial form can also be descending, so during infectious processes in the kidney, the bacteria can descend into the bladder through the ureters.
The penetration of bacteria into the bladder cavity is also possible from the inflammatory foci of the lymph nodes. The hematogenous route of infection is observed when the pathogen enters the bladder cavity through the blood, which occurs in the presence of 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 membranes of the urinary bladder can occur against the background of a current disease of viral etiology, or it can be provoked by latent viruses that have been in an inactive state in the body.
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. As a result of viruses, the blood supply of the bladder wall also changes. Often, in the case of cystitis of viral etiology, a secondary bacterial form develops due to the weakening of local immunity.
fungal form
The most common causative agent of this form is the Candida fungus. Most often, the infection process is ascending, the fungus enters the bladder through the urethra, but a descending form can be observed: in the case of oral candidiasis, the infection enters the gastrointestinal tract and urinary tract, 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 contaminated with this type of trematodes, schistosomiasis develops, which can spread to the bladder wall.
Non-infectious forms of the disease
Pathology is not always caused by an infection. Non-infectious cystitis is usually no less serious than infectious and has its own treatment characteristics. Among non-infectious cystitis, the most common are drug-induced, allergic and interstitial inflammations.
Pharmaceutical form
The drug form occurs after the treatment of some other diseases 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 the skin, but also many internal organs, such as the bladder. The allergic form develops due to the body's reaction to allergens. As a result, eosinophilic infiltrates can form on the inner mucous membrane of the bladder, which is expressed in the appearance of symptoms of allergic cystitis.
Interstitial cystitis
The pathogenesis of this form has not been identified, there are assumptions about autoimmune, neurogenic factors, neuropathies, inflammatory processes of other organs, metabolic disorders of nitric oxide, etc. about its effect. 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:
- emission,
- chemical,
- traumatic,
- thermal.
The radiation form can develop as a result of irradiation of the pelvic area, usually in cancer therapy. The chemical form is burning of the bladder when caustic substances enter its cavity.
The traumatic form occurs after trauma to the organs of the urogenital system. If the surgical intervention leads to this form, then this is the postoperative form of cystitis. The thermal form appears due to prolonged exposure to high or low temperatures in the pelvic region.
Diagnostics
If you suspect a disease, consult a urologist. The diagnosis is made on the basis of anamnesis, clinical picture, and laboratory tests of the patient's blood and urine. Instrumental research methods can be used: ultrasound, cystoscopy, endoscopy.
Treatment of cystitis
What to do about cystitis? 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 the main way to treat cystitis is drug therapy. As part of this, the patient is prescribed effective drugs, the type of which depends on the nature of the disease. In the case of a bacterial pathogen, antibiotics are prescribed, with fungal processes - fungicides, with allergic processes - antihistamines. In addition, in acute cystitis, antispasmodics, pain relievers, and non-steroidal anti-inflammatory drugs are prescribed. If necessary, additional therapy is performed to improve the immune status. Herbal preparations have also shown great effectiveness in chronic cystitis. Folk remedies and herbal decoctions with anti-inflammatory and antibacterial effects are also popular.
Part of the therapy for cystitis is a diet that limits foods that irritate the bladder mucosa (spicy, salty, pickled, smoked foods). Abundant warm drinks are prescribed: fruit drinks, herbal teas, compotes.
Physiotherapy methods are recommended for the treatment of chronic cystitis: magnetophoresis, electrophoresis, induction and hyperthermia, EHF therapy, ultrasound treatment, laser therapy.
In case of acute cystitis, it is important not to limit the course of antibiotic therapy to the moment when the signs of the disease disappear. With great frequency, untreated acute cystitis turns into a chronic form, which is expressed by frequent relapses and endangers the general health of a person.