Pain in the lower abdomen, aggravated by urination, frequent urination, blood in the urine and its 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 often occurs due to a bacterial infection. Despite a favorable prognosis in most cases, the disease can be severe, usually accompanied by painful symptoms.
Who is affected?
Studies have shown that 50% of women have had cystitis at least once in their life. However, the fact that this 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 much more common in women. This is due to the physiological features of the structure of the female body. The main ones are the shorter and wider urethra, and the fact that the opening of the urethra in women is closer to the anus, making it easier for intestinal bacteria from feces to enter the urethra.
The clinical picture of cystitis in women and men also differs. With the disease in men, frequent urination is characteristic. Also, acute cystitis in the stronger sex is accompanied by pain that also extends 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 is more common in girls aged 4 to 12 years.
Common causes of cystitis in children include the following:
- anatomical pathologies and abnormalities 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 cause a sharp decrease in immunity;
- hypothermia;
- drug therapy with the use of certain groups of drugs, in particular, sulfonamides;
- genetic predisposition.
Primary diagnosis in young children is difficult due to lack of speech and difficulty in controlling the frequency of urination. Among the signs of cystitis, darkening of urine, the presence of sediment in it, and involuntary urination during the day can be noted.
In case of illness in children under one year, treatment is carried out in a hospital. The scheme of therapy 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 cystitis
In most cases, when cystitis occurs, symptoms include the following:
- frequent and strong urge to urinate with a small amount of fluid released;
- burning in the urethra during the excretion of urine;
- discomfort, pain in the pelvis, pubis, lower abdomen, genitals (in men);
- subfebrile or febrile hyperthermia (depending on how acute the disease), malaise, symptoms of intoxication of the body.
Signs of cystitis also include such a phenomenon as a change in the color of urine. The liquid darkens, turbidity, the presence of sediment, pus clots 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, the manifestations of the symptoms of inflammation of the kidneys are characteristic: pain in the lower back, 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, periods of exacerbation are 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 the 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, leading to its 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 mucosa and the presence of purulent inclusions in the urine.
In acute hemorrhagic cystitis, the process of blood penetration into the urine is observed. This form occurs due to the spread of the inflammatory process to the location of the blood vessels.
Signs of ulcerative cystitis are ulceration of the bladder membranes, penetration of inflammation into the muscular tissues of the organ and its necrosis.
Symptoms of acute cystitis
In acute cystitis, pain, burning and cramping during the act of urination reach 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 (headaches, nausea, vomiting, muscle aches, weakness).
In the excreted urine, purulent inclusions are noted, with a hemorrhagic form, the presence of blood is visually determined by a color change: from a pinkish shade to burgundy-brown.
Chronic inflammation of the bladder
A common reason for the development of the chronic form is incomplete treatment of acute cystitis. If the patient stops taking the medications as soon as the severe symptoms pass, the body not only retains the infectious agent, but also develops resistance to the antibiotic used, and the lining of the bladder does not recover to its original state.
Such neglect leads to the development of a chronic and 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, with the diagnosis of acute cystitis, it is necessary to continue the course of antibiotic therapy until clinical signs of recovery are detected, regardless of the absence of unpleasant symptoms.
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 urogenital area. Vulvovaginitis, urethritis, pyelonephritis, infections of the reproductive and urinary system organs, 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 flow 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 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 remission stage.
The interstitial form is marked 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 the periods of exacerbations, in which the clinical picture corresponds to the acute stages of cystitis.
Reasons for the development of cystitis
So, we found out how cystitis manifests itself. But what causes this disease? The most common cause of cystitis is infection. The causative agents can be bacteria, less often 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.
Ways of infection with bacterial cystitis.
If a person develops bacterial cystitis, the causes are always found to be infection of the bladder membranes. This circumstance is the most frequent 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 streptococcal 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 an inflammatory process of bacterial etiology occurs against the background of the presence of conditions appropriate for the reproduction of microorganisms, in which local immunity cannot cope with the number or growth rate of a bacterial colony. This occurs 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, change of partner, poor hygiene, catheterization of the urinary tract, etc. ). In such cases, the infection is considered ascending, entering the bladder through the urethra.
There is an increased probability of inflammatory processes in the membranes in patients with diabetes mellitus, 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 descending character, so that during infectious processes in the kidneys, the bacteria can descend to the bladder through the ureters.
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 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 bladder can occur against the background of a current disease of viral etiology or be caused by latent viruses that were in the body in an inactive stage.
Viral diseases such as influenza, parainfluenza, herpes, adenovirus, cytomegalovirus infection often cause inflammation of the bladder. 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 viruses. Often with cystitis of viral etiology, a secondary bacterial form develops due to weakening of local immunity.
fungal form
The most common causative agent of this form is the Candida fungus. In most cases, the infection process is ascending, 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 a contaminated catheter is used. .
parasitic form
The parasitic form is rare, since its causative agent, Schistosoma hematobium, does not live everywhere. Infection occurs when swimming in tropical reservoirs contaminated with this type of fluke, 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 usually proceeds with the same severity as infectious ones and has its own features of treatment. The most common noninfectious cystitis are drug-induced, allergic, and interstitial.
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 walls of the bladder. These can be cytostatic drugs, some 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 allergens that have entered. As a result, eosinophilic infiltrates can form on the inner lining 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 the influence of autoimmune, neurogenic factors, neuropathies, inflammatory processes in other organs, nitric oxide metabolic disorders, etc. In this way, 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 radiation form can develop as a result of irradiation of the pelvic area, usually in cancer therapy. The chemical form is a bladder burn when caustic substances enter its cavity.
The traumatic form occurs after trauma to the organs of the genitourinary system. If surgical intervention leads to this form, then it is specified as a postoperative form of cystitis. The thermal form appears from prolonged exposure to high or low temperatures in the pelvic region.
Diagnostics
If you suspect a disease, you should contact a urologist. Diagnosis is made by collecting anamnesis, clinical picture, laboratory analysis of the patient's blood and urine. Instrumental research methods can be used: ultrasound, cystoscopy, endoscopy.
Treatment of cystitis
What to do with cystitis? Like any other disease, it must be treated. It must be remembered that effective treatment is impossible without an accurate diagnosis of the cause of cystitis.
It is known that with cystitis the main method of treatment is drug therapy. 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, 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 shown high efficacy 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 lining of the bladder (spicy, salty, pickled, smoked foods). A hearty hot drink is prescribed: fruit drinks, infusions, compotes.
For the treatment of chronic cystitis, it is recommended to involve physiotherapy methods: magnetophoresis, electrophoresis, induction and hyperthermia, EHF therapy, ultrasound treatment, laser therapy.
In acute cystitis, it is important not to limit the course of antibiotic therapy to the time signs of the disease disappear. Untreated acute cystitis with high frequency turns into a chronic form, expressed by frequent relapses and threatening the general health of a person.