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Cystitis

The pain in the lower abdomen with cystitis

Cystitis is an inflammatory process that affects the internal walls of the bladder.In the early stages, it affects mainly the mucous membrane, and in severe cases can spread to the muscle layer of the organ.

According to statistics, almost 35% of people (mainly female) at the age of 20-40 years are faced with this pathology, it accounts for up to 67% of all cases of urological diseases.

Important! Inflammation of the bladder is characteristic of both sexes, however, due to anatomical features, in women it occurs 6-8 times more often.A wider, straight and short urethra provides easy access to various urogenital infections.With age, the difference in the frequency of occurrence in men and women is smoothed out due to the growth of cases of prostatitis among elderly men and the associated secondary cystitis.

The diagnostics and treatment of pathology is engaged in a urologist.Women often have to resort to the help of a gynecologist.

Cystitis: forms and types of pathology

Depending on the presence of internal sources of inflammation, 2 types of cystitis are distinguished:

  • primary - develops as independent inflammation of the walls of a previously healthy bladder;more often found in women;
  • Secondary - arises as a result of other diseases of the urea or inflammation of the adjacent tissues and organs (for example, with prostatitis in men).

By the nature of the course of the disease, they distinguish:

  • acute shape;
  • Chronic form - mixed symptoms without pain and burning is characteristic.

In the area of coverage, the disease can be:

  • total, or general;
  • focal - for example, a cervical shape with damage to the neck of the bladder;
  • With the lesion of the ureteral triangle Lieto (trigonite).

Note!The focus of inflammation can cover the entire urinary system - in such cases, cystitis is the first clinical manifestation of kidney stone disease or pyelonephritis.

Given the changes that are observed in the area of the lesion, distinguish:

  • catarrhal - classic acute inflammatory process with damage to only mucous tissues;It is accompanied by severe hyperemia, swelling and the release of serous exudate (serous form);In a neglected case, it can go into a purulent form (with the release of purulent exudate);
  • phlegmonous - a special type of purulent inflammation with spilled purulent damage to the submucosal layer;
  • granulomatous - accompanied by abundant rashes on the mucous membranes of the organ;
  • hemorrhagic - an inflammatory process, accompanied by the release of blood in the urine;
  • interstitial - with the involvement of deep muscle layers;
  • ulcerative - with the formation of characteristic ulcerations of the mucous membrane of the inner walls;
  • Inlapping - for a long time non -healing ulcers are overgrown with salts;
  • cystic - with the formation of cysts on the submucosal organ;
  • Gangrenous - with fabric murder.

Given the reasons, all the variety of cases is divided into 2 large groups of infectious and non -infectious cystitis.

Infectious forms They develop under the influence of various urogenital and general infections.Distinguish:

  • Specific pathologies - pathogens (mainly bacteria) - chlamydia, gonococci, etc.;
  • Non-specific pathologies-the source of the disease are a variety of representatives of the conditionally pathogenic flora

Note!In rare cases, cystitis can occur in response to tuberculosis infection of the kidneys.The disease is accompanied by a pronounced clinical picture.

Non -infectious cystitis - develop as a result of non -biological damage to the mucous membranes of the organ.There are several types of pathological effects:

  • radial - negative impact on the tissue of radiation therapy or radio exposure;
  • allergic or autoimmune - pathological reaction of the body to allergens (mainly personal hygiene products) or antigens of own tissues;
  • traumatic - with chopped or cut wounds, with damage to the walls with urinary stones, catheter, foreign bodies; 
  • parasitic - under the influence of toxic parasites, in particular blood schistosome (type of flat worms);The risk zone includes mainly travelers in the Middle East and Central Asia;
  • thermal - with burns, when washing with too hot solutions;
  • chemical toxic-when exposed to aggressive substances: drugs, concentrated metabolites, poisonous substances, etc.;

How cystitis occurs: causes of pathology

The vast majority of cystitis have an infectious nature.The causative agent in this case can become both conditionally pathogenic bacteria-E. coli, streptococci, staphylococci, enterococci, and frequent representatives of urogenital infection-gonococci, trichomonas, etc.

However, aggression of microorganisms is not the main cause of the disease.For its successful effect, the body should be weakened by the influence of adverse external and internal factors.These include:

  • chronic infections in other body systems - carious tooth damage, intestinal diseases, various forms of acute respiratory viral infections, gynecological inflammations and STD;
  • vitaminosis and hypovitaminosis against the background of an unbalanced diet;
  • regular physical, nervous, mental overwork, as well as insomnia and lack of night sleep;
  • strong psycho -emotional stresses;
  • general weakening of the immune system, including with prolonged use of immunosuppressors;
  • hypothermia of the body, the effect of sudden temperature changes - for women it is sometimes enough to sit on a cold surface to start the inflammatory process in the pelvic organs, including the bladder;
  • High sexual activity in the absence of a permanent partner (non -traditional sexual practices and unprotected sex are especially dangerous);
  • stagnant phenomena in the pelvic organs-sedentary work and a sedentary lifestyle in general, frequent constipation, incomplete emptying due to strictures of the urethra or tumors of the bladder, as well as a banal habit of “enduring to the last”; 
  • Poor or improper body hygiene - in 90% of cases, the pathogen of cystitis is the E. coli, which enters the bladder from the rectum;
  • wearing synthetic linen, especially narrow, squeezing the pelvic organs;
  • abnormal development of urinary organs;
  • injuries and surgical intervention on the pelvic organs;
  • Acute and fatty foods.

Separately, the cause of the disease should be mentioned endocrine disorders (diabetes mellitus, taking hormonal drugs) and general fluctuations in the hormonal background.The latter reason is especially characteristic of the female body, when exacerbations of cystitis accompany the periods of menstruation, pregnancy or menopause.

Symptoms of the disease

The first symptoms of cystitis are an increase in urination and discomfort in the lower abdomen.Otherwise, it all depends on the form of the disease and its cause. 

General list of possible features:

  • frequent urination, sometimes false;
  • Urine has a muddy color, blood impurities (hematuria) and pus are possible;
  • pain in the lower abdomen (can be given to the lower back);
  • carving and burning in the process of urination;
  • constant sensation of the fullness of the bladder;
  • Urine acquires an unpleasant odor;
  • daily or night enuresis;
  • Improving body temperature and general weakness.

In rare cases of acute form, chills, nausea, vomiting are possible.

Important! This disease is not characterized by a temperature above 37.5 degrees.If there is an excess of this indicator, it is necessary to examine the entire urinary system - perhaps the inflammatory process has reached the kidneys.

In women, pathology often proceeds in acute form and is accompanied by a classic set of symptoms.

Men are characterized by a chronic course of the disease with greased symptoms, which is often accompanied by signs of concomitant diseases of the sexual sphere (for example, balanoposthitis or urethritis).

Diagnostics

A clear symptoms of the disease allows you to make the main diagnosis after talking with the patient and palpation.Additional instrumental and laboratory examination methods make it possible to establish the type and form of the disease, identify the pathogen (with infectious lesion) and prescribe the most effective therapeutic complex.

Instrumental diagnostics:

  • Echoscopy (ultrasound) - determines the degree of inflammatory process, makes it possible to simultaneously assess the state of urinary and sexual systems;
  • Endoscopy (cystoscopy) - examination of the bladder cavity using the optical system of the cystoscope allows you to evaluate the state of internal integument, identify possible pathologies and neoplasms;carried out only after the disappearance of acute phenomena;
  • Cystography is an X -ray examination using an X -ray contract.

Laboratory research:

  • general urine analysis - check the level of pH, concentration of leukocytes, red blood cells, protein and uric acid salts;
  • study of urine sediment for more accurate results;
  • Baksev - to identify an infectious pathogen;
  • tissue biopsy, followed by histological examination;
  • PCR diagnostics-as effective as possible when identifying sexual infections.

In some cases, the doctor may prescribe an analysis for blood biochemistry - it allows you to trace the features of the functioning of the body with changes in the concentration of the main electrolytes (potassium, sodium, calcium), as well as evaluate the activity of enzyme systems.

For women, it is important to conduct a gynecological examination for the presence of “female” inflammations, which often become the cause or consequence of cystitis.

Attention! Often, inflammation of the urea is a symptom of a more serious disease, therefore, differential diagnosis is required for tuberculosis, prostatitis (in men), cancer tumors, etc.

How is treatment going?

The acute form of cystitis easily and quickly goes into chronic, therefore it is very important to react to the first signs of the disease on time and correctly.

Attention! Often, after the acute manifestation of the first symptoms, the inflammation independently comes to naught.This does not mean that the patient has recovered - the disease can go “underground”, and a more thorough diagnosis of the body is required to identify the hidden pathological process.

Treatment, as a rule, complex, using conservative methods.With a competent approach, the outcome is favorable.Surgical intervention is required only in the most advanced cases.

The main list of appointments:

  • drug therapy;
  • sparing regime;
  • abundant drink;
  • Compliance with the diet.

In chronic forms to restore the functionality of the bladder, a complex of physiotherapy is assigned.

Drug treatment:

  • Antibiotics - in chronic forms, make an individual selection of drugs based on the results of Bakposev;
  • diuretics - diuretics increase the outflow of urine, washing out the pathogenic flora and reducing the concentration of irritating substances;
  • antispasmodics;
  • Vitamin preparations.

To prevent the pathogenic effect of a large number of chemicals, grades are actively used with cystitis, mainly anti -inflammatory and diuretic: stubborn, lingonberry, renal tea (orthosiphon), St. John's wort, spray, chamomile, parsley.A good effect is given by pharmacy drugs based on plant materials.

Attention! Abundant drinking with cystitis is necessarily!The minimum volume of pure water is 2 liters.Recommended-2.5-3 liters.

Features of the diet:

  • exclude all marinades, sharp spices, pickles, sweets, smoked and fried foods, as well as alcohol, tea, coffee, sweet soda;Salt from the diet should be eliminated to the maximum (!);
  • reduce the amount of meat, fish, poultry, especially fatty varieties; 
  • Milk products are consumed in small quantities - low -fat cottage cheese, yogurt, milk, low -fat and unsolved cheese;
  • increase the consumption of fresh vegetables and fruits (large preference to watermelon, pumpkin);
  • To prevent constipation in the diet, the content of bran, cereals, and vegetable oils should be increased.

Features of cystitis in pregnant women

Changing the hormonal background during pregnancy creates the prerequisites for suppressing the work of the immune system, which increases the risks of developing various inflammatory processes.The slightest hypothermia, a slight violation of hygiene rules and even the usual climate change (the body regards it as stress) can provoke inflammation of the bladder.

When bearing a child, especially in the late stages of pregnancy, the pressure on the bladder due to increased uterus increases.On the one hand, this provokes stagnant phenomena in the pelvic area and contributes to the development of cystitis, on the other hand, exacerbates the manifestation of its symptoms, in particular:

  • the frequency of urination increases;
  • The feeling of pressure in the bladder becomes constant and does not stop even after its emptying.

Treatment during pregnancy is difficult due to the ban on the use of most antibacterial agents-they can negatively affect the full development of the fetus.As an alternative, the method of instillation is used - the introduction of sparing antibacterial agents of local action directly into the cavity of the bladder.The procedure is performed in the hospital under the control of the medical staff.

Attention! Cystitis during pregnancy is dangerous for its complications.The high load on the kidneys during the period of gestation requires constant monitoring of the state of the urinary system and urgent hospitalization in case of the spread of inflammation to its upper departments.

How to warn the disease?

To prevent inflammatory processes in the urinary system, it is enough to adhere to the following rules:

  • Avoid hypothermia of the lower body - do not sit on the cold surface, keep your legs warm.
  • Exclude sharp and salty products from the diet.
  • Timely treat sexual infections, as well as other foci of inflammatory processes (including caries).
  • Refuse synthetic materials, especially in the composition of underwear.Avoid a narrow, tightening pelvic area of clothing.
  • In the presence of sedentary work, do regular 10-15-minute breaks with a warm-up.
  • Carefully observe the rules of personal hygiene (especially for women) - when washing and wiping after defecation, all movements should be directed in the direction back.Lower underwear should be changed daily.During menstruation, it is necessary to change gaskets and tampons as often as possible.
  • Try to urinate on time - at the first “call of nature”, do not tolerate - this provokes stagnation of urine and stretches the walls of the bladder.Natural norm-urinate 5-6 times during the day.

With frequent recurrent cystitis for prevention purposes, you should drink a glass of cranberry juice per day - its pronounced antibacterial properties will prevent the disease or significantly reduce the frequency of its manifestations.