Pain in the lower abdomen, aggravated by urination, frequent urges to urinate, blood in the urine and its unusual color - all these signs, of course, worry every person. In most cases, such an unpleasant disease as cystitis is hidden behind these manifestations.
What is cystitis?
Cystitis is an inflammatory process in the lining of the bladder. It most often occurs due to a bacterial infection. Despite the favorable prognosis in most cases, the disease can be severe, usually accompanied by painful symptoms.
Who is affected?
Studies show that 50% of women have had cystitis at least once in their lives. 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 characteristics of the structure of the female body. The main ones are the shorter and wider urethra, as well as the fact that the opening of the urethra in women is closer to the anus, which makes it easier for intestinal bacteria from feces to enter the urethra.
The clinical picture of cystitis in women and men also differs. The disease in men is characterized by frequent urination. In addition, acute cystitis in the stronger sex is accompanied by pain that 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, but most often in girls aged 4 to 12 years.
Among the common causes of cystitis in children are 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 changing of diapers;
- avitaminosis and other conditions and diseases that provoke 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 because of the lack of speech and the difficulty in controlling the frequency of urination. Among the signs of cystitis can be noted the darkening of urine, the presence of sediment in it and involuntary urination during the day.
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, strong desire to urinate with a small amount of released liquid;
- 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, symptoms of intoxication of the body.
Signs of cystitis also include a phenomenon such as a change in the color of urine. The liquid darkens, turbidity, the presence of sediment, purulent clots can be visually detected in it. In the severe stage, hematuria, the presence of blood in the urine, is noted.
Sometimes the pathological process passes to the kidneys. In this case, symptoms of kidney inflammation are characteristic: 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, but periods of exacerbation are periodically observed with this form. 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, several forms of cystitis are classified. Catarrhal, hemorrhagic and ulcerative forms are most common.
Acute cystitis is more common in the catarrhal form, in which the upper layers of the mucous membrane of the bladder are affected, which leads to its swelling and hyperthermia. The first stage of this form is serous, the second, which develops 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.
In hemorrhagic acute cystitis, the process of blood penetration into the urine is observed. This form occurs due to the spread of the inflammatory process to the site of the blood vessels.
Signs of ulcerative cystitis are ulceration of the membranes of the bladder, penetration of inflammation into the muscle tissues of the organ and their necrosis.
Symptoms of acute cystitis
In acute cystitis, pain, burning, spasms during the act of urination become pronounced.
The general condition of the patient is unsatisfactory: against the background of an increase in body temperature, symptoms of intoxication of the body are observed (headache, nausea, vomiting, muscle pain, weakness).
Purulent inclusions, with a hemorrhagic form, are noticed in the excreted urine, the presence of blood is determined visually by a change in color: from a pink shade to burgundy-brown.
Chronic inflammation of the bladder
A common reason for the development of a chronic form is the incomplete course of treatment of acute cystitis. If the patient stops taking the drugs as soon as the severe symptoms pass, the body not only retains the infectious agent, but develops resistance to the antibiotic used and the bladder mucosa does not recover 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 to 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 reason for 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 organs of the reproductive and urinary system, sexually transmitted diseases are a favorable environment for pathogenic microorganisms involving 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 resistance forces of the body can also provoke the development of a chronic form of cystitis.
In some cases, specialists diagnose the interstitial form, which currently has an unclear 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 manifest itself 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 remission stage.
The interstitial form is characterized by the instability of the alternation of exacerbations and remissions, the unpredictability of the course, the body's reaction.
The general symptoms of the chronic form are not expressed outside the periods of exacerbation, in which the clinical picture corresponds to the acute stages of cystitis.
Causes of 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, then the reasons are always 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 Escherichia coli, Staphylococcus and Streptococcus group.
Among other pathogens of the bacterial form there are:
- Klebsiella (Klebsiella);
- Proteus (Proteus);
- Koch's bacillus, Mycobacterium tuberculosis (Mycobacterium tuberculosis);
- pale treponema (Treponema pallidum);
- gonococci (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 the local immunity cannot cope with the number or growth rate of a bacterial colony. This happens with a decrease in defense forces (for example, with hypothermia of the body) or an increased number of infectious agents, the introduction of varieties that disturb the local flora (with frequent sexual contacts, changing partners, poor hygiene, catheterization of the urinary canal, etc. ). In such cases, the infection is considered ascending, penetrating the bladder through the urethra.
An increased probability of inflammatory processes in the membranes exists in patients with diabetes mellitus, because the 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 during infectious processes in the kidneys, bacteria can descend into 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 noted 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 an ongoing disease of viral etiology or be provoked by latent viruses that have been 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 cause of this form is the fungus Candida. Most often, the infectious 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 using a contaminated catheter.
parasitic form
The parasitic form is rare because 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 walls of the bladder.
Non-infectious forms of the disease
Not in all cases the pathology is caused by some 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 medicinal, allergic and interstitial.
Pharmaceutical form
The medicinal form arises 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 the allergens that have entered it. 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 established, there are assumptions 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 radiation form can develop as a result of radiation to the pelvic area, usually during cancer treatment. 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 genitourinary system. If the surgical intervention leads to this form, then it is defined as a postoperative form of cystitis. The thermal form appears 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 an anamnesis, clinical picture, laboratory tests 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 should be remembered that effective treatment is impossible without an accurate diagnosis of the cause of cystitis.
It is known that the main method of treatment for cystitis is drug therapy. Within it, the patient is prescribed effective drugs, the type of which depends on the nature of the disease. Antibiotics are prescribed for a bacterial pathogen, fungicides for a fungal process, antihistamines for an allergic process. Also, in case of 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 effectiveness in chronic cystitis. Folk remedies and decoctions of herbs with anti-inflammatory and antibacterial effects are also popular.
Part of the treatment of cystitis is a diet that limits foods that irritate the bladder mucosa (spicy, salty, pickled, smoked foods). Copious warm drinks are prescribed: fruit drinks, herbal teas, compotes.
For the treatment of chronic cystitis, the use of physiotherapeutic methods is recommended: 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 until the moment when the signs of the disease disappear. Untreated acute cystitis with a high frequency turns into a chronic form, expressed in frequent relapses and endangering the general health of a person.