Abdominal pain, aggravated during urination, frequent urination, blood in the urine and its unusual color – all these signs undoubtedly alarming any person. In most cases, behind these manifestations lies such an unpleasant disease as cystitis.
- What is cystitis?
- Who is affected?
- Adult Cystitis
- Cystitis in childhood
- Signs of Cystitis
- Classification of Cystitis
- Acute Cystitis
- Symptoms of acute cystitis
- Chronic inflammation of the bladder
- Symptoms of chronic cystitis
- Causes of Cystitis
- Ways of infection with bacterial cystitis
- Viral form of the disease
- Fungal form
- Parasitic form
- Non-infectious forms of the disease
- Drug form
- Allergic form
- Interstitial Cystitis
- Other non-infectious forms
- Treatment of cystitis
What is cystitis?
Cystitis is an inflammatory process in the bladder membrane. Most often it occurs due to a bacterial infection. Despite the favorable prognosis in most cases, the disease can be difficult, usually accompanied by painful symptoms.
Who is affected?
According to research, 50% of women had cystitis at least once in their lifetime. The fact that this disease often affects women, however, does not mean that men are insured against it. The disease can also develop in children, including infants.
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 canal in women is closer to the anus, which facilitates the entry of bacteria of the intestinal origin from the feces into the urethra.
The clinical picture of cystitis in women and men also differs. When the disease in men is characterized by frequent urination. In addition, acute cystitis in the representatives of the stronger sex is accompanied by pain, which also extends to the external genital organs, hyperthermia of the febrile range and signs of general intoxication. At the same time, men are significantly 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 most characteristic for girls aged 4 to 12 years.
Among the common causes of cystitis in children are the following:
- anatomical pathologies and abnormalities of the structure of the external genital organs, for example, narrowing of the foreskin in boys;
- pathologies of the internal organs of the urogenital system;
- insufficient hygiene of the genitals, in infants – the late replacement of diapers;
- avitaminosis and other conditions and diseases that cause a sharp decrease in immunity;
- drug therapy using separate groups of drugs, in particular sulfonamides;
- genetic predisposition.
Primary diagnosis in young children is difficult due to the lack of speech and the difficulty of controlling the frequency of urination. Among the signs of cystitis can be noted darkening of the urine, the presence of sediment in it, involuntary urination during the day.
When the disease in children under one year of treatment is carried out in a hospital. The scheme of therapy in childhood is based on the sensitivity of the organism to the drugs, it is recommended to avoid antibiotic therapy if possible.
Signs of Cystitis
In most cases, symptoms of cystitis include the following symptoms:
- frequent, strong urge to urinate with a small volume of fluid;
- burning in the urethra during urine;
- 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 organism.
Symptoms of cystitis also include the phenomenon of discoloration of urine. The liquid darkens, it can visually detect turbidity, the presence of sediment, clots of pus. In severe stages, hematuria, the presence of blood in the urine, is noted.
Sometimes the pathological process goes to the kidneys. In this case, symptoms of inflammation of the kidneys are typical: 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 may be asymptomatic, but periodically with this form there are periods of exacerbation. Acute cystitis usually develops when the infection first enters the urogenital organs.
According to the analysis of the nature and extent of damage to the walls of the bladder, several forms of cystitis are classified. The most common are 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, which leads to its swelling and hyperthermia. The first stage of this form is serous, the second, developing with a rapid infection or absence of treatment, is purulent, characterized by increased inflammation of the mucous membranes and the presence of purulent inclusions in the urine.
With hemorrhagic acute cystitis, there is a process of blood penetration into the urine. This form occurs due to the spread of the inflammatory process to the site of the blood vessels.
Signs of ulcerative cystitis – ulceration of the membranes of the bladder, penetration of inflammation in the muscle tissue of the organ and their necrosis.
Symptoms of acute cystitis
In acute cystitis, soreness, burning, cracking during urination achieve a pronounced nature.
The patient’s general condition is unsatisfactory: symptoms of intoxication are observed against the background of an increase in body temperature (headaches, nausea, vomiting, muscle aches, weakness).
In the excreted urine, purulent inclusions are noticeable, with a hemorrhagic form, the presence of blood is visually determined by the color change: from pink to maroon brown.
Chronic inflammation of the bladder
A common cause of the development of the chronic form is the incompleteness of the treatment of acute cystitis. If a patient interrupts taking drugs, as soon as severe symptoms pass, the body not only maintains an infectious agent, it develops resistance to the antibiotic used, and the bladder membrane does not recover to its original state.
Such negligence leads to the development of chronic, difficult to treat form of cystitis. Exacerbations of chronic cystitis occur on the background of minor provoking factors, which leads to increased symptoms of an unpleasant disease. To avoid such consequences and cure cystitis, in the diagnosis of acute cystitis, it is necessary to continue the course of antibiotic therapy until the clinical signs of recovery, regardless of the absence of unpleasant symptoms, are detected.
The second most common cause of the development of the 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 systems, sexually transmitted diseases are a reproduction center of pathogenic microorganisms that involve surrounding organs and tissues in the inflammatory process.
Immune disorders and deficiencies, abnormalities in the structure of the genital organs, due to the violation of urine outflow or reduction of body resistance, can also provoke the development of chronic forms of cystitis.
In some cases, experts diagnose the interstitial form, which at the moment it has an unknown etiology.
Symptoms of chronic cystitis
In 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 in laboratory tests and instrumental examination of the patient.
They distinguish the 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.
The interstitial form is marked by instability of alternation of exacerbations and remissions, unpredictability of the course, the reaction of the organism.
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.
Causes of Cystitis
So, we figured out how to manifest cystitis. But what causes this disease? The most common cause of cystitis is infection. Bacteria can be causative agents, less often – viruses or other microorganisms. However, there are 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 always lie 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 E. coli (Escherichia coli, E.coli), Staphylococcus (Staphylococcus) and Streptococcus group (Streptococcus).
Among other pathogens of the bacterial form, there are:
- Klebsiella (Klebsiella);
- Proteus (Proteus);
- Koch wand, Mycobacterium tuberculosis tuberculosis;
- Treponema pallidum (Treponema pallidum);
- gonococcus (Neisseria gonorrhoeae);
- Trichomonas vaginal (Trichomonas vaginalis);
- mycoplasma (Mycoplasma) and others.
The development of an inflammatory process of bacterial etiology arises against the background of the presence of appropriate conditions for the reproduction of microorganisms, under which local immunity does not cope with the number or growth rate of a colony of bacteria. This occurs when the protective forces decrease (for example, when the body is overcooling) or an increased number of infectious agents, the introduction of species that violate the local flora (with frequent sexual intercourse, changing partners, hygiene, catheterization of the urinary channel, etc.). In such cases, the infection is considered ascending, penetrating the bladder through the urethra.
An increased likelihood of inflammation in the membranes exists in diabetic patients, 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 be of a descending nature, so, during infectious processes in the kidneys, bacteria can descend into the bladder through the ureters.
The penetration of bacteria into the cavity of the bladder 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 bloodstream, which happens when there are 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 the current disease of viral etiology or be provoked by latent viruses that were in an inactive state in the body.
Viral diseases such as influenza, parainfluenza, herpes, adenovirus, cytomegalovirus infection, often cause inflammation of the bladder. Acute viral cystitis is characterized by such a sign as the presence of blood in the urine. Also changes in the blood supply to the walls of the bladder under the influence of viruses. Often with cystitis viral etiology develops secondary bacterial form due to weakening of local immunity.
The most common causative agent of this form is Candida fungus. Most often, the infection process is upward, the fungus enters the bladder through the urethra, but a downward form can be observed: in case of oral candidiasis, the infection enters the gastrointestinal tract and urinary system, as well as direct infection when using a contaminated catheter.
The parasitic form in Russia is rare, since its causative agent, Schistosoma hematobium, does not inhabit our latitudes. Infection occurs when bathing in tropical water bodies polluted by this species of trematodes, and 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 infections. Non-infectious cystitis usually occur no less difficult than infectious and have their own characteristics of treatment. The most common of non-infectious cystitis are drug, allergic and interstitial.
The drug form occurs after the treatment of some other diseases with certain types of drugs that irritate the walls of the bladder. These may be cytotoxic drugs (cyclophosphamide, ifosfamide), some groups of antibiotics, sulfonamides.
Allergic reactions can affect not only the outer mucous membranes and skin, but also many internal organs, such as the bladder. An allergic form develops due to the body’s reaction to the allergens it has received. As a result, eosinophilic infiltrates may form on the inner lining of the bladder, resulting in the appearance of symptoms of allergic cystitis.
The pathogenesis of this form has not been identified, there are assumptions about the effect of autoimmune, neurogenic factors, neuropathies, inflammatory processes in other organs, disorders of nitric oxide metabolism, 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:
The radiation form can develop as a result of irradiation of the pelvic region, as a rule, in the treatment of cancers. The chemical form is a burn of the bladder when caustic substances get into its cavity.
The traumatic form occurs after trauma to the organs of the urogenital system. If surgical intervention leads to this form, then it is specified as a postoperative form of cystitis. Thermal form appears due to prolonged exposure of the pelvic region to high or low temperatures.
If you suspect a disease, you should consult a urologist. The diagnosis is made by collecting history, clinical presentation, laboratory tests of blood and urine of the patient. Can be used instrumental research methods: 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 in cystitis the main treatment method is drug therapy. In its framework, the patient is prescribed effective drugs, the type of which depends on the nature of the disease. Antibiotics are prescribed for bacterial pathogens, fungicides for fungal processes, antihistamines for allergies. 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. Medicinal herbs, such as Canephron, have also shown high efficacy in chronic cystitis. Popular as well as folk remedies and decoctions of herbs with anti-inflammatory and antibacterial effect.
Part of therapy for cystitis is to follow a diet that restricts products that irritate the bladder mucosa (spicy, salted, pickled, smoked products). Plentiful warm drink is prescribed: fruit drinks, fitozbory, compotes.
For the treatment of chronic cystitis, the use of physiotherapy methods is recommended: magnetic therapy, 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 symptoms of the disease disappear. Untreated acute cystitis with a high frequency of becoming chronic, expressing frequent relapses and threatening the overall health of the person.