The danger of cystitis lies not only in the pain of the symptoms: the lack of adequate treatment is fraught with complications, especially in women; Improper selection and use of medications can lead to life-threatening consequences.
Causes and pathogenesis
A predisposing factor for the development of cystitis in women is the peculiarities of the anatomical structure of their urinary tract: a short and wide urethra, which allows access to unhindered penetration of microbes. Anal and vaginal openings located near the urethra increase the risk of infection.
Another physiological feature that influences the frequent development of pathology in women is a larger bladder volume than men, which allows them to endure the need to go to the toilet for a long time. Periodic stagnation of urine causes the persistence and proliferation of the infection in the organ cavity.
The development of the inflammatory process is facilitated by the use of tight or synthetic underwear, creating the effect of a thermos, as well as the lack of personal intimate hygiene and the lack of indiscriminateness in sexual intercourse.
Microbes enter the bladder via the ascending (through the urethra) or descending (through the ureters from the kidneys) route. Infection with lymphatic flow from the pelvic organs is possible. Rarer, but probable, is the hematogenous route of infection from distant foci of inflammation: the nasopharynx, decayed dental cavities.
The most common causative agent of the disease is E. coli or streptococcus, less often - viruses, yeast-like fungi or sexually transmitted infections: gonococcus, trichomonas.
Normally, the bladder mucosa is protected from infection by the glycocalyx, a protective substance produced under the influence of female sex hormones. The cavity of a healthy organ is not sterile: single cells of pathogenic microflora may be present in it, but the active development of microbes is blocked by the body's immune forces. Furthermore, the infection is eliminated by the periodic flow of urine.
The impetus for the development of acute cystitis can be:
- decreased immunity due to hypothermia, ARVI, nervous overstrain, stress, physical fatigue;
- allergies to certain medications;
- pyelonephritis, urolithiasis, accompanied by impaired urine outflow;
- diabetes;
- final stages of pregnancy;
- menopause, a state of imbalance of female sex hormones.
Cystitis can occur in acute and chronic forms. The latter is the result of improper treatment, persistent renal dysfunction and systemic diseases associated with hormonal imbalance.
Development of acute cystitis
The disease always begins suddenly, most often at night or the next morning after getting your feet wet, getting wet in the rain, or sitting on something cold. The symptoms are vivid and painful, it is impossible not to notice them:
- nagging pain in the lower abdomen above the pubis, radiating to the lumbosacral region;
- nocturia: the need to urinate every 10-15 minutes;
- dysuria: a constant feeling of fullness of the bladder;
- urine output is scanty, difficult, drip, accompanied by sharp cutting pain, burning, itching;
- the color is cloudy, with flakes, there may be admixtures of pus or blood;
- weakness, weakness, headache, fever, low-grade fever, or high temperature.
The inflammatory process often affects the urethra, provoking the development of urethritis, in which pain and itching intensify.
There can be no question of performance in such a situation. The best thing to do is to consult a doctor immediately.
Treatment started in the first hours of illness increases the chances of getting rid of cystitis in a short time and forever.
Diagnostics
To treat cystitis, you will need to consult a urologist, gynecologist, or infectious disease specialist.
A series of tests will need to be done:
- general urinalysis;
- microscopic examination of urine;
- bacterial culture to determine the sensitivity of the pathogen to antibiotics;
- Ultrasound of the bladder is necessary to ensure that there are no changes in the submucosal and deep muscular layers of the bladder, polyps and cysts.
Cystitis is indicated by a high leukocyte level - leukocyturia greater than 2000/ml.
Based on the content of red blood cells and cylindrical formations in the urine, it is possible to identify associated problems and factors provoking the development of cystitis: traumatic kidney damage, urolithiasis, acute and chronic glomerulonephritis, nephropathies, purulent abscesses, toxic lesions of the urinary system, presence of viruses.
In addition, a gynecological examination is necessary: analysis of a vaginal smear for the presence of sexually transmitted infections and pathogenic microflora.
Such a detailed history will help to reliably identify the causative agent of inflammation and the degree of tissue damage to the organ.
Treatment with antibiotics
For the treatment of acute infectious cystitis that is not burdened by complications, a course of antibiotics is prescribed for a period of 2 to 7 days. Tetracycline drugs based on clavulanic acid, from the penicillin group and fluoroquinolones, are used.
The choice of drug is made by the doctor based on the results of tests for sensitivity to pathogens. Spontaneous use of drugs can only suppress symptoms and contribute to the development of a slow inflammatory process. The developed resistance of microbes will complicate further treatments, narrowing the range of effective drugs.
It is not possible to independently extend the prescribed period of taking antibiotics: due to the suppression of the normal internal microflora of the body, there will be a danger of developing dysbacteriosis and immunodeficiency states.
In addition to antibiotics, in the treatment of cystitis in women, antispasmodics, analgesics and herbal medicines in tablets and other dosage forms are prescribed to relieve symptoms.
Herbal medicines and food supplements
Complexes based on plant raw materials are non-toxic, have anti-inflammatory, diuretic, choleretic, antimicrobial effects, improve the work of antibiotics without disturbing the balance of microflora. They can be taken for a long time, from 2 weeks to 1 month during the treatment of acute and chronic cystitis. The choice of funds is quite wide:
- tablets containing cranberry extract - a well-known natural antibiotic and diuretic. Cranberry has an astringent and anti-inflammatory effect, accelerating the removal of infection through urine;
- capsules containing ascorbic acid, cranberry, bearberry and horsetail are intended for the prevention and treatment of cystitis as part of complex therapy;
- herbal remedy for cystitis based on medicinal plants. Available in the form of solutions and dragees, containing centaury, lovage, rosemary;
- natural complex based on orange, pine, sage and other plant oils. Available as a thick green paste. Before ingesting, dissolve a small quantity of product in warm water;
- the product, made in tablets, contains extracts of hops, peppermint, oregano and fir oil;
- a drug intended for the treatment of urolithiasis and the prevention of bladder infections. Contains kidney tea, curly silkworm leaves, papaya, cubebe pepper. Available in capsules and tablets. In addition to its pronounced diuretic effect, the product stops the inflammatory process of the urinary tract, improves its permeability, removes sand and dissolves small kidney stones, and acts as an antispasmodic and analgesic.
Antispasmodics
To relieve pain, relax the smooth muscles of the bladder and facilitate the passage of urine, myotropic antispasmodics are prescribed. The drugs relieve severe symptoms, reduce pain and discomfort caused by the contraction of muscle fibers.
A single dose should not exceed 2-3 tablets. An overdose may cause dizziness, drowsiness and decreased blood pressure. Don't forget that an antispasmodic only provides temporary relief, but does not cure the disease.
Analgesics
Severe pain, accompanied by fever, fever and weakness, is the reason for prescribing drugs from the group of propionic acid derivatives. The drugs used have a general anti-inflammatory and analgesic effect. Side effects are rare but possible, so be sure to check their safety by talking to your doctor before using the medications. Contraindications to taking products containing propionic acid derivatives include severe renal and hepatic insufficiency, pregnancy and early childhood under 6 years of age.
Probiotics
To prevent dysbacteriosis and disorders of the gastrointestinal tract when taking antibiotics, drugs containing natural complexes of lactobacilli and bifidobacteria - probiotics are used. The products have been proven to protect and restore the microflora of the female genital organs, strengthening local immunity and reducing the undesirable consequences of antibiotic treatment. There are few contraindications to taking probiotics: hypersensitivity to drug components or allergic reaction.
For acute uncomplicated cystitis, treatment with dry and moist heat is effective. Hot steam baths and sitz baths with a decoction of St. John's wort or yarrow are useful: for a steam bath, pour a hot herbal decoction into a basin. You need to squat on the emanating steam and sit for 10-15 minutes. The steam should be warm, but not hot. For sitz baths, a decoction of medicinal herbs is added to the water at a temperature of approximately 45°C.
At rest, you can apply a warm heating pad to the lower abdomen, in the location of the bladder.
Thermal procedures stimulate intertissue exchange and have a relaxing, analgesic and antispasmodic effect.
Heating is allowed only in the absence of inflammatory processes in the genital organs, otherwise such treatment may cause further damage.
Additional treatments
Bladder massage techniques can be used as an additional treatment.
- In a reclining position on your back, bend your knees slightly (you can put a pillow or pillow under your back).
- Place the fingertips of both hands on your stomach 2-3 fingers below your belly button.
- Exhaling, press gently and deeply on the abdominal wall until you feel a slight pain inside, after a few seconds release your hands and press on the belly again. Do 5 or 6 repetitions.
The movements are aimed at eliminating delayed diuresis, congestion and accelerating blood circulation in the bladder area. If the massage is done correctly, after its completion you will feel a strong urge to go to the toilet.
During the treatment of cystitis it is necessary to drink more fluids than usual to irrigate the bladder. In addition to clean drinking water, it is useful to drink slightly alkaline mineral water without gas, fruit drinks made from cranberries, black and red currants, cherries, sea buckthorn and other berries. Acidic drinks have an antimicrobial effect, prevent the persistence of infection on the walls of the organ and accelerate the removal of inflammatory products from the bladder cavity.
Decoctions and infusions of seeds and herbs of dill, chamomile, parsley, cranberry leaves and millet have a high diuretic and anti-inflammatory effect. To prepare them, 2 tablespoons of crushed raw materials are poured into 1 liter of boiling water, boiled for 15 minutes in a water bath and left for about an hour. The liquid is carefully filtered and consumed hot, 1 glass 3 times a day.
Diuretic drinks should be used with caution in case of renal insufficiency, tendency to hypertension or hypotension.
During the treatment of cystitis, it is necessary to exclude from the diet hot seasonings, pickled and salty foods, sweets, carbonated sweet drinks, strong coffee and alcohol. These products interfere with the excretory function of the kidneys, promote the accumulation of uric acid and irritate the urinary tract.
Chronic cystitis
Premature onset or incorrect and negligent treatment of acute cystitis leads to an advanced chronic form with periodic relapses. Chronic cystitis is a long-term disease. Periods of remission or a slow inflammatory process, during which the disease practically does not make itself felt, alternate with a strong exacerbation of symptoms.
The danger of chronic cystitis lies not only in the severe discomfort and pain that occurs during flare-ups. A focus of inflammation that has existed for a long time in the bladder affects the deep layers of the organ, contributing to the formation of intractable morphological forms of the disease: interstitial, cystic, hemorrhagic, gangrenous cystitis, polypous growths. The inflammation process involves not only the mucosa, but also the submucosal layer, muscle tissue and the circulatory system of the organ. Gradually, the affected areas are replaced by rough scar tissue, the organ loses its elasticity and ceases to adequately cope with its functions.
In addition, the inflammatory process can spread to nearby organs, causing the development of paracystitis - damage to the perivesical tissue, pyelonephritis. The gradual spread of the infection can cause the development of adnexitis, adhesions of the fallopian tubes and subsequent infertility.
In pregnant women, an exacerbation of the chronic process is inevitable, which is influenced by changes in hormonal levels, fluctuations in immunity, compression of internal organs by the growing uterus, which additionally causes stagnation of urine and an inflammatory process. The most serious complication of cystitis in pregnant women is acute pyelonephritis with severe intoxication of the body and threat of miscarriage.
Treatment of complicated forms of cystitis is carried out in hospital. In addition to taking medications, the following types of therapy may be prescribed:
- instillation - the introduction into the bladder cavity of medicinal solutions that eliminate toxins and have an anti-inflammatory effect;
- physiotherapy - treatment with electrical current pulses, iontophoresis, UHF, mud applications, acupuncture;
- positional therapy - special poses that help eliminate congestion and restore patency of the urinary tract. The method is suitable for pregnant women;
- surgical treatments: laser cauterization or excision of the affected bladder tissue. In severe cases of complete loss of organ functions, plastic surgery of the bladder from its own intestinal tissue is resorted to.
The duration of treatment for chronic cystitis is several months. The course is aimed at eliminating the inflammatory process, preventing complications, maximizing the restoration of the urinary system and preventing irreversible changes in the structure of organ tissues.
Basic measures to prevent cystitis: maintaining good hygiene, wearing underwear made from natural fabrics, choosing shoes and clothing in accordance with the weather and season, timely treatment of colds and chronic pathologies, taking general strengthening vitamin complexes.