Pain in the lower abdomen, aggravated by urination, frequent urge to urinate, blood in the urine and an unusual color - all these signs, of course, worry any person. In most cases, behind these manifestations there is an unpleasant disease such as cystitis.
What is cystitis?
Cystitis is an inflammatory process in the lining of the bladder. Often it 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 have shown that 50% of women have experienced cystitis at least once in their lives. The fact that this disease often attacks women, however, does not mean that men are immune from it. Also, this disease can develop in children, including infants.
cystitis in adults
This disease is more common in women. This is due to the physiological characteristics of the female body structure. 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, which makes it easier for intestinal bacteria from feces to enter the urethra.
The clinical picture of cystitis in women and men is also different. With the disease in men, frequent urination is characteristic. In addition, acute cystitis in the stronger sex is accompanied by pain that also extends to the external genitalia, feverish hyperthermia and signs of general intoxication. At the same time, men are more likely than women to experience 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 common in girls aged 4 to 12 years.
Among the common causes of cystitis in children are as follows:
- anatomical pathology and anomalies 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 cleanliness of the genitals, in babies - untimely replacement of diapers;
- beriberi and other conditions and diseases that trigger a sudden decrease in immunity;
- hypothermia;
- drug therapy with the use of certain drug groups, in particular, sulfonamides;
- genetic predisposition.
Primary diagnosis in young children is difficult due to lack of speech and difficulty controlling the frequency of urination. Among the signs of cystitis, one can note the darkness of urine, the presence of sediment in it, and involuntary urination during the day.
In case of illness in children under the age of one year, treatment is carried out in the hospital. Therapy schemes in childhood are built taking into account the body's sensitivity to drugs, it is recommended to avoid antibiotic therapy if possible.
Symptoms of cystitis
In most cases, when cystitis occurs, symptoms include the following:
- a frequent and strong desire to urinate with little fluid released;
- burning in the urethra during urination;
- discomfort, pain in the pelvis, pubis, lower abdomen, genitals (in men);
- subfebrile or febrile hyperthermia (depending on the acute level of the disease), general lethargy, symptoms of intoxication.
Signs of cystitis also include phenomena such as changes in the color of urine. Darkness of the liquid, turbidity, the presence of sediment, lumps of pus can be visually detected in it. In severe cases, hematuria is observed, the presence of blood in the urine.
Sometimes the pathological process bypasses the kidneys. In this case, the manifestation of symptoms of kidney inflammation is 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 may be asymptomatic, however, periodically with this form, a period of exacerbation is 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 bladder wall, several forms of cystitis are classified. The most common are catarrhal, hemorrhagic and ulcerative forms.
Acute cystitis is more common in the catarrhal form, where the upper layer of the mucous membrane of the bladder is affected, which leads to swelling and hyperthermia. The first stage of this form is serous, the second, which develops with rapid infectious lesions or no treatment, is purulent, characterized by increased mucosal inflammation and the presence of purulent inclusions in the urine.
In acute hemorrhagic cystitis, the process of penetration of blood into the urine is observed. This form occurs due to the spread of the inflammatory process to the location of blood vessels.
Signs of ulcerative cystitis are ulcers on the bladder membrane, inflammatory penetration into the muscle tissue of the organ and its necrosis.
Symptoms of acute cystitis
In acute cystitis, pain, burning, spasms during the act of urination reach a pronounced character.
The general condition of the patient is unsatisfactory: symptoms of intoxication are observed against the background of increased body temperature (headache, nausea, vomiting, muscle pain, weakness).
In the excreted urine, purulent inclusions can be seen, with a hemorrhagic form, the presence of blood is visually determined by a change in color: from pink to burgundy brown.
Chronic inflammation of the bladder
A common reason for the development of the chronic form is the incomplete course of treatment of acute cystitis. If the patient stops taking the medicine as soon as the severe symptoms pass, the body not only retains the infectious agent, it develops resistance to the antibiotics used, and the lining of the bladder does not recover to its original state.
Such negligence leads to the development of a chronic form of cystitis that is difficult to treat. The severity of chronic cystitis occurs against the background of minor provoking factors, which lead to an increase in unpleasant symptoms of the disease. To avoid such consequences and cure cystitis, with the diagnosis of acute cystitis, it is necessary to continue the course of antibiotic therapy until signs of clinical recovery are detected, regardless of the absence of unpleasant symptoms.
The second most common cause of the development of the inflammatory process in the bladder wall is the presence of undiagnosed or untreated diseases in the urogenital area. Vulvovaginitis, urethritis, pyelonephritis, infections of the organs of the reproductive and urinary systems, venereal diseases are breeding grounds for pathogenic microorganisms, which involve the organs and tissues around them in the inflammatory process.
Immune disorders and deficiencies, pathology of the structure of the genital organs, due to a violation of the outflow of urine or a decrease in the body's resistance, can also trigger the development of chronic forms of cystitis.
In some cases, experts diagnose the interstitial form, which currently has an unexplained etiology.
Symptoms of chronic cystitis
In the chronic form, the clinical picture of this disease may be characterized by the absence of any 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 infrequent (1 or less exacerbations per year) and remission levels.
The interstitial form is marked by the instability of the alternation of exacerbations and remissions, the uncertainty of the course, the body's response.
The general symptoms of the chronic form are not expressed outside the period of exacerbation, where the clinical picture corresponds to the acute stage of cystitis.
Reasons for the development of cystitis
So, we know how cystitis manifests itself. But what causes this disease? The most common cause of cystitis is infection. The causative agent 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 someone has bacterial cystitis, then the cause is always an infection of the bladder membrane. This condition 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 in the form of bacteria, there are:
- Klebsiella (Klebsiella);
- protease (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 inflammatory processes of bacterial etiology occurs against the background of the presence of conditions suitable for the reproduction of microorganisms, where the local immunity cannot cope with the number or growth rate of bacterial colonies. This happens with a decrease in protective power (for example, with hypothermia of the body) or an increase in the number of infectious agents, the introduction of varieties that violate the local flora (with frequent sexual intercourse, changing partners, poor hygiene, catheterization of the urinary tract, etc. ). In such cases, the infection is considered ascending, penetrating the bladder through the urethra.
The possibility of an increase in the inflammatory process in the membrane exists in patients with diabetes mellitus, because the increase in the 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, during the infectious process in the kidney, the bacteria can descend into the bladder through the ureter.
Bacterial penetration into the bladder cavity is also possible from the focus of inflammation in the lymph nodes. The hematogenous route of infection is observed when pathogens enter the bladder cavity through the blood, which occurs in the presence of a septic process in the body.
The viral form of this disease
The viral form is the result of a general decrease in immunity. Damage to the bladder membrane can occur against the background of a current disease of viral etiology or provoked by a latent virus that is 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 are also changes in the blood supply to the bladder wall under the influence of the virus. Often, with cystitis of viral etiology, the secondary bacterial form develops due to the weakness of local immunity.
fungal form
The most common causative agent in this form is the fungus Candida. Most often, 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 using a contaminated catheter. .
parasitic form
The parasitic form is rare, because the causative agent, Schistosoma hematobium, does not live everywhere. Infection occurs when swimming in tropical reservoirs contaminated with this type of trematode, schistosomiasis develops, which can spread to the bladder wall.
Non-infectious forms of the disease
Not in all cases, pathology is caused by some type of infection. Non-infectious cystitis is usually no less severe than infectious and has its own treatment characteristics. The most common non-infectious cystitis is drug-induced, allergic and interstitial.
Pharmaceutical form
The medicinal form occurs after the treatment of some other diseases with certain types of drugs that have an irritating effect on the bladder wall. These can be cytostatic drugs, several groups of antibiotics, sulfonamides.
form of allergy
Allergic reactions can affect not only the external mucous membranes and skin, but also many internal organs, such as the bladder. Allergic forms develop due to the body's response to allergens that have entered it. As a result, an eosinophilic infiltrate 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 autoimmunity, neurogenic factors, neuropathy, inflammatory processes in other organs, nitric oxide metabolic disorders, etc. In this form, the symptoms of cystitis are not accompanied by an inflammatory process in the membrane, which complicates the diagnosis and treatment of the disease.
Other non-infectious forms
Other non-infectious forms include:
- radiation,
- chemistry,
- traumatic,
- terms.
Radiation forms can develop as a result of irradiation of the pelvic area, usually in cancer therapy. Its chemical form is the burning of the bladder 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 expressed as a form of postoperative cystitis. The thermal form appears due to prolonged exposure to high or low temperatures in the pelvic area.
Diagnostics
If you suspect a disease, you should contact a urologist. Diagnosis is made by collecting anamnesis, clinical pictures, laboratory tests of blood and urine of the patient. 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. Keep in mind that effective treatment is impossible without an accurate diagnosis of the cause of cystitis.
It is known that with cystitis the main treatment method is drug therapy. In its framework, the patient is given an effective drug, the type of which depends on the nature of the disease. With bacterial pathogens, antibiotics are prescribed, with fungal processes - fungicides, with allergic processes - 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 efficiency 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 bladder mucosa (spicy, salty, pickled, smoked foods). Many warm drinks are prescribed: fruit drinks, herbal teas, compotes.
For the treatment of chronic cystitis, it is recommended to involve physiotherapy methods: magnetophoresis, electrophoresis, inducto- and hyperthermia, EHF-therapy, ultrasound treatment, laser therapy.
In acute cystitis, it is important not to limit the course of antibiotic therapy when the symptoms of the disease disappear. Acute cystitis that is not treated with high frequency turns into a chronic form, expressed by frequent relapses and threatens the general health of a person.