The danger of cystitis lies not only in the pain of the symptoms - lack of proper treatment leads to complications, especially in women, and improper selection and use of medications can have life-threatening consequences.
Causes and pathogenesis
A predisposing factor in the development of cystitis in women is the peculiarities of the anatomical structure of the urinary tract - a short, wide urethra that allows microbes to penetrate unhindered. Anal and vaginal openings near the urethra increase the risk of infection.
Another physiological characteristic that affects the frequent development of pathology in women is the larger bladder volume than in men, which allows them to endure the urge to go to the toilet for a long time. Periodic stagnation of urine provokes the persistence and multiplication of the infection in the organ cavity.
The development of the inflammatory process is facilitated by wearing tight or synthetic underwear, creating the effect of a thermos, as well as the lack of personal intimate hygiene and the lack of selection in sexual contact.
Microbes enter the bladder either ascending (through the urethra) or descending (from the kidneys through the ureters). Infection with lymph flow from the pelvic organs is possible. Hematogenous infection from distant sources of inflammation - from the nasopharynx, carious tooth cavities - is rarer, but more likely.
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 mucous membrane of the bladder is protected from infections 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 the pathogenic microflora may be present in it, but the active development of microbes is inhibited by the body's immune system. In addition, the infection is eliminated with a periodic flow of urine.
Stimulation of the development of acute cystitis can be:
- reduced immunity due to hypothermia, ARVI, nervous overload, stress, physical fatigue;
- allergy to certain medications;
- pyelonephritis, urolithiasis, which is accompanied by a disturbance in the outflow of urine;
- diabetes;
- late stages of pregnancy;
- menopause, a state of imbalance of female sex hormones.
Cystitis can occur in acute and chronic form. The latter is the result of inadequate treatment, persistent kidney dysfunction and systemic diseases associated with hormonal imbalance.
Development of acute cystitis
The disease always starts suddenly, most often at night or the next morning, after wet feet, soaked in the rain or sitting in something cold. The symptoms are vivid and painful, it is impossible not to notice them:
- stabbing pain in the lower abdomen above the pubis, radiating to the lumbosacral region;
- nocturia - urge to urinate every 10-15 minutes;
- dysuria - a constant feeling of bladder fullness;
- urination is scanty, difficult, drop by drop, accompanied by sharp cutting pain, burning, itching;
- the color may be cloudy, flaky, mixtures of pus or blood;
- weakness, weakness, headache, fever, low-grade fever or high temperature.
The inflammatory process often affects the urethra, which leads to the development of urethritis, in which pain and itching intensify.
In such a situation, there is no question of performance. It is best to see a doctor immediately.
Treatment started in the first hours of the disease increases the chances of getting rid of cystitis forever in a short time.
Diagnostics
To treat cystitis, you should consult a urologist, gynecologist or infectious disease specialist.
A number of tests must be performed:
- general urinalysis;
- microscopic examination of urine;
- bacterial culture to determine the pathogen's sensitivity to antibiotics;
- An ultrasound examination of the bladder is necessary to ensure that there are no changes in the deep submucosa and muscle layer of the bladder, polyps, or cysts.
Cystitis is indicated by a high level of leukocytes - leukocyturia more than 2000/ml.
Based on the red blood cell content and cylindrical formations of the urine, related problems and the factors causing the development of cystitis can be identified: traumatic kidney damage, urolithiasis, acute and chronic glomerulonephritis, nephropathies, purulent abscesses, toxic changes in the urinary system, the presence of viruses.
In addition, a gynecological examination is required - an analysis of the vaginal smear for the presence of sexually transmitted infections and pathogenic microflora.
Such a detailed history helps to reliably identify the causative agent of inflammation and the extent of organ tissue damage.
Treatment with antibiotics
A 2-7 day course of antibiotics is prescribed to treat uncomplicated acute infectious cystitis. Clavulanic acid-based tetracycline drugs from the group of penicillins and fluoroquinolones are used.
The doctor selects the medicine based on the results of pathogen sensitivity tests. Spontaneous use of drugs can only suppress the symptoms and contribute to the development of a sluggish inflammatory process. The developed resistance of microbes makes further treatment difficult and narrows the range of effective drugs.
The prescribed duration of taking antibiotics cannot be extended independently - due to the suppression of the normal internal microflora of the body, there is a risk of developing dysbacteriosis and immunodeficiency conditions.
In addition to antibiotics, when treating cystitis in women, antispasmodics, pain relievers and herbal medicines in tablets and other dosage forms are prescribed to relieve symptoms.
Herbal medicines and dietary supplements
Complexes based on plant materials are non-toxic, anti-inflammatory, diuretic, choleretic, antimicrobial, and enhance the effect of antibiotics without disturbing the balance of the microflora. They can be taken for a long time - from 2 weeks to 1 month - during the treatment of acute and chronic cystitis. The selection of funds is quite wide:
- tablets containing cranberry extract - a well-known natural antibiotic and diuretic. Cranberry has an astringent and anti-inflammatory effect, accelerates the removal of infection with urine;
- capsules containing ascorbic acid, blueberries, gooseberry and horsetail are intended for the prevention and treatment of cystitis as part of complex therapy;
- herb-based herbal remedy for cystitis. It is available in the form of solutions and dragees, in which centaury, evening primrose, rosemary;
- natural complex based on the oil of orange, pine, sage and other plants. It is available in the form of a thick green paste. Before swallowing, a small amount of the product should be dissolved in warm water;
- the product in the form of tablets contains extracts of hops, peppermint, oregano and pine oil;
- medicine for the treatment of urolithiasis and the prevention of bladder infections. It contains kidney tea, curly silkworm leaves, papaya and diced pepper. Available in capsule and tablet form. In addition to its pronounced diuretic effect, the product stops inflammatory processes in the urinary tract, improves its permeability, removes sand and dissolves small kidney stones, has an antispasmodic and pain-relieving effect.
Anticonvulsants
Myotropic antispasmodics are prescribed to relieve pain, relax the smooth muscles of the bladder and facilitate the emptying of urine. Medicines relieve severe symptoms and reduce pain and discomfort caused by the contraction of muscle fibers.
A single dose should not exceed 2-3 tablets. Overdose can cause dizziness, drowsiness and a drop in blood pressure. Do not forget that the antispasmodic only provides temporary relief, but does not cure the disease.
Pain relievers
Severe pain accompanied by fever, fever and weakness is the reason for prescribing drugs belonging to the group of propionic acid derivatives. The drugs used have a general anti-inflammatory and pain-relieving effect. Side effects are rare but possible, so be sure to check their safety and talk to your doctor before using medications. Contraindications to taking products containing propionic acid derivatives include severe kidney and liver failure, pregnancy and early childhood under 6 years of age.
Probiotics
Medicines containing natural complexes of lactobacilli and bifidobacteria - probiotics - are used to prevent dysbacteriosis and disorders of the gastrointestinal tract while taking antibiotics. The products have proven to protect and restore the microflora of the female genital organs, strengthen local immunity, and reduce the undesirable consequences of antibiotic treatment. There are few contraindications to taking probiotics - hypersensitivity to the components of the drugs or an allergic reaction.
In case of uncomplicated acute cystitis, dry and moist heat treatment is effective. Warm steam and sitz baths with a decoction of St. John's wort or yarrow are useful: for a steam bath, a hot herbal decoction is poured into a pool. Squat over the escaping steam and sit for 10-15 minutes. The steam should be hot but not scalding. In sitz spas, a decoction of herbs is added to the water, which is around 45 °C.
At rest, you can place a warm heating pad on the lower abdomen - the place of the bladder.
Thermal procedures stimulate the exchange between tissues, have a relaxing, pain-relieving and antispasmodic effect.
Warming up is allowed only in the absence of inflammatory processes in the genitals, otherwise such treatment may cause additional damage.
Additional treatments
Bladder massage techniques can be used as an additional treatment.
- Lying on your back, bend your knees slightly (you can put a pillow or pillow under your back).
- Place the fingertips of both hands on the stomach 2-3 fingers below the navel.
- As you exhale, gently and deeply press the abdominal wall until you feel a slight pain inside, after a few seconds release your hand and press the stomach again. Do 5 or 6 repetitions.
The purpose of the movements is to eliminate diuresis delays, congestion and speed up blood circulation in the bladder area. If the massage is done correctly, after it is finished, there will be a strong urge to visit the toilet.
During the treatment of cystitis, it is necessary to drink more fluids than usual to flush the bladder. In addition to clean drinking water, it is useful to drink slightly alkaline mineral water without gas, fruit drinks made from blueberries, blackcurrants, cherries, sea buckthorn and other berries. Acidic drinks have an antimicrobial effect, prevent the infection from remaining on the wall of the organ, and accelerate the removal of inflammatory products from the bladder cavity.
Decoctions and decoctions made from dill, chamomile, parsley, cranberry leaves and millet seeds and herbs have a high diuretic and anti-inflammatory effect. To prepare them, pour 2 tablespoons of crushed raw material into 1 liter of boiling water, steam for 15 minutes in a water bath, and leave for about an hour. The liquid is carefully filtered and consumed warm, 1 glass 3 times a day.
Diuretic drinks should be used with caution in patients with insufficient renal function, high blood pressure or hypotension.
During the treatment of cystitis, hot spices, pickled and salty foods, sweets, carbonated sweet drinks, strong coffee and alcohol should be excluded from the diet. These products inhibit the excretory function of the kidneys, promote the accumulation of uric acid and irritate the urinary tract.
Chronic cystitis
Premature onset of acute cystitis or improper and careless treatment leads to an advanced chronic form with periodic relapse. Chronic cystitis is a long-term disease. Periods of remission or slow inflammatory processes, during which the disease practically does not make itself felt, alternate with sharp exacerbations of symptoms.
The danger of chronic cystitis lies not only in severe discomfort and pain during exacerbations. The long-standing inflammatory focus in the bladder affects the deep layers of the organ, contributing to the development of untreatable morphological forms of the disease: interstitial, cystic, hemorrhagic, gangrenous cystitis, polyp growth. The process of inflammation affects not only the mucous membrane, but also the submucosal layer, the muscle tissue and the organ's circulatory system. Gradually, the affected areas are replaced by rough scar tissue, the organ loses its elasticity and cannot cope with its functions properly.
In addition, the inflammatory process can spread to nearby organs, which can cause the development of paracystitis - damage to the peri-vesical 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, the aggravation of the chronic process is inevitable, it is influenced by changes in hormonal levels, fluctuating immunity, compression of internal organs by the growing uterus, which also provokes stagnation of urine and the inflammatory process. The most serious complication of cystitis in pregnant women is acute pyelonephritis, which is associated with severe poisoning and the risk of miscarriage.
Complicated forms of cystitis are treated in a hospital. In addition to taking medications, the following types of therapy may also be prescribed:
- instillation - the introduction of medical solutions into the bladder cavity that flush out toxins and have an anti-inflammatory effect;
- physiotherapy - treatment with electric current pulses, iontophoresis, UHF, mud treatment, acupuncture;
- positional therapy - special poses that help eliminate congestion and restore the 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, in case of complete loss of the organ's functions, they resort to plastic surgery of the bladder from its own intestinal tissue.
The duration of treatment of chronic cystitis is several months. The aim of the course is to eliminate the inflammatory process, prevent complications, maximize the recovery of the urinary system and prevent irreversible changes in the structure of organ tissues.
Basic measures for the prevention of cystitis: maintaining proper hygiene, wearing underwear made of natural materials, choosing shoes and clothing according to the weather and season, timely treatment of colds and chronic pathologies, taking general strengthening vitamin complexes.