Pain in the lower abdomen, aggravated by urination, frequent urge to urinate, blood in the urine and its unusual color - all these symptoms, of course, alarm any person. In most cases, behind these manifestations lies an unpleasant disease such as cystitis.
What is cystitis?
Cystitis is an inflammatory process in the mucous membrane of the bladder. It is often caused by 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 experience cystitis at least once in their lifetime. 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 more common in women. This is related to the physiological characteristics of the structure of the female body. The main ones are that the urethra is shorter and wider, and 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. In men, frequent urination is characteristic of the disease. In addition, acute cystitis in the stronger sex is accompanied by pain that spreads to the external genitalia, febrile hyperthermia and signs of general intoxication. At the same time, men suffer from chronic cystitis, which is not accompanied by severe symptoms, more often than women.
cystitis in childhood
The disease occurs with almost equal frequency in boys and girls, although it is more common in girls aged 4-12 years.
Common causes of cystitis in children include:
- anatomical pathologies and anomalies in the structure of the external genitalia, for example, narrowing of the foreskin in boys;
- pathology of the structure of internal organs of the genitourinary system;
- insufficient hygiene of the genitals, in babies - not changing diapers on time;
- beriberi and other conditions and diseases that cause a sharp decrease in immunity;
- hypothermia;
- drug treatment with the use of certain drug groups, especially sulfonamides;
- genetic predisposition.
Early diagnosis in young children is difficult due to lack of speech and difficulty controlling urination. Symptoms of cystitis include dark urine, sediment in it, and involuntary urination during the day.
Children under one year of age are treated in the hospital in case of illness. In childhood, the therapy scheme is established taking into account the sensitivity of the body to drugs, it is recommended to avoid antibiotic therapy if possible.
Symptoms of cystitis
In most cases, when cystitis occurs, the symptoms are as follows:
- frequent, strong urge to urinate with a small amount of 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 severity of the disease), general malaise, signs of intoxication of the body.
Symptoms of cystitis include a phenomenon such as a change in the color of urine. Then the liquid darkens, turbidity, the presence of sediment, pus clots can be visually detected. In the severe stage, hematuria, the presence of blood in the urine is noted.
Sometimes the pathological process goes to the kidneys. In this case, manifestations of kidney inflammation symptoms 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 with this form, periodic periods of exacerbation are 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 walls of the bladder, several forms of cystitis are classified. The most common are catarrhal, hemorrhagic and ulcerative forms.
Acute cystitis mostly occurs in the catarrhal form, in which the upper layers of the mucous membrane of the bladder are affected, which causes its swelling and hyperthermia. The first stage of this form is serous, and the second stage is characterized by an increase in inflammation of the mucous membrane and the presence of purulent inclusions in the urine, developing with a rapid infectious lesion or without treatment.
In hemorrhagic acute cystitis, the process of blood entering the urine is observed. This form occurs due to the spread of the inflammatory process to the location of the blood vessels.
Symptoms of ulcerative cystitis are ulcers of the bladder membranes, penetration of inflammation into the muscle tissues of the body and their necrosis.
Symptoms of acute cystitis
In acute cystitis, pain, burning, cramps during urination become obvious.
The general condition of the patient is unsatisfactory: signs of intoxication of the body are observed against the background of increased body temperature (headache, nausea, vomiting, muscle pain, weakness).
In the excreted urine, purulent inclusions are noticeable, the presence of blood with a hemorrhagic form is visually determined by a change in color: from pink to dark red-brown.
Chronic inflammation of the bladder
The common reason for the development of the chronic form is the incomplete treatment course of acute cystitis. If the patient stops taking medication as soon as severe symptoms pass, the body not only harbors the infectious agent, but develops resistance to the antibiotic used, and the bladder lining does not return to its original state.
Such negligence leads to the development of a chronic, difficult to treat form of cystitis. Exacerbation of chronic cystitis occurs against the background of minor provoking factors that lead to an increase in the symptoms of an unpleasant disease. To prevent such consequences and treat 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 with the diagnosis of acute cystitis.
The second most common reason for the development of an inflammatory process in the walls of the bladder is undiagnosed or untreated diseases of the urogenital region. Vulvovaginitis, urethritis, pyelonephritis, reproductive and urinary system infections, sexually transmitted diseases are a breeding ground for pathogenic microorganisms that involve the surrounding organs and tissues in the inflammatory process.
Pathologies of the structure of the genital organs due to immune disorders and deficiencies, urinary flow disorders or a decrease in the body's resistance can also lead to the development of a chronic form of cystitis.
In some cases, experts diagnose the interstitial form, which currently has an unexplained etiology.
Symptoms of chronic cystitis
The clinical picture of the disease in its chronic form can be characterized by the absence of any symptoms (more often in men) and is visible only during laboratory tests and instrumental examination of the patient.
There are frequent episodes of acute cystitis (2 times a year), rare (1 or less exacerbations per year) and a chronic form of the disease with a remission phase.
The interstitial form is characterized by the instability of changes in exacerbations and remissions, the unpredictability of the course, and the body's reaction.
The general symptoms of the chronic form are not expressed outside of periods of exacerbation, when the clinical picture corresponds to the acute stages of cystitis.
The reasons for the development of cystitis
Thus, we understood how cystitis manifests itself. But what is the cause of this disease? The most common cause of cystitis is infection. The causative agent of the disease 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, the cause is always an infection of the bladder membranes. 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 of the bacterial form:
- Klebsiella (Klebsiella);
- proteins (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 an inflammatory process of bacterial etiology occurs against the background of the presence of appropriate conditions for the reproduction of microorganisms, which the local immunity cannot cope with the number or growth rate of the bacterial colony. This occurs due to a decrease in protective forces (for example, with hypothermia of the body) or an increase in the number of infectious agents, the introduction of species that disrupt the local flora (often with sexual intercourse, changing partners, poor hygiene, catheterization). urethra etc. ). In such cases, the infection is considered ascending, penetrating the bladder through the urethra.
In patients with diabetes mellitus, there is a possibility of increased inflammatory processes in the membranes, 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 infectious processes in the kidneys, bacteria can enter the bladder through the ureters.
It is also possible for bacteria to penetrate into the bladder cavity 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 with the participation of septic processes in the body.
Viral form of the disease
The viral form is the result of a decrease in general immunity. Damage to the membranes of the bladder can occur against the background of a current disease of viral etiology or can be provoked by hidden viruses 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. Under the influence of viruses, there is also a change in the blood supply to the walls of the bladder. Often, with cystitis of viral etiology, a secondary bacterial form develops due to the weakening of local immunity.
mushroom shape
The most common causative agent of this form is Candida fungus. Often, the infection process rises, the fungus enters the bladder through the urethra, but a descending form can be observed: infection with oral candidiasis 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 during swimming in tropical reservoirs contaminated with this type 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 kind of infection. Non-infectious cystitis is usually less severe than infectious cystitis and has its own treatment characteristics. The most common types of non-infectious cystitis are drug, 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 walls of the bladder. These can be cytostatic drugs, some groups of antibiotics, sulfonamides.
allergic form
Allergic reactions can affect not only 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 enter it. As a result, eosinophilic infiltrates can form in the inner lining of the bladder, which is expressed by the appearance of symptoms of allergic cystitis.
Interstitial cystitis
The pathogenesis of this form has not been determined, autoimmune, neurogenic factors, neuropathies, inflammatory processes in other organs, metabolic disorders of nitric oxide, etc. There are speculations about the effect. In this form, the symptoms of cystitis are an inflammatory process in the membranes that complicates the diagnosis and treatment of the disease.
Other non-infectious forms
Other non-infectious forms include:
- radiation,
- chemical,
- traumatic,
- heat.
A form of radiation can usually develop as a result of radiation to the pelvis during cancer treatment. The chemical form is a burn 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 indicated as a postoperative form of cystitis. The thermal form appears due to prolonged exposure to high or low temperatures in the pelvic region.
Diagnostics
If you suspect a disease, you should contact a urologist. The diagnosis is made by collecting the 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 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 with cystitis is drug treatment. Within its framework, the patient is prescribed effective drugs, their type depends on the nature of the disease. With a bacterial pathogen, antibiotics are prescribed, with a fungal process - fungicides, with an allergic process - antihistamines. Also, in acute cystitis, antispasmodics, analgesics, non-steroidal anti-inflammatory drugs are prescribed. If necessary, additional therapy is carried out to improve the state of immunity. 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, acidic, smoked foods). Plenty of hot drinks are prescribed: fruit drinks, herbal teas, compotes.
For the treatment of chronic cystitis, it is recommended to involve physiotherapy methods: magnetophoresis, electrophoresis, induction- and hyperthermia, EHF-therapy, ultrasound treatment, laser therapy.
It is important not to limit the course of antibiotic therapy in acute cystitis to the moment when the symptoms of the disease disappear. Untreated acute cystitis turns into a chronic form with a high frequency, is often expressed by relapses and poses a threat to the general health of a person.