Pain in the lower abdomen, aggravated by urination, frequent urge to urinate, blood in the urine and its unusual color - all these signs, of course, disturb every person. In most cases, such an unpleasant disease as cystitis is hidden behind these manifestations.
What is cystitis?
Cystitis is an inflammatory process in the lining of the bladder. It is most 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 have had cystitis at least once in their life. The fact that this disease often affects women, however, does not mean that men are immune to it. Also, the disease can develop in children, including infants.
cystitis in adults
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, and the fact that the opening of the urethra in women is closer to the anus, which makes it easier for intestinal bacteria from the stool to enter the urethra.
The clinical picture of cystitis in women and men also differs. With the disease in men, frequent urination is characteristic. In addition, acute cystitis in the stronger sex is accompanied by pain that extends to the external genitalia, febrile hyperthermia and signs of general intoxication. At the same time, men much more often than women 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 common in girls aged 4 to 12 years.
Among the common causes of cystitis in children are the following:
- anatomical pathologies and anomalies in the structure of external genital organs, for example, narrowing of the foreskin in boys;
- pathology of the structure of the internal organs of the genitourinary system;
- insufficient hygiene of the genital organs, in infants - untimely changing of diapers;
- beriberi and other conditions and diseases that cause a sudden drop in immunity;
- hypothermia;
- drug therapy with the use of certain groups of drugs, especially sulfonamides;
- genetic predisposition.
Primary diagnosis in young children is difficult due to the lack of speech and difficulty in controlling the frequency of urination. Among the signs of cystitis, you can notice the darkening of urine, the presence of sediment in it and involuntary urination during the day.
In case of illness in children under one year of age, treatment is carried out in a hospital. The scheme of therapy in childhood is built taking into account the sensitivity of the organism to drugs, it is recommended to avoid antibiotic therapy if possible.
Signs of cystitis
In most cases, when cystitis occurs, symptoms include the following:
- frequent, strong desire to urinate with a small amount of released liquid;
- burning in the urethra during urination;
- discomfort, pain in the pelvis, pubis, lower abdomen, genitals (in men);
- subfebrile or febrile hyperthermia (depending on how acute the disease is), general weakness, symptoms of body intoxication.
Signs of cystitis also include a change in urine color. The liquid darkens, turbidity, the presence of sediment, purulent clots can be visually detected in it. In the severe stage, hematuria, the presence of blood in the urine, is observed.
Sometimes the pathological process moves to the kidneys. In this case, the symptoms of kidney inflammation are characteristic: pain in the lower back, high temperature, 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, however, periodically with this form, periods of deterioration 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 bladder walls, 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 bladder mucosa are affected, which leads to its swelling and hyperthermia. The first stage of this form is serous, the second, which develops with a rapid infectious lesion or without treatment, is purulent, characterized by increased inflammation of the mucous membrane and the presence of purulent inclusions in the urine.
In hemorrhagic acute cystitis, the process of blood penetration into the urine is observed. This form is caused by the spread of the inflammatory process to the place of blood vessels.
Signs of ulcerative cystitis are ulceration of the bladder membranes, penetration of the inflammation into the muscle tissue of the organs and their 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 of the body are observed against the background of an increase in body temperature (headache, nausea, vomiting, muscle pain, weakness).
Purulent inclusions are noticeable in the excreted urine, with a hemorrhagic form, the presence of blood is visually determined by a change in color: from pink to dark brown.
Chronic inflammation of the urinary bladder
A frequent 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 antibiotic used, and the bladder mucosa does not return to its original state.
Such negligence leads to the development of a chronic, difficult-to-treat form of cystitis. Exacerbations of chronic cystitis occur against the background of minor provoking factors, which leads to an increase in the symptoms of the unpleasant disease. In order to avoid such consequences and cure cystitis, with the diagnosis of acute cystitis, it is necessary to continue antibiotic therapy until clinical signs of recovery are detected, regardless of the absence of unpleasant symptoms.
The second most common cause of the development of an inflammatory process in the walls of the urinary bladder is the presence of undiagnosed or untreated diseases of the urogenital area. Vulvovaginitis, urethritis, pyelonephritis, infections of organs of the reproductive and urinary systems, sexually transmitted diseases are fertile ground for pathogenic microorganisms that involve the surrounding organs and tissues in an inflammatory process.
Immune disorders and deficiencies, pathologies of the structure of the genital organs, due to violations of the outflow of urine or a decrease in the resistance of the body, can also cause 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
In the chronic form, the clinical picture of the disease can be characterized by the absence of any symptoms (more often in men) and appears 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 rare (1 or less exacerbations per year) and remission stage.
The interstitial form is characterized by the instability of alternating exacerbations and remissions, the unpredictability of the course, the body's reaction.
General symptoms of the chronic form are not expressed outside the period of exacerbations, in which the clinical picture corresponds to the acute stage of cystitis.
Reasons for the development of cystitis
So, we understood how cystitis manifests itself. But what causes this disease? The most common cause of cystitis is an infection. The causative agents 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, then the causes 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 of the urinary bladder are E. coli (Escherichia coli, E. coli), staphylococcus (Staphylococcus) and streptococcus group (Streptococcus).
Among other pathogens of bacterial form, there are:
- Klebsiella (Klebsiella);
- proteus (Proteus);
- Koch's bacillus, mycobacterium tuberculosis (Mycobacterium tuberculosis);
- pale treponema (Treponema pallidum);
- gonococcus (Neisseria gonorrhoeae);
- Trichomonas vaginalis (Trichomonas vaginalis);
- 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, in which local immunity cannot cope with the number or speed of bacterial colony growth. This happens with a decrease in protective forces (for example, with hypothermia of the body) or an increased number of infectious agents, the introduction of varieties that disrupt the local flora (frequent sexual intercourse, changing partners, poor hygiene, catheterization of the urinary canal, etc. ). In such cases, the infection is considered ascending, penetrating the bladder through the urethra.
The probability of inflammatory processes in the membranes of patients with diabetes is increased, because the increased 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 descend into the bladder through the ureters.
Penetration of bacteria into the bladder cavity is also possible from the focus of inflammation in the lymph nodes. The hematogenous route of infection is recorded when the pathogen enters the bladder cavity through the blood, which occurs in the presence of septic processes in the body.
Viral form of the disease
The viral form is a consequence of a decrease in general immunity. Bladder membrane damage can occur against the background of a current disease of viral etiology or be caused by latent viruses that were in the body in an inactive phase.
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 is also a change in the blood supply of the bladder walls under the influence of the virus. Often, with cystitis of viral etiology, a secondary bacterial form develops due to the weakening of local immunity.
fungal form
The most common cause of 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 a contaminated catheter is used.
parasitic form
The parasitic form is rare, because its 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 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 no less severe than infectious and has its own treatment characteristics. The most common non-infectious cystitis are caused by drugs, allergic and interstitial.
Pharmaceutical form
The drug 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 cytostatics, 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 is caused by the body's reaction to allergens that have entered it. As a result, eosinophilic infiltrates can form on the inner lining of the urinary bladder, which is expressed by the appearance of symptoms of allergic cystitis.
Interstitial cystitis
The pathogenesis of this form has not been determined, there are assumptions about the influence of autoimmune, neurogenic factors, neuropathy, inflammatory processes in other organs, metabolic disorders of nitric oxide, 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:
- radiation,
- chemical,
- traumatic,
- thermal.
A form of radiation can develop as a result of radiation to the pelvic area, usually in cancer therapy. The chemical form is a bladder burn 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 referred to as a postoperative form of cystitis. The thermal form is caused by prolonged exposure to high or low temperatures in the pelvic area.
Diagnostics
If you suspect the disease, consult 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 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 the main method of treatment for cystitis is drug therapy. Within this, the patient is prescribed effective drugs, the type of which 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, antispasmodics, analgesics, and nonsteroidal anti-inflammatory drugs are prescribed for acute cystitis. 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 treatment of cystitis is a diet that restricts foods that irritate the lining of the bladder (hot, salty, sour, smoked foods). Abundant warm drinks are prescribed: fruit drinks, herbal teas, compotes.
For the treatment of chronic cystitis, the use of physiotherapy methods is recommended: magnetophoresis, electrophoresis, induction and hyperthermia, EHF therapy, ultrasound treatment, laser therapy.
In acute cystitis, it is important not to limit the course of antibiotic therapy to the moment when the signs of the disease disappear. Untreated acute cystitis very often turns into a chronic form, characterized by frequent relapses and endangering the general health of a person.