The danger of cystitis lies not only in the painfulness of the symptoms - the lack of proper 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 in the development of cystitis in women is the peculiarities of the anatomical structure of their urinary tract - a short, wide urethra, which allows access to the unhindered penetration of microbes. The 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 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 proliferation of 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 a lack of personal intimate hygiene and lack of indiscriminateness in sexual intercourse.
Microbes enter the bladder through the ascending (through the urethra) or descending (through the ureters from the kidneys) route. Infection with lymph flow from the pelvic organs is possible. More rare, but likely, is the hematogenous route of infection from distant foci of inflammation - the nasopharynx, carious 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 mucous membrane of the bladder is protected from infections by glycocalyx, a protective substance that is produced under the influence of female sex hormones. The cavity of a healthy organ is nonsterile - single cells of pathogenic microflora may be present in it, but the active development of microbes is blocked by the body's immune forces. In addition, the infection is eliminated by periodic flow of urine.
The impetus for the development of acute cystitis can be:
- decreased immunity as a result of hypothermia, ARVI, nervous overstrain, stress, physical fatigue;
- allergies to certain medications;
- pyelonephritis, urolithiasis, accompanied by impaired urine outflow;
- diabetes;
- late 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 abruptly, most often at night or the next morning after getting wet feet, 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 urge to urinate every 10-15 minutes;
- dysuria - a constant feeling of fullness of the bladder;
- urine output is scanty, difficult, drop by drop, accompanied by acute 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, resulting in the development of urethritis, in which pain and itching intensify.
There can be no talk of performance in such a situation. The best thing to do is consult a doctor immediately.
Treatment started in the first hours of illness increases the chances of getting rid of cystitis in a short time forever.
Diagnostics
To treat cystitis, you will need to consult a urologist, gynecologist, or infectious disease specialist.
A number of tests will need to be done:
- general urine analysis;
- 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 deep submucosal and muscular layers of the bladder, polyps, cysts.
Cystitis is indicated by a high level of leukocytes - leukocyturia more 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, the presence of viruses.
Additionally, 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 damage to organ tissue.
Treatment with antibiotics
For the treatment of acute infectious cystitis that is not burdened with complications, a course of antibiotics is prescribed for a period of 2 to 7 days. Tetracycline drugs based on clavulanic acid, from the group of penicillins and fluoroquinolones, are used.
The choice of medication is made by the doctor based on the results of pathogen sensitivity tests. Spontaneous use of medications can only suppress the symptoms and contribute to the development of a sluggish inflammatory process. The developed resistance of microbes will complicate further treatment, narrowing the range of effective medications.
You cannot 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, when treating cystitis in women, antispasmodics, analgesics and herbal medicines in tablets and other dosage forms are prescribed to relieve symptoms.
Herbal medicines and dietary supplements
Complexes based on plant raw materials are non-toxic, have anti-inflammatory, diuretic, choleretic, antimicrobial effects, enhance the work of antibiotics without disturbing the balance of microflora. They can be taken for a long period - 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 that contain 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 herb, rosemary;
- natural complex based on oils of orange, pine, sage and other plants. Available in the form of a thick green paste. Before ingestion, a small amount of the product should be dissolved in warm water;
- the product, produced in tablet form, 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, cubeb pepper. Available in capsules and tablets. In addition to its pronounced diuretic effect, the product stops the inflammatory process in the urinary tract, improves its permeability, removes sand and dissolves small kidney stones, and works 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 contraction of muscle fibers.
A single dose should not exceed 2-3 tablets. An overdose can cause dizziness, drowsiness, and decreased blood pressure. Do not forget that an antispasmodic provides only temporary relief, but does not cure the disease.
Analgesics
Severe pain, accompanied by fever, fever, and weakness, is the reason for prescribing medications 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 medications. Contraindications for taking products containing propionic acid derivatives include severe renal and liver failure, pregnancy, and early childhood under 6 years of age.
Probiotics
To prevent dysbacteriosis and disorders of the gastrointestinal tract while taking antibiotics, drugs containing natural complexes of lactobacilli and bifidobacteria - probiotics - are used. The products have proven themselves as protecting and restoring 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 the components of the drugs or an allergic reaction.
For uncomplicated acute cystitis, treatment with dry and moist heat 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 basin. You need to squat down over the emanating steam and sit for 10–15 minutes. The steam should be warm, but not scalding. For sitz baths, a decoction of medicinal herbs is added to water at a temperature of about 45 °C.
At rest, you can apply a warm heating pad to the lower abdomen - to the location of the bladder.
Thermal procedures stimulate intertissue exchange and have a relaxing, analgesic, and antispasmodic effect.
Warming is allowed only in the absence of inflammatory processes in the genital organs, otherwise such treatment may cause additional harm.
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 bolster or pillow under your back).
- Place the fingertips of both hands on the stomach 2-3 fingers below the navel.
- Exhaling, gently and deeply press on the abdominal wall until you feel a slight pain inside, after a few seconds, release your hands and press on the stomach again. Do 5 or 6 repetitions.
The movements are aimed at eliminating diuresis delays, congestion and accelerating blood circulation in the bladder area. If the massage is done correctly, after its completion there will be a strong urge to visit the toilet.
During the treatment of cystitis, you need 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 cranberries, black and red currants, cherries, sea buckthorn and other berries. Acidic drinks have an antimicrobial effect, prevent infection from lingering 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, lingonberry 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, simmered for 15 minutes in a water bath and left 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 cases of insufficient renal function, a tendency to hypertension or hypotension.
During the treatment of cystitis, it is necessary to exclude hot seasonings, pickled and salty foods, confectionery, carbonated sweet drinks, strong coffee, and alcohol from the diet. These products interfere with the excretory function of the kidneys, promote the accumulation of uric acid, and irritate the urinary tract.
Chronic cystitis
Untimely initiation or incorrect and careless 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 sluggish inflammatory process, during which the disease practically does not make itself felt, alternate with a sharp exacerbation of symptoms.
The danger of chronic cystitis lies not only in the severe discomfort and pain that occurs during exacerbations. A focus of inflammation that exists 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 process of inflammation involves not only the mucous membrane, 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 properly cope with its functions.
In addition, the inflammatory process can spread to nearby organs, causing the development of paracystitis - damage to the peri-vesical tissue, pyelonephritis. The gradual spread of 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, this is influenced by changes in hormonal levels, fluctuations in immunity, compression of internal organs by the growing uterus, which additionally provokes 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 the threat of miscarriage.
Treatment of complicated forms of cystitis is carried out in a hospital. In addition to taking medications, the following types of therapy may be prescribed:
- instillation - the introduction into the cavity of the bladder of medicinal solutions that flush out toxins and have an anti-inflammatory effect;
- physiotherapy - treatment with electric 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 affected bladder tissue. In severe cases 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 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 according to the weather and season, timely treatment of colds and chronic pathologies, taking general strengthening vitamin complexes.