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, alarm any person. In most cases, behind these manifestations lies such an unpleasant disease as cystitis.
What is cystitis?
Cystitis is an inflammatory process in the lining of the bladder. It most often occurs due to a bacterial infection. Despite a 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 lifetime. The fact that this disease often affects women, however, does not mean that men are immune from it. Also, the disease can develop in children, including infants.
cystitis in adults
The disease is much more common in females. 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 urethral inlet.
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 also extends to the external genitalia, febrile hyperthermia and signs of general intoxication. At the same time, men are much more likely than women to 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 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 hygiene of the genital organs, in infants - untimely replacement of diapers;
- beriberi and other conditions and diseases that provoke a sharp decrease in immunity;
- hypothermia;
- drug therapy with the use of certain groups of drugs, in particular, sulfonamides;
- genetic predisposition.
Primary diagnosis in young children is difficult due to the lack of speech and the difficulty of controlling the frequency of urination. Among the signs of cystitis, one can note 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 old, treatment is carried out in a hospital. The scheme of therapy in childhood is built taking into account the sensitivity of the body 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 urge to urinate with a small amount of fluid released;
- burning in the urethra during the excretion of urine;
- discomfort, pain in the pelvis, pubis, lower abdomen, genitals (in men);
- subfebrile or febrile hyperthermia (depending on how acute the disease is), general malaise, symptoms of intoxication of the body.
Signs of cystitis also include a phenomenon such as a change in the color of urine. The liquid darkens, turbidity, the presence of sediment, and clots of pus can be visually detected in it. In the severe stage, hematuria is noted, the presence of blood in the urine.
Sometimes the pathological process passes to the kidneys. In this case, manifestations of symptoms of inflammation of the kidneys are characteristic: pain in the lower back, high fever, nausea, vomiting.
Classification of cystitis
Depending on the severity of symptoms, the disease is divided into chronic and acute cystitis. The chronic form of cystitis may be asymptomatic, however, periodically with this form, 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 is more common in the catarrhal form, in which the upper layers of the mucous membrane of the bladder 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 no treatment, is purulent, characterized by increased inflammation of the mucosa 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 occurs due to the spread of the inflammatory process to the location of the blood vessels.
Signs of ulcerative cystitis are ulceration of the membranes of the bladder, the penetration of inflammation into the muscle tissues of the organ and their necrosis.
Symptoms of acute cystitis
In acute cystitis, soreness, burning, cramps 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 (headaches, nausea, vomiting, muscle aches, weakness).
In the excreted urine, purulent inclusions are noticeable, with a hemorrhagic form, the presence of blood is visually determined by a change in color: from a pink hue to burgundy-brown.
Chronic inflammation of the bladder
A common reason for the development of the chronic form is the incompleteness of the course of treatment of acute cystitis. If the patient stops taking the drugs as soon as severe symptoms pass, the body not only retains the infectious agent, it develops resistance to the antibiotic used, and the bladder lining does not recover 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 an unpleasant 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 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 bladder is the presence of undiagnosed or untreated diseases of the urogenital area. Vulvovaginitis, urethritis, pyelonephritis, infections of the organs of the reproductive and urinary system, sexually transmitted diseases are a breeding ground for pathogenic microorganisms, involving the surrounding organs and tissues in the inflammatory process.
Immune disorders and deficiencies, pathologies 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 provoke the development of a chronic form of cystitis.
In some cases, specialists diagnose the interstitial form, which currently has an unexplained etiology.
Symptoms of chronic cystitis
In the chronic form, the clinical picture of the 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 rare (1 or less exacerbations per year) and a stage of remission.
The interstitial form is marked by the instability of the alternation of exacerbation and remissions, the unpredictability of the course, the reaction of the body.
The general symptoms of the chronic form are not expressed outside periods of exacerbations, in which the clinical picture corresponds to the acute stages of cystitis.
Reasons for the development of cystitis
So, we figured out how cystitis manifests itself. But what causes this disease? The most common cause of cystitis is 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 membranes of the bladder. This circumstance 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 the streptococcal group (Streptococcus).
Among other pathogens of the bacterial form, there are:
- Klebsiella (Klebsiella);
- proteas (Proteus);
- bacillus Koch, tuberculosis mycobacterium (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, in which local immunity cannot cope with the number or growth rate of a bacterial colony. This occurs 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 violate the local flora (with frequent sexual intercourse, changing partners, poor hygiene, catheterization of the urinary canal, etc. ). In such cases, the infection is considered ascending, penetrating into the bladder through the urethra.
An increased likelihood of inflammatory processes in the membranes exists in patients with diabetes mellitus, since an 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.
The penetration of bacteria into the cavity of the bladder is also possible from the foci of inflammation in the lymph nodes. The hematogenous route of infection is noted when the pathogen enters the cavity of the bladder through the blood, which happens 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. Damage to the membranes of the bladder can occur against the background of a current disease of viral etiology or be provoked by latent viruses that were 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 is also a change in the blood supply to the walls of the bladder under the influence of viruses. Often, with cystitis of viral etiology, a secondary bacterial form develops due to a weakening of local immunity.
fungal form
The most common causative agent of this form is the Candida fungus. 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, since 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 usually proceed no less severely than infectious ones and have their own characteristics of treatment. The most common of non-infectious cystitis are drug-induced, allergic and interstitial.
Pharmaceutical form
The drug 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 the external mucous membranes and skin, but also many internal organs, such as the bladder. The allergic form develops due to the reaction of the body to the allergens that have entered it. As a result, eosinophilic infiltrates may 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 autoimmune, neurogenic factors, neuropathies, 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.
The radiation form can develop as a result of irradiation of 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 specified as a postoperative form of cystitis. The thermal form appears due to prolonged exposure to high or low temperatures on the pelvic region.
Diagnostics
If you suspect a disease, you should contact a urologist. The diagnosis is made by collecting 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 with cystitis the main method of treatment is drug therapy. Within its framework, 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, 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 decoctions of herbs 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). A plentiful warm drink is 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 to the moment the signs of the disease disappear. Untreated acute cystitis with a high frequency turn into a chronic form, expressed by frequent relapses and threatening the general health of a person.