The danger of cystitis lies not only in the pain of the symptoms - the lack of proper treatment is full of complications, especially in women; the inappropriate choice and use of drugs can lead to life-threatening consequences.
Causes and pathogenesis
A predisposing factor for the development of cystitis in women is the peculiarities of the anatomical structure of their urinary system - a short, wide urethra, which allows access to the unhindered penetration of microbes. Anal and vaginal openings that are close to the urethra increase the risk of infection.
Another physiological feature that affects the frequent development of pathology in women is the larger volume of the bladder than in men, which allows them to endure the urge to go to the toilet for a long time. The periodic stagnation of urine causes the persistence and multiplication of the infection in the cavity of the organ.
The development of the inflammatory process is facilitated by wearing tight or synthetic underwear, creating the effect of a thermos, as well as lack of personal personal hygiene and lack of indiscriminate sexual intercourse.
Germs enter the bladder via the ascending (via the urethra) or descending (via the ureters from the kidneys). Infection with lymphatic flow from the pelvic organs is possible. More rare, but possible, 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 the glycocalyx, a protective substance produced under the influence of female sex hormones. The cavity of a healthy organ is non-sterile - individual cells of pathogenic microflora may be present in it, but the active growth of microbes is prevented by the immune forces of the body. In addition, the infection is eliminated by periodic flow of urine.
The impetus for the development of acute cystitis can be:
- reduced immunity as a result of hypothermia, ARVI, nervous overstrain, stress, physical fatigue.
- allergies to certain medications.
- pyelonephritis, urolithiasis, accompanied by reduced urine output.
- Diabetes;
- late stages of pregnancy;
- menopause, a state of female sex hormone imbalance.
Cystitis can occur in acute and chronic forms. The latter is a result of improper treatment, persistent renal dysfunction and systemic diseases associated with hormonal imbalance.
Development of acute cystitis
The illness always starts suddenly, 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:
- annoying pain in the lower abdomen above the pubis, radiating to the lumbosacral region.
- nocturia - the desire to urinate every 10-15 minutes.
- dysuria - a constant feeling of fullness of the bladder.
- The production of urine is scanty, difficult, drop by drop, accompanied by sharp cutting pain, burning, itching.
- the color is cloudy, flaky, 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 question of performance in such a situation. The best thing to do is to consult a doctor immediately.
Treatment that begins in the first hours of the disease increases the chances of getting rid of cystitis in a short time forever.
Diagnostics
For the treatment of cystitis, you will need to consult a urologist, gynecologist or infectious disease specialist.
A number of tests will need to be done:
- general urinalysis;
- 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 submucosa and muscle layers of the bladder, polyps, cysts.
Cystitis is indicated by a high level of leukocytes - leukocytosis over 2000/ml.
Based on the content of red blood cells and cylindrical formations in the urine, it is possible to identify related problems and factors that cause the development of cystitis: traumatic kidney damage, urolithiasis, acute and chronic glomerulonephritis, kidney diseases, purulent abscesses, toxic lesions of the urinary system, presenceviruses.
In addition, a gynecological examination is required - vaginal smear analysis for the presence of sexually transmitted infections and pathogenic microflora.
Such a detailed history will help to reliably determine the causative agent of inflammation and the degree of damage to organ tissue.
Treatment with antibiotics
For the treatment of uncomplicated acute infectious cystitis, 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 drugs can only suppress symptoms and contribute to the development of a subdued inflammatory process. The developed resistance of microbes will complicate further treatment, limiting the range of effective drugs.
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 risk of developing dysbacteriosis and immunodeficiency states.
In addition to antibiotics, during the treatment of cystitis in women, antispasmodics, analgesics and herbal medicines in tablets and other dosage forms are prescribed to relieve symptoms.
Herbal medicines and nutritional 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 time - from 2 weeks to 1 month during the treatment of acute and chronic cystitis. The selection of funds is quite large:
- 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 the urine.
- Capsules containing 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. It is available in the form of solutions and sugar gels, containing centaury, lovage herb, rosemary.
- natural complex based on oils 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, produced in tablet form, contains extracts of hops, mint, oregano and oil.
- a medicine intended to treat urolithiasis and prevent bladder infections. Contains kidney tea, curly silkworm leaves, papaya, pepper. Available in capsules and tablets. In addition to its strong diuretic effect, the product stops the inflammatory process in the urinary system, improves its permeability, removes sand and dissolves small kidney stones and acts as a spasmolytic and analgesic.
Anticonvulsants
To relieve pain, relax the smooth muscles of the bladder and facilitate the passage of urine, myotropic antispasmodics are prescribed. Medicines relieve severe symptoms, reduce pain and discomfort caused by the contraction of muscle fibers.
A single dose should not exceed 2-3 tablets. Overdose may cause dizziness, drowsiness and decreased blood pressure. Do not forget that an anticonvulsant only provides temporary relief, but does not cure the disease.
Analgesics
Severe pain, accompanied by fever, fever and weakness, is the reason for prescribing drugs 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 to taking products containing propionic acid derivatives include severe renal and hepatic insufficiency, pregnancy and early childhood under 6 years of age.
Probiotics
To prevent dysbacteriosis and disorders of the gastrointestinal tract when taking antibiotics, drugs containing natural complexes of lactobacilli and bifidobacteria - probiotics are used. The products have been proven to protect and restore the microflora of the female genital organs, strengthen local immunity and reduce the unwanted 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, dry and moist heat therapy is effective. Warm steam baths and sitting baths with a decoction of St. John's wort or fairy are useful: for a steam bath, a warm herbal decoction is poured into a basin. You have to squat over the emitted steam and sit for 10-15 minutes. The steam should be hot, but not scalding. For sitting 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 - in place of the bladder.
Thermal procedures stimulate the exchange between tissues and have a relaxing, analgesic and antispasmodic effect.
Heating is allowed only in the absence of inflammatory processes in the genitals, otherwise such treatment can 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 support 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 the abdominal wall until you feel a slight pain inside, after a few seconds, release your hands and press the stomach again. Do 5 or 6 reps.
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 cystitis treatment, 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 from cranberries, black and red currants, cherries, sea buckthorn and other berries. Acidic drinks have an antimicrobial effect, prevent infection from remaining on the walls of the organ and accelerate the removal of inflammatory products from the bladder cavity.
Decoctions and decoctions of seeds and herbs of dill, chamomile, parsley, berry and millet leaves have a high diuretic and anti-inflammatory effect. For their preparation, 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, tendency to hypertension or hypotension.
During the treatment of cystitis, it is necessary to exclude from the diet hot spices, pickled and salty foods, sugary, carbonated sweet drinks, strong coffee and alcohol. These products interfere with the excretory function of the kidneys, promote the accumulation of uric acid and irritate the urinary system.
Chronic cystitis
The untimely onset 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 subdued inflammatory process, during which the disease is practically not 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, the 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 cope with its functions properly.
In addition, the inflammatory process can spread to nearby organs, causing the development of paracystitis - damage to the pericystic tissue, pyelonephritis. The gradual spread of the infection can cause the development of adexitis, adhesions of the fallopian tubes and subsequent infertility.
In pregnant women, an exacerbation of the chronic process is inevitable, it is affected by changes in hormonal levels, fluctuations in immunity, compression of internal organs by the growing uterus, which causes additional stagnation of urine and inflammatory process. The most serious complication of cystitis in pregnant women is acute pyelonephritis with severe poisoning of the body and the threat of miscarriage.
Treatment of complicated forms of cystitis is carried out in a hospital. In addition to taking medication, the following types of treatment may be prescribed:
- instillation - the introduction into the bladder cavity of medicinal solutions that flush out toxins and have an anti-inflammatory effect.
- physiotherapy - treatment with electric current pulses, iontophoresis, UHF, mud applications, acupuncture.
- position therapy - special positions that help eliminate congestion and restore the patency of the urinary system. The method is suitable for pregnant women.
- surgical treatments - laser cauterization or excision of the affected bladder tissue. In severe cases of complete loss of the functions of the organ, 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 recovery of the urinary system and preventing irreversible changes in the structure of the tissues of the organs.
Basic measures for the prevention of cystitis: maintaining good hygiene, using underwear made of natural fabrics, choosing shoes and clothes according to the weather and season, early treatment of colds and chronic pathologies, receiving general reinforcement of vitamin complexes.