Inflammation of the bladder
introduction
Inflammation of the bladder (Cystitis) falls into the somewhat more general area of the uncomplicated Urinary tract infections. One always speaks of such an uncomplicated infection when the kidney is not concerned with. Often, when the bladder is inflamed, there is also an irritation in the area of the urethra in front.
causes
Inflammation of the bladder is usually the cause bacterial pathogens. Main pathogen are there E. coli (the part of the natural Intestinal flora is), as well as Proteus, Klebsiella, Streptococci and Enterococci. This bacteria, reach from smear infections, in the urinary tract and can lead to infections there. Hence are straight Hygienic aspects, such as. the Wipe direction after defecation, important in the development of urinary tract infections. Also a total Insufficient fluid intake can promote inflammation of the bladder, as higher amounts of urine can effectively flush the urinary tract and reduce bacterial colonization. A excessive hygienee.g. with intimate sprays or vaginal douching can also be done with a Destruction of the normal vaginal flora, contribute to inflammation of the bladder. The can have a similar negative effect Adjustment of the hormonal balance, in the Menopause, entail.
diagnosis
Diagnostics The inflammation of the bladder differs depending on the patient group affected. Generally groundbreaking are those in the anamnese recorded symptoms that represent the clinical picture relatively precisely. Especially in young, otherwise healthy women, in whom there is no evidence of kidney involvement or other complications, these symptoms are sufficient for the diagnosis.
A urine test is Not imperative required. When it first occurs, it should also be here a microbiological examination of urine. The usual ones Urine stix, which are also available for home use, increase the accuracy of the diagnosis not essential. For women in the pregnancy However, a urine test should always take place.
If the bladder is inflamed in men, can only be classified as uncomplicated cystitis after excluding possible complications. That means there should be one here too Examination of the urethra and a rectal exam to identify more complicated causes. There is also one here Examination of the urine important. So-called cultures of urine are also created on which pathogens then grow during incubation, whereby the exact pathogen can be determined. It is important that the urine sample from the Midstream urine and after prior cleaning of the limb or the labia in women, as otherwise physiologically existing pathogens from the external genital area can falsify the sample. With the appropriate experience of the doctor, the urine can also be under the microscope be assessed to rule out a urinary tract infection. In the case of a urinary tract infection, in addition to bacteria, the urine can Red or White blood cells Find. Also the Levels of inflammation in the blood, so CRP and Leukocytes can be increased.
With frequent inflammation of the bladder or complicated courses should the kidneys and urinary tract means Ultrasonic to be examined. A Cystoscopy, that is, the endoscopic examination of the bladder from within, is usually with a urinary tract infection not necessary.
Frequencies
Generally are Women very much more often affected by inflammation of the bladder as men. One of the reasons for this is that the urethra, which is the connection between the bladder and the outside, in women much shorter is. This risk continues to increase with sexually active women, especially when using a Diaphragms or from Spermicides as Contraceptive method. Urinary tract infections often occur in close temporal connection with Sexual intercourse on, especially the so-called "Honeymoon Cystitis", on the honeymoon.
Also in the pregnancy If the incidence of inflammation of the bladder is increased, it is important to ensure that the inflammation does not affect the area of the bladder Kidneys overlaps. In old age the frequency of urinary tract infections also increases as it increases Changes in the bacterial flora in the genital areathat can increase colonization with other pathogens.
In men if a urinary tract infection occurs, it is usually followed by a complicated course Kidney involvement and should be clarified particularly thoroughly. Other risk factors for bladder inflammation include Diabetes mellitus or congenital malformations of the urinary tract.
Symptoms
There are a number of symptoms that indicate inflammation of the bladder. This includes Discomfort when urinating, such as. Pain, Burn, particularly strong need to urinate or frequent urination with then only small amounts. If the burning sensation occurs the whole time while urinating, it is usually more of a (co-) inflammation of the urethra. Also Burning sensation after urination may indicate inflammation of the bladder.
Often can an unusual odor in the urine be perceived. Blood and Cloudiness of the urine are possible. A new one Incontinence Can be indicative of inflammation of the bladder.
Other symptoms include Flank pain, fever, Tension pain in the bladder area, and general feeling of illness.
With children The inflammation of the bladder can also develop with rather unspecific symptoms, such as stomach pain, nausea and Vomit demonstrate.
therapy
Although the bladder is generally not expected to have serious complications, it should be Antibiotics be treated. In principle, one is also pure symptomatic therapy possible, but the regression of the infection can be greatly accelerated by antibiotics. A short-term outpatient therapy with an orally taken antibiotic is sufficient. Typical antibiotics used to treat inflammation of the bladder are so-called Quinolones (e.g. ciprofloxazine), Cephalosporins or Co-trimoxazole. Which antibiotic the doctor prescribes for you depends very much on individual historical points. These include e.g. existing allergies or Intolerances, but also regional peculiarities in the pathogen spectrum. In any case, as with any antibiotic treatment, the antibiotic must be taken by the end of the prescribed time. Even if the symptoms go away sooner. During pregnancy become Penicillins or Cephalosporins used to prevent damage to the mother and child from the inflammation.
The use of means such as Paracetamol or Ibuprofen. Many patients also report the helpful effect of Heat pads. If necessary, a Bladder muscle relaxing drug added to the Urination to facilitate.
As an independent supplement to the therapy, care should be taken if possible much liquid to take in. Best of all in the form of water or Herbal teas. A particular effectiveness of the "kidney and bladder teas" has not yet been proven. As a rule, a minimum of 2-3 liters is appropriate for patients with Heart failure, the amount to drink should be discussed with the doctor. Through the increased urinary tract flushing, the number of bacteria can be reduced or washed out. It is important to ensure that the bladder is emptied as completely as possible. There are also indications that Cranberry juice positively influences the course of urinary tract infections.
prophylaxis
Targeted prophylaxis is not possible. Usually certain people, e.g. Due to certain anatomical conditions, there is an increased risk of repeatedly developing inflammation of the bladder. With enough drinking, the urinary tract is better flushed, which can prevent infections from rising into the bladder. In addition, you should wear sufficiently warm clothing, e.g. Also sufficiently long coats should be taken into account. Observing hygiene is also extremely important. Women should make sure that after using the toilet, cleaning always takes place from the direction of the vagina towards the anus. Otherwise, faecal germs, which are part of the natural flora in the intestine, can get into the vagina and thus into the urethra, where they cause inflammation of the bladder. Even after sexual intercourse, women should make sure to urinate promptly to rinse out any germs. The use of washing lotions, intimate sprays or the like in the genital area should be avoided, as these can destroy the normal bacterial flora and thus contribute to increased infections. There is also a vaccination against cystitis, which can reduce the frequency of urinary tract infections.
forecast
Inflammation of the bladder is, by and large, one harmless infection. It is mostly treated mainly because of the painful and uncomfortable symptoms to eliminate faster. With timely treatment there is an expansion the kidney mostly to be avoided with the resulting damage. This risk is only increased if the urinary tract infection, e.g. due to simultaneously occurring Menstrual cramps or other diseases are not immediately perceived and treated. Even if the bladder inflammation more than 3 times a year occurs is the risk for a later complicated urinary tract infection elevated. In addition, there is a certain predisposition to inflammation of the bladder, which means that some people repeatedly develop urinary tract infections.
