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Cystitis (Inflammation of the urinary Bladder)

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The term CYSTITIS refers to inflammation of the urinary bladder. The recurrence of cystitis may in some cases, be associated with kidney trouble.

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Symptoms:
The patient complains of an almost continual urge to void and a burning sensation on passing urine. There may be feeling of pain in the pelvis and lower abdomen. The urine may become thick, dark and stringy. It may have an unpleasant smell and may contain blood or pus. Some pain in the lower back may also be felt in certain cases. In an acute stage, there may be rise in body temperature. In the chronic form of cystitis the symptoms are similar but generally less severe and longer lasting, and without a fever.

Root causes:
Cystitis may result from infection in other parts connected with or adjacent to the bladder such as the kidneys, the urethra the vagina, or the prostate gland. There may be local irritation and inflammation in the bladder if urine is retained there for an unduly long time. Cystitis may also results from acute constipation. Other conditions like an infected kidney, stones in the kidneys or bladder, or an enlarged prostate may also lead to this disorder.

Diagnosis
When cystitis is suspected, the doctor first examines a person’s abdomen and lower back, to evaluate unusual enlargements of the kidneys or swelling of the bladder. In small children, the doctor checks for fever, abdominal masses, and a swollen bladder.

The next step in diagnosis is collection of a urine sample. The procedure involves voiding into a cup, so small children may be catheterized to collect a sample. Laboratory testing of urine samples as of the early 2000s can be performed with dipsticks that indicate immune system responses to infection, as well as with microscopic analysis of samples. Normal human urine is sterile. The presence of bacteria or pus in the urine usually indicates infection. The presence of hematuria (blood in the urine) may indicate acute UTIs, kidney disease, kidney stones, inflammation of the prostate (in men), endometriosis (in women), or cancer of the urinary tract. In some cases, blood in the urine results from athletic training, particularly in runners.

Other tests
Women and children with recurrent UTIs can be given ultrasound exams of the kidneys and bladder together with a voiding cystourethrogram to test for structural abnormalities. (A cystourethrogram is an x-ray test in which an iodine dye is used to better view the urinary bladder and urethra.) In some cases, computed tomography scans (CT scans) can be used to evaluate people for possible cancers in the urinary tract.

Medications
Uncomplicated cystitis is treated with antibiotics. These include penicillin, ampicillin, and amoxicillin; sulfisoxazole or sulfamethoxazole; trimethoprim; nitrofurantoin; cephalosporins; or fluoroquinolones. (Fluoroquinolones generally are not used in children under 18 years of age.) A 2003 study showed that fluoroquinolone was preferred over amoxicillin, however, for uncomplicated cystitis in young women. Treatment for women is short-term; most women respond within three days. Men and children do not respond as well to short-term treatment and require seven to 10 days of oral antibiotics for uncomplicated UTIs.

Persons of either gender may be given phenazopyridine or flavoxate to relieve painful urination.

Trimethoprim and nitrofurantoin are preferred for treating recurrent UTIs in women.

Individuals with pyelonephritis can be treated with oral antibiotics or intramuscular doses of cephalosporins. Medications are given for ten to 14 days and sometimes longer. If the person requires hospitalization because of high fever and dehydration caused by vomiting, antibiotics can be given intravenously.

Surgery
A minority of women with complicated UTIs may require surgical treatment to prevent recurrent infections. Surgery also is used to treat reflux problems (movement of the urine backward) or other structural abnormalities in children and anatomical abnormalities in adult males.

Alternative treatment
Alternative treatment for cystitis may emphasize eliminating all sugar from the diet and drinking lots of water. Drinking unsweetened cranberry juice not only adds fluid but also is thought to help prevent cystitis by making it more difficult for bacteria to cling to the bladder wall. A variety of herbal therapies also are recommended. Generally, the recommended herbs are antimicrobials, such as garlic (Allium sativum), goldenseal (Hydrastis canadensis), and bearberry (Arctostaphylos uva-ursi); and/or demulcents that soothe and coat the urinary tract, including corn silk and marsh mallow (Althaea officinalis).Cucumber juice ,Radish Leaves ,Spinach ,Sandalwood Oil.

Diet: At the onset of acute Cystitis, it is essential to withhold all solid foods immediately. If there is fever, the patient should take only liquid food like fruit juices, soups, barley water, boiled vegetables etc. After the fever is over then patient should take non-spicy food for few days. Then gradually embark upon the all types of food.

Lifestyle : During the first three or four days of acute cystitis, when the patient is on a liquid diet, it is advisable to rest and keep warm. Pain can be relieved by immersing the pelvis in hot water. Alternatively, heat can applied to the abdomen, by using a towel wrung out in hot water and covering it with a dry towel to retain warmth. The treatment may be continued for three or four days by which time the inflammation should have subsided and the temperature returned to normal.

Regular pratice of Yoga , particularly Pranayama and Padma Asana will give a very good result.

Homeopathic medicine also can be effective in treating cystitis. Choosing the correct remedy based on the individual’s symptoms is always key to the success of this type of treatment. Acupuncture and Chinese traditional herbal medicine can also be helpful in treating acute and chronic cases of cystitis.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.

Source:www.healthline.com and www.allayurveda.com

You can exert control your bladder

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Incontinence should not be summarily dismissed as an inevitable consequence of ageing. Basic tests should be done to rule out any correctable cause Dr Gita Mathai

The urge to urinate is under voluntary control and can be suppressed until a suitable opportunity appears…...click & see
Coughing, sneezing and laughing are normal, unavoidable day-to-day activities which cause a transient increase in intra abdominal pressure. Young people are unaffected, but in 25 per cent of women and 15 per cent of men above 65 years of age, the actions involuntarily produce embarrassing dribbling of urine or stress incontinence.

The bladder can normally accommodate 500 ml of urine. The urge to void appears when it contains 200 ml. If there is an obstruction to free voiding due to an enlarged prostate, an uterine or ovarian tumour, or even constipation, the bladder becomes overfilled. The urine can then leak from the full bladder in small quantities leading to overflow incontinence.

The urge to urinate is under voluntary control; it can be suppressed until a suitable opportunity appears. Hyperactivity of the muscles in the bladder can allow urine to escape even if the bladder is not overfilled, as soon as the urge is felt, before reaching the toilet. This can occur with increasing age especially if the person also has diabetes, stroke, dementia or Parkinsonâ€™s disease. It may be secondary to stones in the bladder or an urinary tract infection.

Incontinence is commoner in women. Statistics show that 50 per cent of women have occasional urinary incontinence and 10 per cent have frequent incontinence. The incidence increases until 20 per cent of women over the age of 75 years experience daily urinary incontinence.

This is because anatomically, women have a shorter urethra and weaker pelvic muscles. Damage can also occur as a result of childbirth. The onset of menopause decreases the levels of the female hormones, causing atrophy of the vaginal mucosa and loss of pelvic muscle tone. This causes the bladder to protrude into the vaginal space increasing incontinence.

Incontinence should not be summarily dismissed as an inevitable consequence of ageing. Basic tests should be done to rule out any correctable cause .

A physical pelvic examination to rule out abnormalities of the pelvic organs.

Blood tests to rule out diabetes.

Urinalysis and culture if infection is suspected.

A few simple lifestyle interventions can help to reduce stress incontinence .

Reduction in weight, such that the BMI (body mass index) is around 25.

Control over volume of fluids drunk and reduction in the quantity if it is more than two-three litres per day.

Prevention of constipation as hard faecal matter acts as an obstruction that aggravates stress incontinence.

Regular voiding, so that the bladder is never too full.

Women can increase the strength and tone of the pelvic muscles and re-train their pelvic musculature with Keegle’s exercises.

To perform these exercises correctly, the right muscles first need to be located. To do this, stop and start urination without using the stomach, leg or buttock muscles.

Squeeze these muscles. Hold for a count of 10. Relax for a count of 10. Do this 20 times, three-four times a day.

Alternatively, each time you go to the toilet to pass urine, stop and restart the process voluntarily several times, so that you exert control over the action.

The bladder can also be re-trained by consciously increasing the time between voiding.

Within four weeks, 70 per cent of women markedly improve and 15 per cent are permanently cured. The benefit disappears within a few days if the exercises are not consciously continued.

Medications can be used as an adjuvant to exercises. Tricyclic antidepressants and other groups of medications can be used to treat stress incontinence in patients with mild-to-moderate symptoms. Fifty per cent of the people respond favourably.

Oestrogen replacement, either taken orally as part of HRT (hormone replacement therapy) or applied locally in the vagina as a cream, improves urinary frequency, urgency, stress incontinence and burning in postmenopausal women.

Surgical treatment can be considered after a thorough evaluation, examination and investigation to determine the exact cause of the urinary incontinence. Surgery can help by correcting the anatomical abnormalities, supporting the bladder and urethra in the proper position, and tightening the urethral sphincter. This helps to achieve voluntary control. Surgery has a 75-95 per cent cure rate if the patients are carefully selected. The procedure involves anaesthesia and hospital stay and is not totally risk free. The eventual outcome is unsatisfactory in people .

With prior surgical failures

If there are other genital or urinary problems

In case of other complicating diseases that may prevent adequate healing or make the technical aspects of the surgery more difficult.

As age advances, the bladder capacity reduces; the urinary stream becomes weaker, and visits to the toilet more frequent. This does not, however, mean that urinary frequency, urgency and stress incontinence have to be accepted as an inevitable part of ageing.

Most incontinence problems, provided they do not require corrective surgery, can be cured by motivation, weight loss, dedicated re-training of the bladder and pelvic exercises.

Source:The Telegraph (Kolkata,India)

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