Thursday, April 19, 2012

Cystitis


Introduction
Urinary tract infections are common in bacterial infection, after respiratory infections. They can be found in people of both sexes and all age groups. Women of childbearing potential 10 times more likely than men. The largest number of urinary tract infection occurs in otherwise healthy women.

What is it?
Cystitis is the most common bacterial infections of the urinary bladder. Cystitis starts suddenly, and include dysuria (painful urination), frequent urination of small amounts of urine (polakisuriju), urinary urgency (urgent need to urinate) and sometimes pain above the pubic bone.

Description of the disease (causes, incidence, physiology)
Cystitis occurs when the normally sterile lower urinary tract (urethra tube or urethra and bladder) become infected with bacteria, which resulted in inflammation. Over 90% of cases of cystitis caused by Escherichia coli.Bacteria that get into the bladder is usually removed during urination. However, if the bacteria remain in the bladder, easily and rapidly multiply resulting in infection. Cystitis is a common disease, 2 100 people will get sick.Most common in sexually active women aged 20 to 50 years, but it can occur in sexually inactive or girl. Women are prone to develop cystitis because of their shorter urethra (the bacteria do not have far to travel to the bladder) and the relatively short distance between the openings of the urethra and anus. Cystitis is rare in men with anatomically normal urinary tract. In the elderly the risk of cystitis is large, with an incidence of up to 33 per 100 persons.

Who gets (risk factors)?
Risk factors for cystitis have bladder or urethral obstruction with consequent arrest of urine, insertion of instruments into the urinary tract (such as catheterization or cystoscopy), pregnancy and diabetes. In women, sexual intercourse usually precedes uncomplicated cystitis. In the elderly population is at increased risk of developing cystitis due to incomplete emptying of the bladder associated with conditions such as benign prostatic hyperplasia (BPH), prostatitis and urethral stenosis. Also, increased risk of developing cystitis exists in people who do not consume enough fluids, not to control stool and urine (incontinence) among less mobile, fixed or placed in a nursing home.

Symptoms:
Onset is usually sudden. Cystitis usually causes the following symptoms:
frequent urination (polakisurija)
baking and feeling pressure when urinating,
painful urination (dysuria),
urgent need to urinate (urgency),
the need to urinate at night (nikturija)
discolored urine (urine blurred)
Sometimes blood in the urine (haematuria),
unpleasant or strong odor of urine,
pressure in pelvic pain and low back pain.

Other symptoms that may be associated with this disease:
painful sexual intercourse,
Pain in the penis,
pain in the loins,
fatigue,
fever,
shivering,
vomiting,
mental changes or confusion.
In the elderly mental changes or confusion often are the only signs of possible infection of the urinary tract.

What results can a doctor do?
The doctor will ask the findings of urine. The sample is taken after the patient has not urinated for three hours, preferably the first morning urine. Commonly used methods of pure MSU. After washing the genitals should be the middle stream of urine. Less commonly, the sample is taken urinary catheter or puncture above the pubic bone.
The analysis of urine is usually reveal white blood cells (WBC) or red blood cells (erythrocytes).
Sometimes it is necessary to make a urine culture to determine the types of bacteria in the urine and prescribed the proper antibiotic treatment.

Treatment:
Mild cases of acute cystitis may disappear spontaneously without treatment. However, because of the danger of infection spreading to the kidneys (complicated urinary tract infection), usually the recommended treatment.Also, due to high mortality in the elderly population, it is recommended to start treatment quickly.

In the treatment of bacterial cystitis using the following antibiotics:
trimethoprim-sulfamethoxazole (or co-trimoxazole, Bactrim, Esbesul))
nitrofurantoin
amoxicillin (alone or in combination with clavulanic acid)
cephalosporins
fluoroquinolones (Citeral, Siprobel, Noracin)

Keep the following recommendations:
First Take your medicine as instructed by your doctor.

Second Keep taking it until you spend in full, even if you feel good after a few days.

Third Drink plenty of fluids such as water, apple juice, cranberry juice, or soft drinks without caffeine.

4th Drink at least 8 large glasses (2 ounces) of fluid a day.

5th Urinate when you feel the need, or at least every 4 hours.

6th Try to completely empty the bladder during urination.

7th If you have severe back pain, high fever, vomiting, or still have problems after 10 days, contact your doctor again.

8th Do not drink alcohol (beer, wine, hard liquor) while taking the drug for bladder infection.

9th Go to control when you're at the doctor ordered.

Chronic cystitis or cystitis, which is a pattern to be treated thoroughly because of the possibility of kidney infection (pyelonephritis). You may need to apply antibiotics for a long time (up to 6 months to 2 years). Drugs that zakiseljuju urine, such as ascorbic acid (vitamin C) can reduce the concentration of bacteria in the urine.

Control
Control may include a urine culture to confirm that bacteria are no longer present in the bladder.

Forecast
Cystitis is uncomfortable, but usually responds well to treatment.

Complications
Chronic or frequent urinary tract infections
complicated urinary tract infections
pyelonephritis
When to seek medical
Contact your doctor if symptoms are present that indicate cystitis if symptoms worsen or new symptoms appear, especially fever, back pain or flank, or vomiting.

Prevention:
Preventive measures can reduce symptoms and prevent the infection returning. Keeping the genital area clean and clear from front to back may reduce the potential transfer of Escherichia coli from the rectal area to the urethra. Urinating immediately after sexual intercourse may help eliminate bacteria that may have entered during intercourse. Refraining from urinating for a long time may allow bacteria to multiply, so frequent urination may reduce the risk of cystitis in patients who are prone to urinary tract infections. Related disorders include:
pyelonephritis
Acute urethral syndrome (can be caused by Chlamydia trachomatis)

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