Bladder infection / bladder infection

A bladder infection is caused in most cases by bacteria that nest and multiply within the bladder. Theoretically, infections with viruses or unicellular parasites (protozoa such as Trichomonas vaginalis) are possible, but these are extremely rare in practice. The result of bladder infection is usually cystitis, which in turn can be associated with extremely unpleasant symptoms such as painful urination, abdominal and flank pain.

contents

• definition
• symptoms
• pathogen
• Causes and risk factors
• diagnosis
• Naturopathy in bladder infections
• prevention

definition

As a bladder infection, all pathological propagation of bacteria, viruses or unicellular organisms in the bladder area are called. They fall into the wide spectrum of possible urinary tract disorders and are here to differentiate against infections of the ureter, the urethra or the renal pelvis.

A urinalysis provides information about infections of the urinary tract and bladder. (Photo: www.fotolia.com © Jürgen Fälchle)

symptoms

An infection of the bladder is usually in the form of acute inflammatory phenomena of the mucous membranes inside the bladder. These are accompanied by a constant urge to urinate with low urine output, pain during urination and persistent unpleasant pain in the abdomen. Occasionally, there are also slight blood residues in the urine and those affected have an increased body temperature. Not infrequently, the infection from the bladder also passes to other sections of the urinary tract or even the kidneys. For example, sufferers develop a pyelonephritis or even nephritis. Possible consequences include kidney pain, fever, chills, nausea and vomiting. Severe inflammations of the urinary tract and kidneys occasionally lead to clearly visible changes in the urine delivered, for example in the form of hematuria (increased red blood cells in the urine) or proteinuria (increased protein in the urine).

pathogen

Triggering pathogens are usually bacteria, especially from the genus Escherichia coli. These so-called Kolibakterien reach from the genital or anal region in the urinary tract, rise up to the bladder and begin to multiply here. Infections with Escherichia coli are responsible for a large proportion of bladder infections (some sources speak of over 90 percent). Other bacteria that can cause bladder infections include staphylococci and enterococci. In rare cases, a bacterial bladder infection can also be caused by bacteria of the genus Proteus mirabilis, Chlamydia trachomatis or Klebsiella.

Theoretically, viruses can also cause an infection in the bladder when they enter the interior of the bladder. For example, human adenoviruses are known as potential causes of bladder infection and associated bladder infections. In practice, however, this is rarely the case since the body's protective mechanisms relatively effectively prevent the pathogens from entering the urinary bladder. The same applies to parasitic infections of the bladder with so-called protozoa (for example Trichomonas vaginalis). A parasitic form of urinary bladder infection, especially in the tropical and subtropical regions of the world, is the so-called schistosomiasis. It is caused by paired flukes (special sucking worms) whose larvae (cercariae) live in waters and can penetrate through the skin into the organism. Once in the organism, the larvae migrate to different parts of the body and develop into mature parchment. The leeches of the genus Schistosoma haematobium nest thereby in the bladder wall, while others invade the large intestine or small intestine. In the bladder wall, the couple's angels also lay their eggs, which then penetrate the tissue, thus reach the interior of the bladder and are excreted in the urine. The penetration of the bladder wall is accompanied by an inflammatory reaction of the mucous membranes or a bladder infection, which goes into a chronic stage in the absence of treatment.

Causes and risk factors

Normally, the body's defense mechanisms prevent bacteria and other pathogens from rising through the urethra. Here, on the one hand, the steady flow of urine towards the exit of the urethra plays a role, with which a large part of the pathogens is flushed out. On the other hand, the potential pathogens are controlled by the antibodies (immunoglobulin A) of the so-called urothelium - the multilayer covering tissue within the urinary tract. Possible factors that can promote an uprising of the pathogens into the urinary bladder are, for example, urinary drainage disorders or impaired bladder emptying. If the immune system is weakened overall, as often in patients with diabetes or in cancer patients after chemotherapy, this may also favor a bladder infection. Imbalances in the hormone balance, such as an estrogen deficiency or an androgen excess are also considered as favoring factors for infections of the bladder.

Hypothermia, such as may occur when wearing wet swimming trunks and bathing suits, are known as a risk factor for bladder infections. The wet swimwear provides good conditions for the penetration of bacteria through the urethra and the immune defense is additionally weakened by the cooling of the abdomen. Last but not least, sexual intercourse is a frequent risk factor for urinary bladder infections, as this facilitates the transfer of germs and thus promotes urethral uplift. If objects are introduced into the urinary tract in the course of medical interventions, such as in the case of a bladder mirror or a bladder catheter, there is also the risk that pathogens enter the bladder and subsequently multiply here.

In general, due to their anatomy (shorter urethra, closeness between the urethral opening, vagina and anus) women are much more frequently affected by a bladder infection than men. In women, the bacterial milieu in the vagina - the so-called vaginal flora - plays a special role in the defense against germs. If this is impaired, for example, by taking antibiotics or the "healthy" bacteria of the vaginal flora die off as a result, harmful bacteria can disproportionately multiply and thus cause a bladder infection.

diagnosis

If there is a suspicion of a bladder infection from the anamnesis, the next step is to analyze the urine in order to detect and identify possible pathogens. With the help of special test strips, decomposition products of bacteria and red and white blood cells in the urine can be detected. Also, the pathogens may be under the microscope recognizable. The creation of bacterial cultures based on the urine sample, serves the purpose of targeted pathogen determination. If protozoa are the cause of the bladder infection, they can be detected by microscopic examination of a smear of the vagina or urethra. Accompanying blood tests not only provide general information on the inflammatory process in the organism or possible impairments of kidney function, but in certain cases pathogens in the bloodstream can also be detected in severe infections. If there is a suspicion that the infection has spread to other organs, further investigations are necessary.

Since most of the bladder infections are bacterial, antibiotics are usually an essential part of therapy. However, in view of the growing prevalence of resistant pathogens, the selection of the appropriate antibiotics today is much more difficult than a few years ago. In case of doubt, a corresponding change to another product must be made here. Ultimately, however, a bacterial bladder infection by means of antibiotics can be successfully treated in most cases. Accompanying pain-relieving and antispasmodic remedies can be used.

Parasitic bladder infections are also treated by medication, with so-called anti-Trichomonas vaginalis Nitroimidazole be used and against the schistosomiasis special worm (anthelminthic) used. In the case of viral infections in the bladder area, therapy usually proves to be much more difficult and those affected are particularly dependent on their self-healing powers. Only a medical relief of the symptoms can be concomitant here. In general, those affected with bladder infections are advised to take plenty of fluids to flush out the pathogens. At least two liters of water or (bladder) tea are recommended here.

Naturopathy in bladder infections

Bladder doses based on antibacterial, diuretic and anti-inflammatory medicinal herbs are especially recommended for bladder infections in the field of natural remedies. A mild bladder infection can be treated with her help often without further medication. In particular bearberry leaves, birch leaves, bucco leaves, and orthosiphon leaves are used here. Not infrequently also goldenrod sheets are used against accompanying abdominal cramps. Extracts of the marshmallow root are also intended to counteract mucosal inflammation inside the bladder. A special extract of horseradish and nasturtium can be used as a herbal antibiotic against bacterial bladder infections. Also accompanying measures, which generally strengthen the immune system, are often part of the therapy. Lingonberry juice is also credited with a positive effect on bacterial bladder infections, as the juice hinders the colonization or spread of bacteria, has an anti-inflammatory effect on the mucous membranes and promotes the excretion of the bacteria. Cranberry juice also has a prophylactic effect against bladder infections, which is why daily intake is recommended for at-risk patients.

In the field of homeopathy, agents such as apis, cantharis, nux vomica and sarsaparilla are used against bladder infections or bladder infections. The selection should, however, be reserved for experienced therapists and if the preparations do not promptly lead to relief, it is necessary to resort to conventional medicines.

prevention

In general, adequate fluid intake is of particular concern to patients prone to bladder infections. In addition, women should pay particular attention to the usual hygiene recommendations and, after using the toilet, always wipe the toilet paper from the front to the back, in order to avoid entry of bacteria from the anal region in the direction of the vaginal opening. Disorders of the vaginal milieu, which favor a spread of bacteria, can be caused during showering or bathing, for example by intensive cleaning of the genital region with shower gel or soap. Here sensitive women are advised to use only warm water for cleaning.

Also, risk patients should generally be careful not to withhold their urge to urinate, but to go to the bathroom immediately. Because with the emptying of the bladder and the pathogens are eliminated. This is especially true after intercourse. Ideally, the bladder will be emptied within the first quarter of an hour after the sexual intercourse. The risk of bladder infection in the bathing season can be significantly reduced by changing the wet swimwear immediately after bathing and avoiding excessively long stays in the water. Last but not least, the daily change of underwear is advised to counteract the spread of bacteria and their penetration into the urinary tract. (Fp)

Picture: Rainer Sturm