Cystitis is inflammation of the urinary bladder caused by bacteria, including Escherichia Coli (for 70%), fecal Streptococcus (1-3%), Staphylococcus epidermidis (9%), and more rarely by enterobacteria (bacteria that make up the flora intestinal) such as Proteus, Pseudomonas, Klebsiella and Enterobacter.
Three types of cystitis can usually be identified:
– symptomatic: difficulty urinating (dysuria), increased frequency of urination (pollakiuria), burning urination, sensation of urgent and painful urge to urinate;
– asymptomatic, evidenced only by the presence of bacteria in the urine;
– with non-specific symptoms and difficult to attribute to this problem (fever, malaise, exhaustion).
The infection can occur sporadically or, especially when neglected, become chronic. In this case, the infectious process can also involve the genital or upper urinary tract, a phenomenon that causes acute or chronic inflammation of the kidney or renal pelvis (pyelonephritis).
This pathology mainly affects the female gender, as it has an urethra of only 5 cm, as opposed to the 16 cm of the male; in this way in women the bacteria present in the stool have a greater ease of going up to the bladder.
Cystitis has an incidence that varies with age, less frequent under the age of 20 while it increases considerably with the progress of time; in fact, in women, due to the decrease in estrogen, the risk increases during menopause.
In addition to the personal data, there are other risk factors including poor intimate hygiene, unprotected intercourse, constipation, use of: diaphragm, spiral, spermicidal liquid, tampons, tight-fitting and synthetic clothing; and also: diabetes, stress, irritating chemicals.
For the male gender, however, cystitis can be caused mainly by obstructive phenomena due to an enlarged prostate, which causes the so-called bacterial prostatitis.
Once the symptoms have been identified, it is useful for the patient to carry out the urinary microbiological test with the count of bacterial cultures and the relative antibiogram in order to prescribe targeted therapy.
Cystitis can also be hemorrhagic, as the small capillaries of the submucosa can be involved and injured. Unlike the simple form of cystitis, in the hemorrhagic form there is the appearance of blood in the urine (hematuria). This type of infections affects 15 to 80 years and represents the 10% of total urinary infections. The onset of this form can also be caused by exposure to radiation and the use of some cytotoxic drugs (for example anticancer drugs).
There drug treatment for bacterial cystitis consists of taking antibiotics including:
- Fluoroquinolines (eg: ciprofloxacin, Ciproxin®), are a family of drugs able to clean up the fecal reservoir of gram-negative bacteria responsible for most cystitis and their relapses; are a very well tolerated group of drugs. They are currently the first choice in urinary tract infections and in the prevention of recurrence. The dosage of ciprofloxacin ranges from 250 mg, to 500 mg up to a maximum of 1 g in the most complicated cases.
- 3g Phosphomycin (Monuril®), is a natural, broad-spectrum, acidic antibiotic obtained today by chemical synthesis. Over the years, fosfomycin has maintained its spectrum of activity and the percentage of resistant bacterial strains has remained stable.
- Trimetroprim-sulfamethoxazole (Batrim®) and nitrofurantoin (Neofuradantin® 50 mg, Neofuradantin® 100 mg): they have similar efficacy to the previous class but have some resistance problems, lower tolerance, lower urinary concentrations.
- Penicillin or second or third generation injectable cephalosporins: in relapsing cystitis and with a high microbial load.
In addition to the use of antibiotics, which must be taken on medical prescription, for this disorder, you can resort to some herbal medicines that can help in a natural way by disinfecting the urinary tract.
It is widely used substances such as D-Mannose, Cranberry, Bearberry and Grapefruit Seeds.
The D-Mannose it is a simple sugar that occurs naturally in the form of polymers. It can be easily detected in some fruits such as apples, pears and oranges.
It represents a kind of natural antibiotic, with no contraindications. Its antibacterial function is carried out thanks to its ability to bind to the anchoring organs of Escherichia coli, that is small filamentous appendages that are found on the surface of the bacterium, essential for adhering to the cavities of the urinary tract, known as pili. Mannose interposes itself between pili and bladder wall, limiting the adhesion capacity of the bacterium itself.
Mannose is excreted through the urine, taking pathogenic bacteria with it.
Unfortunately, not all the varieties of Escherichia coli are endowed with more sensitive to Mannose; therefore, this natural substance is only effective against some of these pathogens.
Another function of mannose is to block the formation of biofilms by bacteria, making them more sensitive to the action of antibiotics and to the reaction of the immune system. Being also a glucosaminoglycan, Mannose is a component of the bladder wall: it itself forms a layer of the mucosa, especially if damaged by previous infections.
D-Mannose can be taken orally as a preventive measure, as it improves the immune defenses of the vaginal environment, thus reducing the phenomena of cystitis due to frictional micro-lesions during sexual intercourse.
The Cranberry (Vaccinium vitis idaea) can be taken daily as the best defense to combat this symptomatology. This small evergreen shrub belongs to the ERICACEE family and is considered in medicine the "Prince of the intestine". Its properties allow to regulate colon disorders: abdominal pain, cramps, bloating, constipation and diarrhea.
No less important are the clinical studies that highlight blueberry as a disinfectant for the urinary and intestinal tract. It is therefore advisable to take it just after the summer period as the body, by changing its biorhythm and the hours of sunlight, makes a modification in the production of some neurotransmitters (melatonin and serotonin) which affect both the circadian rhythm and the tone of the mood. Alterations in these neurotransmitters can cause insomnia, irritability, rheumatic pain, digestive problems and intestinal disorders. It is as if the body were to readjust itself on this new phase of climate change, which by habit determines a greater need for the consumption of complex carbohydrates (pasta and bread) that cause swelling and alteration of intestinal and, consequently, urinary functionality .
Another substance capable of defeating cystitis and urinary infections is theBearberry.
To learn more, Uva Ursina, also called Bear Grape (Arctostaphylos uva-ursi), of the ERICACEE family, is an evergreen fruit that produces a red berry with a flavor similar to cranberry. It grows in northern and central Italy, mainly in the Alps and the Apennines. Fresh or dried caulinary leaves represent the drug: they mainly contain quinones (at least 6%), including arbutin (5-15%), methylarbutin and piceoside, along with hydrolyzable tannins (6-40%), iridoids (monotropein), terpenoids ( uveol, ursolic acid).
It is used as a diuretic or urinary disinfectant, as well as an astringent, as it is able to create unfavorable conditions for the life of microorganisms by acting as an anti-inflammatory for the mucous membranes. To act it needs alkaline urine (around pH 8), in fact to activate this active principle it is preferable to take it together with a teaspoon of sodium bicarbonate or citrosodine. In this way, hydroquinone (the molecule with curative activity) is generated from Arbutin, so it is better to avoid acidic foods in the diet (such as tomatoes, orange, grapefruit and lemon juices).
The grapefruit (Citrus paradisi), of the RUTACEE family, is the fruit of a plant native to Asia, of which the seeds that have beneficial properties for health are mainly used. The mechanism of action of the latter is to inhibit the structure and efficiency of the microbial cell membrane, leading to the loss of cytoplasmic elements. The bacteria thus undergo cellular degradation (apoptosis) due to lack of amino acid supply. Still in the context of alternative medicine it is believed that grapefruit seeds can also have a disinfectant activity for the urinary tract, in fact they are generally used in association with other dry extracts already described (cranberry, bearberry), to enhance their action .
The effects of grapefruit seeds can be attributed to the flavonoids contained in them, for example, hesperidin, neoesperidin, quercetin, canferol, apigenin.
Another substance widely used in cases of cystitis is the extract of Birch, which as for the aforementioned grapefruit seeds, has an antiseptic action on the urinary tract, diuretic, lymphatic draining and anti-inflammatory. This is thanks to its content of triterpene saponins (up to 3-4%), flavonic glucosides (hyperoside, quercetin, rutin) and polysaccharides (methylpentosans), which together have a draining effect of excess liquids and nitrogenous waste.
To conclude, in case of cystitis a good level of hydration is recommended to increase the functioning of the colon; a regular intestine, in fact, hardly favors the proliferation of fecal bacteria. Therefore, it is indicated in these cases the introduction of fiber into the diet or, better, the intake of any supplements rich in fiber and lactic ferments, which have a laxative action but unlike classic drugs do not prevent the absorption of vitamins. fat-soluble.
One last tip for the woman is to have an accurate perianal hygiene, using an intimate soap based on Tea Tree Oil, a substance with antifungal and antibacterial action, in order to externally disinfect the genito-urinary mucous membranes. During washing it is advisable to always move from the vagina to the anus and never the other way around as it would risk carrying fecal material inside and therefore triggering a urinary infection.