Symptoms and treatment of cystitis in girls

Raising a daughter and never encountering cystitis is an almost impossible task. This unpleasant disease in childhood is widespread, and it is girls who most often suffer from it. We will tell you about how to recognize cystitis and treat it in this article.

About the disease

Cystitis medical encyclopedias call inflammation of the bladder. In practice, this concept is more extensive, and speaking of cystitis, doctors mean not only inflammatory processes in the bladder, but also a urinary infection, which leads to irritation of the mucous membranes of this organ, dysfunction and significant changes in urinary sediment.

Cystitis in children occurs ten times more often than in adults.

This is due to the peculiarities of children's immunity, and physiological differences in the structure of the genitourinary system. Girls are more susceptible to developing inflammation than boys - for one boy with cystitis, there are about 5-6 girls with a similar diagnosis. This is due to the length and width of the urethra - in boys it is narrow and long, in girls it is wide and short.

It is much easier for pathogens that have entered the canal to survive and reach their goal - the bladder - in a wide and short canal, through which they manage to pass much faster. In the boy, significantly fewer microbes will reach the bladder, most will die on the way. For a girl, most of them will be able to get where they want. However, this is not the only way bacteria and fungi can enter a child's urinary system. Sometimes the infection descends from the kidneyswho are sick sometimes pathogens "arrive" with bloodif there is a focus of severe inflammation in the girl's body, and sometimes microbes enter the bladder through the lymph flow from the pelvic organs.

This is not to say that every girl, to whom germs have entered the urinary tract, will develop cystitis. Pathogenic organisms can exist for a long time without causing manifestations of the disease. Their reproduction and pathological activity can be provoked by the following factors:

weakness of the child's immunity (for example, after an illness);
deficiency of essential vitamins and minerals;
metabolic disease;
hypothermia of the body (with vasoconstriction, the kidneys cannot fully filter urine);
violation of blood supply (caused by tight and uncomfortable underwear, crushing clothing);
violation of hygiene rules and requirements, insufficient hygiene, in which bacteria from the anus can enter the urinary tract;
excessive hygiene, especially with the use of aggressive detergents on the genitals. Such funds disrupt the level of natural acidity, chemical irritation and inflammation develop.

Cystitis can be an independent disease, or it can only act as a secondary complication of another disease.

Causes of occurrence

The most common cause of cystitis in children is intestinal bacteria. They enter the urinary tract with improper or insufficient hygiene. If a child is rarely changed underwear, rarely washed or washed incorrectly, then the probability of infection is very high. In a newborn girl, an older toddler and a teenage girl, microbial inflammation is very often the result of improper washing technique. The hygiene procedure should not be carried out in a basin or bath. For washing girls, only running water is used, and the movements of the hand during ablution should be directed strictly from the pubis to the anus, and not vice versa.

The second most common reason is hypothermia. Many parents believe that walking barefoot is very dangerous. This is not true. If the baby stomps barefoot, the vessels on the feet quickly narrow and there is no heat loss. The child receives hypothermia at the moment when he is sitting on a cold one, since the vessels of the priests are not able to narrow, and, therefore, the body begins to rapidly lose heat. With a general loss of heat, the vessels of the kidneys are narrowed, and normal urine filtration is impaired.

There are other reasons why girls develop cystitis:

hormonal "disruptions" (cystitis is often accompanied by periods of the onset and height of puberty, as well as diseases of the endocrine system);
disorders of urodynamics (if the child "suffers" for a long time, if the emptying of the bladder is not complete);
allergic reaction (both local - to detergent, powder used to wash panties and underwear, and general - to food or medicines).

In girls of any age (from infants to adolescents), cystitis can be triggered existing chronic ailments, from this point of view, diabetes mellitus and dysfunction of the pancreas are especially dangerous. The bladder very often reacts with inflammation to the intake of drugs that suppress the activity of the immune system (such drugs can be prescribed for autoimmune diseases).

Separately, it should be said about the neurological and psychological reasons for the development of cystitis.

Girls are impressionable, vulnerable, who can hardly endure stress, are afraid of new things, are constrained in communication, can react to certain life situations with cystitis. In this case, doctors do not find by laboratory methods any real cause that could cause inflammation.

Kinds

Cystitis can be acute or chronic:

Acute form. Quite a short period of illness with vivid and painful symptoms. It is possible to talk about cystitis in an acute form only within a few days after the onset of inflammation. Very quickly, the disease becomes chronic, and therefore help must be quick and correct.
Chronic form. The most common type of bladder inflammation with subtle, worn out symptoms. In the latent stage, such an ailment is characterized by rare and not too painful exacerbations. In the persistent stage, the symptoms are brighter, but the functions of the bladder are not impaired. In the interstitial stage, the pain is almost constant, the functions of the bladder are impaired.

By the type of causative agent of the disease, several types of cystitis are distinguished:

Hemorrhagic cystitis. This disease is caused by viruses. Acute hemorrhagic cystitis usually occurs against the background of adenovirus infection or as a complication after it. This is one of the most painful sensations of the genitourinary system; when urinating, a child may experience bloody discharge in the urine.
Follicular cystitis. This type of disease is caused by bacteria. This name was given to the disease for characteristic nodules - follicles, which are formed during inflammation on the mucous membrane of the bladder. Follicular cystitis is usually not acute; it develops against a background of chronic inflammation. The girl may have kidney pain, a tendency to thrush, but improper hygiene is considered the main cause of such cystitis.

Such an ailment can be very dangerous for a child if he is not provided with timely medical care.

Bullous cystitis. This type of disease always has an acute course. It develops in the form of swelling of the bladder. The mucous membrane of the organ increases in size, the circulation of serum fluid becomes difficult. Most often, this cystitis develops against the background of hypothermia. But other factors - bacteria, viruses, hormonal disorders of the girl - can also contribute to the pathological process.

Granular (granular) cystitis. This diagnosis is made by about a quarter of all girls with urinary problems. This type of ailment is associated with the development of a small granular rash over the entire surface of the mucous membrane of the bladder. In this process, chlamydia, mycoplasma and ureaplasma are most often "guilty".
Allergic cystitis. There are many factors that can cause the disease in this form. They are quite individual and depend on the child's personal perception of certain aggressive substances - antigens. Allergic cystitis most often occurs in children as a result of food allergies or inadequate drug reactions. In pediatric practice, cases are described when cystitis of an allergic origin was caused by parasites that live in the intestines, or, more precisely, by the reaction of children's immunity to toxic waste products of helminthic invasions.
Cervical cystitis. In this form, various pathogens and agents cause inflammation of the sphincter, which is responsible for urinary retention. There are episodes of incontinence and this is sometimes the only symptom of this kind of disease. Urine leakage can be accompanied by pain, especially in the acute period of the disease.
Neurogenic bladder. The people call this disease easier - cystitis from the nerves.

In this case, neither bacteria, nor viruses, nor chlamydia are found in the analyzes, and signs of cystitis are evident.

It is believed that the nervous system plays a role in the disease, and pathology develops due to a failure at one stage or another of impulse transmission. The process of urination is quite complicated when viewed from the point of view of nerve impulses and signals. The cause is most often considered to be congenital and acquired neuroses and neuralgias, as well as other neurological problems. Very often, this cystitis is accompanied by incontinence and urinary leakage.

Age features

In infants, cystitis is easily explained by the structural features of the urinary tract. If the disease began at such an early age, then with a high degree of probability it is associated with congenital defects or abnormalities in the structure of organs responsible for the formation, accumulation and excretion of urine from the body. If the baby was born completely healthy, then the likelihood of developing inflammation of the bladder is affected by the fact how high quality diapers she wears and how often they are changed - improper care, low-quality materials that come into contact with the baby's delicate skin in the genital area, allergic reactions affect the process of bacteria reproduction.

At 2-3 years old, cystitis in a girl is most often caused by hypothermia - children of this age love to play squatting or on the pope. It is also possible that bacterial contamination due to incorrect washing is carried out. At 4 years old and 5 years old, children are already adapted to kindergarten, they go to the potty or the toilet, but usually they do not know how to wipe their bottom carefully or do not attach due importance to it. Therefore, inflammation of the bladder at this age is most often bacterial in nature.

Younger schoolchildren 6-8 years old are very susceptible to stressful situations, because the beginning of school for them is a serious nervous and mental test. Therefore, at this age there are not only viral and bacterial forms of the disease, but also neurological... Most teenage girls are more concerned with how they look than the risks of developing the disease.

In an attempt to be fashionable and stylish, they wear tight pants, panties, skirts, which disrupts the blood supply to the pelvic organs and also often causes problems with the bladder.

Also, this age is characterized by hormonal changes in the body, during which cystitis is not the most pleasant, but not the only "side effect".

Symptoms

Different types of cystitis have differences in clinical manifestations, but these differences are more diagnostic in nature, they are visible only to specialists. For ordinary people, all types of the disease manifest themselves in almost the same way. The difference can only be in the strength of the severity of the clinical picture - with some forms the signs are stronger, with others - weaker. Acute cystitis is usually accompanied by severe painful sensations, chronic cystitis in a state of remission has no symptoms, and in the stage of exacerbation the symptoms are more "smoothed".

Symptoms characteristic of the disease look like this:

Increased urge to urinate. The girl begins to walk very often due to small need, sometimes in an acute form, the desire to pee can arise every 5-7 minutes. At the same time, often even after going to the toilet, the feeling of a full bladder remains.
Pain when urinating. Pain syndrome manifests itself as acute pain at the time of urination with a slight painful spasm in the lower abdomen at the end of this process. Sometimes the pain "shoots out" after emptying the bladder into the rectum, it is quite painful and painful for the child.

Changes in urine characteristics... Visually, at home, you can see only part of the pathological changes. For example, urine, which should normally be clear, becomes cloudy with cystitis. The amount of liquid is small. Suspension and sediment are visible even without a microscope. Sometimes there may be blood, pus, or blood clots in the urine. The rest of the changes become apparent in laboratory analysis.
Lower abdominal pain... In the intervals between urination, the pain may be pulling, unsharp. They increase significantly with the urge to empty the bladder and immediately after that.

Elevated temperature. The temperature generally rises only with acute cystitis. Its values are at subfebrile values (37.0-37.8 degrees). This is unusual for chronic cystitis.
Deterioration of the general condition... A girl with an acute illness or exacerbation of a chronic form becomes lethargic, gets tired faster, the skin may be paler than usual, since with frequent urination, the body rapidly loses calcium, phosphorus and iron. Anemia is a frequent companion of cystitis.

In an infant, cystitis manifests itself with all the same symptoms, only the baby cannot talk about them, and therefore he will refuse to eat, often (as he urinates) shrill screaming.

Sleep and general condition of the child are disturbed. The body temperature often rises. The skin looks pale, a slight cyanosis may appear in the area of the nasolabial triangle.

Danger

Cystitis is popularly considered to be an easy and simple disease that can be treated with almost a decoction of chamomile. Any fertility doctor can tell a lot about the sad consequences of untreated or untreated cystitis for women's health. Quite often, complicated cystitis leads to dysfunction of both the bladder and kidneys. In girls, it is still dangerous because the infection can persist in a “dormant” state, and subsequently cause female infertility, chronic miscarriage.

If you do not treat the disease with all responsibility and seriousness, then the case may end with total changes in the tissues of the bladder, which may lead to the need to remove it and form its analog from other tissues of the body. This is a complex operation. After her, it will be rather difficult to call the girl's life full - perhaps chronic urinary incontinence, infertility, life with a lot of lifelong restrictions - on certain types of food and drinks, on physical activity.

Diagnostics

If symptoms of cystitis are found, you should visit your pediatrician as soon as possible. The pediatrician, evaluating the clinical picture, will write out a referral for consultation with a nephrologist or urologist.

This narrow specialist should be sent with the test results. A urine test is required to confirm the diagnosis.

The urine is collected in the morning after the girl has been washed. Cover the vaginal opening with a cotton swab to prevent vaginal secretions from entering the urine sample. Dishes for liquids should be clean and sterile, it is best to use special containers purchased from a pharmacy to collect urine.

It is important to deliver the jar to the clinic within 2-3 hours. After that, certain changes occur in the urine, urinary sediment falls out and this can give false information to a laboratory assistant who will conduct a macroscopic and microscopic examination of the sample. In the urine, they will look not only for signs of inflammation, but also samples of the causative agent of the infection. If bacteria are found, they will conduct an additional study of individuals for sensitivity to different types of antibiotics.

For the diagnosis of acute cystitis, these tests are quite enough. Treatment begins. With chronic cystitis or ineffective treatment of the acute form of the disease, diagnostic studies continue only after the acute attack of the disease has been passed. In a state of remission, the girl is assigned a cystoscopy procedure.

Cystoscopy is a technique in which an endoscope is inserted into the urethra... The doctor gets the opportunity to see the bladder, assess its condition, size, presence of neoplasms, adhesions, edema. This is usually enough to clarify the type of cystitis.

In some cases, the little girl will be shown a visit to the pediatric gynecologist.

All adolescent girls with cystitis will be referred to the same specialist, but without fail. The female doctor will assess the state of the reproductive system, identify the source of the infection, if it is hidden there, and prescribe concomitant treatment in order to keep the girl's reproductive functions in perfect order.

If the child is registered on the occasion of the detection of chronic cystitis, several times a year the girl will need to undergo tests and take the following tests:

general urine analysis;
urine analysis according to Nechiporenko;
bacterial urine culture;
smears on the composition of the vaginal microflora;
Ultrasound of the genitourinary system;
cystoscopy.

Medical errors in making this diagnosis are extremely rare, since the disease has not only characteristic clinical manifestations, but also well-defined laboratory parameters - specific numbers and parameters of the presence of components in the urine.

First aid

All the actions described above to identify the disease will take a certain time - from a day to several days. But the pains with cystitis are quite tangible and the girl will find it difficult to endure them. Therefore, at the time of the examination, you can provide the child with first aid, which will alleviate his condition:

The child can be given an antispasmodic drug, for example "No-shpu" in an age dosage. This will help relieve the aching pains in the lower abdomen a little and reduce the intensity of the cramps during urination.

Immediately after detecting signs of inflammation of the bladder, it should be provided to the daughter plentiful drinking regime. All drinks should be warm, tea, juice, coffee should be avoided. The volume of liquid that needs to be given to drink should be sufficient - for a teenager at least 2 liters, for a baby girl - at least 700-800 grams.
The child must be at rest, in case of severe pain, he should be transferred to bed rest, visits to kindergarten and school should automatically be canceled.

There is a common misconception that warmth on the abdomen and perineum will relieve the condition. According to subjective feelings, perhaps this is so. But don't forget that heat exposure only enhances the inflammatory process, and therefore a heating pad on the tummy is a prohibited use for cystitis. The same goes for a hot bath.
If symptoms of cystitis appear, you should immediately exclude salty foods from the child's diet. Ideally, it is better to give food without salt at all, in extreme cases - not salting enough.

Naturally, these measures do not replace or cancel the primary treatment. As part of first aid, you should not give your child antibiotics and other medications, since it is not known which pathogen caused the inflammatory process in the bladder.

Treatment

Acute cystitis involves bed rest. The girl should not move a lot and actively, walk. It is very important to drink a lot throughout the treatment. The fluid is needed so that pathogenic bacteria and other organisms that caused inflammation leave the bladder with frequent urination.

A special diet is a prerequisite for a speedy and complete recovery.

The food given to the baby should not contain a large amount of salt and spices. Spicy, smoked, fried foods are completely excluded from the diet. To stimulate urination, the child can brew kidney tea or make a decoction of bearberry. For severe pain, warm sitz baths are allowed, but the water temperature should not be too hot. At the same time, you can give the girl drugs that can relieve muscle tension - antispasmodics, for example, "Papaverine" or "No-shpu".

The basis of treatment is drugs that can actively resist pathogens. Since in the course of diagnostics, the exact type of microbe and its ability to resist various antibiotics are established, the doctor has all the data in order to prescribe exactly the remedy against which the bacteria will have nothing to oppose. With fungal inflammation of the urinary bladder, the basis of treatment will be antifungal drugs, and with viral inflammation, antiviral and anti-inflammatory drugs. Allergic cystitis is necessarily treated with antihistamines, and sometimes there is a need for hormonal therapy.

Primary treatment - should always address the main cause of cystitis, and therefore the child may also need the help of a neurologist and a psychotherapist if the doctor diagnoses his neurogenic bladder. And in case of circulatory disorders of the pelvic organs, the doctor may advise vascular drugs as the main therapy. For all types of cystitis, diuretics are included in the treatment regimen - diuretic drugs. And together with them, in order to avoid the loss of important trace elements that are excreted by the kidneys - preparations of calcium, phosphorus, iron.

Sometimes the problem can only be solved with surgery.

This usually applies to cases of congenital anomalies of the structure of the urethra or the sphincter of the bladder. So, the pathological narrowness of the urethra, which makes it difficult for the normal outflow of urine and causes cystitis, can be corrected with surgery. The urethra is dilated, the outflow of fluid is restored, the residual inflammation is then treated according to the standard scheme described above.

To avoid relapse, parents are advised to show the baby to other specialist doctors in order to identify possible foci of inflammation (for example, tonsillitis or adenoids) and to take measures to cure them as soon as possible. Any source of infection in the body increases the chances of the disease recurring and its transition to the chronic stage. Treatment of cystitis is always complex. Diuretics or antibiotics alone are not enough. It is quite difficult to completely cure the disease, but if all the rules and recommendations of the doctor are followed, this is real.

Drugs

In the treatment of cystitis in girls, the following drugs are most often used.

Diuretics

The main drug is "Kanefron". It is a herbal compound that comes in drops and tablets. Children under 5 years old can only be given drops, over this age - a tablet form. Babies under one year old are prescribed 10 drops three times a day, girls from 1 to 5 years old - 15 drops three times, children over five - 1 tablet three times a day. Teenagers from 12 years old - 2 tablets three times a day. The remedy can act independently during the treatment of chronic cystitis, if the doctor prescribes it for a long course.

In the treatment of the acute form of the disease, "Kanefron" is always used as an auxiliary medicine.

Antibiotics

Among them:

"Monural". This is a new modern antibiotic that is active against a wide range of bacteria. This is a granular dry substance that is diluted with water in the proportion indicated in the instructions. Children under 5 years old should not take an antibiotic. Children over five - try to give the medicine as early as possible. It is taken once in a dosage of 2-3 g.
Flemoxin Solutab. Penicillin antibiotic, which is available in dissolving tablets. Even a small amount of water is enough to make the tablets into a suspension that is comfortable for children. A baby from 1 to 3 years old is given the drug three times a day, 125 mg. Girls from 3 to 6 years old - 250 mg three times, a girl from 6 to 12 years old - 500 mg twice a day. The minimum course of treatment is 5 days. The maximum is 2 weeks.

Augmentin. It is a combined broad-spectrum antibiotic. It is produced in tablets and powders, from which you can easily prepare a suspension at home.
"Levomycetin". The dosage of the drug is calculated by the doctor based on the weight and age of the girl.

Nitrofuran preparations

Among them:

"Furadonin"... The tool is not an antibiotic, but it is considered a bacteriostatic - it stops the growth of bacteria. Available in the form of tablets and suspensions. The drug is approved for use in children from 1 month. The suspension and tablets can be mixed with milk. The doctor determines the dose based on the weight of the child (6 mg per 1 kilogram of weight). The resulting amount is divided into four doses. The course of treatment can be from 5 to 10 days.
"Furazolidone". This antimicrobial is available in tablets and granules for suspension. The drug is considered quite heavy, so girls under 12 years old should not take it. For adolescents with cystitis, the remedy is prescribed for 3-5 days, 100 mg three or four times a day. The drug significantly reduces appetite and affects the work of the gastrointestinal tract, and can also cause an allergic reaction.
"Furagin". This is another fairly effective drug with antimicrobial action, which cannot be considered an antibiotic, despite its aggressive effect on some bacteria and fungi. The product is available in tablets. The course of treatment is from 10 to 14 days. The drug can be taken by children, but in a strict age dosage, it is calculated by the doctor, using the formula "5 mg per kilogram of weight". While taking this medicine, the girl must be given protein-rich food, as well as plenty of water.

Other antimicrobial agents

The main one is "Nitroxoline". This antimicrobial drug is effective in treating not only bacterial cystitis, but also fungal infections of the urinary tract. It is not an antibiotic. This tool can be prescribed not only for treatment, but also during diagnosis, if the child needs to undergo cystoscopy to avoid infection after inserting the endoscope. For girls under 5 years old, for the treatment of cystitis, four-time tablets are prescribed with a dosage of 50 mg, 1 tablet. Girls from 5 to 15 years old can take 1 to 2 tablets four times a day. Tongue and urine against the background of taking this drug are painted in a rich raspberry color. Do not be afraid of this. After the end of the course of treatment, the color is normalized.

Antispasmodics

Among them:

"No-shpa". A well-known fast-acting remedy that relaxes smooth muscles. Available in the form of tablets and solution. The tablet form can be given to girls from 6 years old. Babies under this age are not given the drug. The solutions are for adults only. The dosage is not more than 80 mg per day. It is better to divide this amount into two steps.
"Papaverine". This myotropic antispasmodic is also effective in relieving pain and smooth muscle tension, but can be given to young children. The drug is approved for use in children from six months. Available in the form of tablets, solution and rectal suppositories.

The dosage is calculated by the doctor individually.

Ethnoscience

Experts do not recommend treating children's cystitis at home with folk remedies, since the disease can have very sad consequences due to the lack of antibiotics and antimicrobial agents that act quickly and precisely. But as an auxiliary therapy, official medicine favorably treats such alternative medicine recipes as parsley decoction and millet decoction as a drink, as well as chamomile decoction for adding to warm baths.

For a diuretic effect, it is very useful to give the girl a decoction of dill seeds, an infusion made from birch leaves and boiling water. It should be borne in mind that with allergic cystitis, the use of herbal remedies is strictly prohibited. Treatment of other forms of the disease can be accompanied by recipes of traditional medicine.

Prevention

There is nothing difficult in preventing the development of this disease:

From birth, you need to properly wash the girl - only under running water, making movements with your hand from front to back, and not vice versa.

This will protect the girl's genitals and her urethra from the penetration of microbes from the intestines.

You cannot often wash the child's genitals with soap - this leads to irritation, allergic reactions and inflammation not only of the genitals, but also of the urinary tract.
Frequent and prolonged constipation should not be allowed - this disrupts the blood supply to the pelvic organs.
Hypothermia should be avoided - the child should not swim in natural reservoirs for too long, sit on cold surfaces.

Teenage girls should dress warmly, regardless of fashion, and overly tight pants and skirts should be replaced with more loose fit.
It is necessary to monitor the cleanliness of the girl's genitals. After playing in the sandbox, if the girl was squatting, after swimming in a river or sea, you should quickly wash the child and change him into clean panties.

The child should not be allowed to endure for a long time before going to the toilet for little need. This has a detrimental effect on the process of urine breakdown and the state of the retaining sphincter of the bladder.
All inflammatory diseases, helminthic invasions should be treated on time, without bringing them to an advanced stage.

About what and how often you need to wash girls, Dr. Komarovsky will tell in the next video.