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In most cases, a bladder infection is caused by bacteria that nest and multiply within the bladder. In theory, infections with viruses or unicellular parasites (protozoa such as Trichomonas vaginalis) are also possible, but in practice these are extremely rare. The bladder infection usually results in a bladder infection (cystitis), which in turn can be accompanied by extremely unpleasant symptoms such as pain during urination, abdominal pain and flank pain.
All pathological multiplications of bacteria, viruses or single cells in the area of the urinary bladder are called bladder infections. They fall into the broad spectrum of possible urinary tract diseases and are to be differentiated here from infections of the ureter, urethra or renal pelvis.
Infection of the bladder usually shows up in the form of acute inflammation of the mucous membranes inside the bladder. These are accompanied by a constant urge to urinate with low urine output, painful urination and persistent uncomfortable pain in the lower abdomen. Sometimes there are also slight blood residues in the urine and those affected have an increased body temperature. It is not uncommon for the infection to pass from the bladder to other sections of the urinary tract or even the kidneys. For example, those affected develop kidney inflammation or kidney infection. Possible consequences are
- Kidney pain,
- Nausea and vomiting.
Serious inflammations of the urinary tract and kidneys sometimes 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).
The causative agents are usually bacteria, particularly from the genus Escherichia coli. These so-called coli bacteria enter the urinary tract from the genital or anal region, rise to the bladder and begin to multiply here. Infections with Escherichia coli are responsible for a large part of the bladder infections (some sources speak of over 90 percent). Staphylococci and enterococci are examples of other bacteria that can cause bladder infections. In rare cases, a bacterial bladder infection can also be caused by bacteria of the genus Proteus mirabilis, Chlamydia trachomatis or stickies.
In theory, viruses can also cause an infection in the bladder if they get inside the bladder. For example, human adenoviruses are known to trigger bladder infections and bladder infections. In practice, however, this is only very rarely the case, since the body's own protective mechanisms prevent the pathogens from entering the bladder relatively effectively. The same applies to parasitic infections of the bladder with so-called protozoa (e.g. Trichomonas vaginalis). A so-called schistosomiasis is a parasitic form of urinary bladder infection that is particularly common in the tropical and subtropical regions of the world. It is caused by pair gel (special suction worms) whose larvae (cercariae) live in water and can penetrate the organism through the skin. Once in the organism, the larvae migrate to different parts of the body and develop into mature couple rules. The leeches of the genus Schistosoma haematobium nest in the bladder wall, while others attack the large or small intestine. The couple gels also lay their eggs in the bladder wall, which then penetrate the tissue, get into the inside of the bladder and are excreted in the urine. Penetration of the bladder wall is accompanied by an inflammatory reaction of the mucous membranes or a bladder infection, which changes to a chronic stage if treatment is not carried out.
Causes and risk factors
The body's own defense mechanisms normally prevent bacteria and other pathogens from rising through the urethra. On the one hand, the constant flow of urine towards the exit of the urethra plays a role, with which a large part of the pathogens are flushed out. On the other hand, the potential pathogens are combated by the antibodies (immunoglobulin A) of the so-called urothelium - the multi-layered covering tissue within the urinary tract. Possible factors that can encourage the pathogen to rise up into the bladder are, for example, urinary drainage disorders or impaired bladder emptying. If the immune system as a whole is weakened, such as often in patients with diabetes or in cancer patients after chemotherapy, this can also promote a bladder infection. Imbalances in the hormonal balance, such as an estrogen deficiency or an androgen excess, are also considered to be beneficial factors for urinary bladder infections.
Hypothermia, which can occur, for example, when wearing wet swimming trunks and swimsuits, is known as a risk factor for bladder infections. The wet swimwear offers good conditions for the bacteria to penetrate through the urethra and the immune system is additionally weakened by the cooling of the abdomen. Last but not least, frequent intercourse should be mentioned as a risk factor for infections of the urinary bladder, since this facilitates the transfer of germs and thus promotes ascending through the urethra. If objects are introduced into the urinary tract as part of medical interventions, such as during a bladder mirroring or a bladder catheter placement, there is also the risk that pathogens get into the bladder and subsequently multiply here.
In general, women are significantly more often affected by a bladder infection than men because of their anatomy (shorter urethra, proximity between urethral opening, vagina and anus). In women, the bacterial milieu in the vagina - the so-called vaginal flora - also plays a special role in the defense against germs. If this is impaired by taking antibiotics, for example, or if the “healthy” bacteria in the vaginal flora die, harmful bacteria can multiply disproportionately and thus cause a bladder infection.
If the patient's medical history suggests a bladder infection, the next step is to analyze the urine to identify and identify possible pathogens. With the help of special test strips, breakdown products of bacteria as well as red and white blood cells in the urine can be determined. The pathogens can also be seen under the microscope. The creation of bacterial cultures based on the urine sample is used for the targeted determination of the pathogen. If protozoa are the cause of the bladder infection, they can be detected by microscopic examination of a smear of the vagina or urethra. An accompanying blood test not only provides general information on the inflammatory process in the organism or possible impairments of kidney function, but under certain circumstances, pathogens can also be detected in the bloodstream if there are pronounced infections. If there is a suspicion that the infection has spread to other organs, corresponding further examinations are necessary.
Since the majority of bladder infections are bacterial, antibiotics are usually an essential part of therapy. In view of the growing spread of resistant pathogens, the selection of suitable antibiotics is now much more difficult than a few years ago. In case of doubt, a corresponding switch to another preparation must be made here. Ultimately, however, a bacterial bladder infection can be successfully treated with antibiotics in most cases. In addition, pain relieving and antispasmodic medicines can be used.
Parasitic bladder infections are also treated with medication, whereby so-called nitroimidazoles are used against Trichomonas vaginalis and special worms (anthelmintics) are used against schistosomiasis. In the case of viral infections in the bladder area, therapy is generally much more difficult and those affected are primarily dependent on their self-healing powers. Only a medicinal relief of the symptoms can come into question here. In general, those affected by a bladder infection are advised to ingest plenty of fluids to flush out the pathogens. At least two liters of water or (bubble) tea are advised here.
Naturopathy for bladder infections
In the field of naturopathy, bladder teas based on various antibacterial, diuretic and anti-inflammatory medicinal plants are particularly recommended for bladder infections. A mild bladder infection can often be treated with it without any additional medication. Bearberry leaves, birch leaves, bucco leaves and orthosiphon leaves are used here in particular. It is not uncommon for goldenrod leaves to be used against accompanying abdominal cramps. Extracts of the marshmallow root are also said to counter inflammation of the mucous membrane inside the bladder. A special extract from horseradish and nasturtium can be used as an herbal antibiotic against bacterial bladder infections. Accompanying measures that generally strengthen the immune system are often part of the therapy. Cranberry juice is also said to have a positive effect on bacterial bladder infections, since the juice hinders the settlement 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 patients at risk are recommended to take it daily.
Homeopathy for cystitis
Even though homeopathy is scientifically controversial, many people trust its effectiveness. For example, agents such as Apis, Cantharis, Nux Vomica and Sarsaparilla are used against bladder infections or bladder infections. However, the selection should be reserved for experienced therapists and if the preparations do not lead to immediate relief, conventional medicines should be used.
Sufficient hydration is generally of particular importance for patients who are prone to bladder infections. Women in particular should also observe the current hygiene recommendations and always wipe the toilet paper from front to back after using the toilet to prevent bacteria from the anal region from entering the vaginal opening. Disorders of the vaginal environment, which promote the spread of bacteria, can be caused by showering or bathing, for example, by intensive cleaning of the genital region with shower gel or soap. Sensitive women are advised to only use warm water for cleaning.
Risk patients should also generally take care not to hold back their urge to urinate, but to go to the toilet immediately. Because when the bladder is emptied, the pathogens are also eliminated. This is especially true after sexual intercourse. Ideally, the bladder is emptied here within the first quarter of an hour after the sexual act. The risk of a 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, changing your underwear every day is advisable to counteract the spread of bacteria and their penetration into the urinary tract. (fp)
Author and source information
This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
Dipl. Geogr. Fabian Peters
- Merck and Co., Inc .: Interstitial Cystitis (accessed: September 3, 2019), msdmanuals.com
- eutsche Gesellschaft für Urologie e.V. (DGU): S3 guideline epidemiology, diagnostics, therapy, prevention and management of uncomplicated, bacterial, community-acquired urinary tract infections in adult patients, as of April 2017, detailed view of guidelines
- German Society for Urology (DGU) / Professional Association of German Urologists: Kidney and urinary tract infections (accessed: 03.09.2019), urologenportal.de
- Institute for Quality and Efficiency in Health Care (IQWiG): Cystitis (accessed: 03.09.2019), gesundheitsinformation.de
- Medical center for quality in medicine: cystitis (available: 03.09.2019), patienten-information.de
- Mayo Clinic: Cystitis (access: 03.09.2019), mayoclinic.org
- European Association of Urology: Guideline Urological Infections (accessed: 03.09.2019), uroweb.org
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK): Interstitial Cystitis (Painful Bladder Syndrome) (access: July 15, 2019), niddk.nih.gov
ICD codes for this disease: N28, N34ICD codes are internationally valid encodings for medical diagnoses. You can find yourself e.g. in doctor's letters or on disability certificates.