Cystitis in children is a urinary infection. It causes the inflammatory process of the mucous membrane and the layer under it in the bladder. In children, cystitis occurs with pain and pain during urination, urinary incontinence, frequent urges with the release of small portions. At a young age, fever and intoxication are often manifested.
Diagnosis of cystitis in childhood involves analysis of urine (bacosow, general analysis, two-glass test), ultrasound of the bladder, during chronic cystitis cystoscopy is performed. During the treatment of cystitis in small patients, an increased drinking regime and diet, herbal medicine, the use of medications (antispasmodic, antibacterial, uroseptic drugs) are required.
Causes of cystitis
The main causes of cystitis in children are various infections of the intestinal (staphylococcus, Escherichia coli, etc.), viral (e.g. flu) and sexually transmitted infections (chlamydia, herpes, more characteristic of adolescents), penetrating the body in the following ways:
- lymphogenous or hematogenous: through lymph or blood, with a severe course of viral infections;
- descending, that is, from the urethra, most often due to insufficient hygiene of the intimate organs;
- ascending, that is, from the intestines or kidneys, while cystitis in boys is most often formed against the background of kidney pathologies.
It should be remembered that the penetration of infection directly into the bladder does not in any way mean the development of an inflammation process. Most often, its cause is internal or external reasons:
- urine retention: cleansing the mucous membrane of the bladder is carried out together with the flowing urine; its delay in children with a neurogenic bladder or phimosis in boys (when the foreskin is narrow) can become a factor in the appearance of inflammation;
- hypothermia: in childhood, it often occurs due to games and activity of the child;
- the presence of morphological changes in the sphincter or bladder, a violation of the integrity of the mucosa, the presence of foreign bodies in the bladder (stones, sand, etc.);
- prolonged catheterization or other invasive measures (including surgical) that can cause inflammation and infection.
In adolescence, boys can develop cystitis due to unsuccessful first sexual contact, which leads to infection of the patient with sexually transmitted diseases. Infections of a similar nature can also occur at a younger age if proper hygiene is not observed (especially when visiting public places - swimming pools, baths, etc.) or if one of the parents who is the carrier of the infection passes it on contact way.
Disease classification
The classification of cystitis in children by form, course, morphological transformations, the prevalence of the inflammation process and the presence of complications is generally accepted.
According to the characteristics of the course, there are cystitis of a chronic and acute nature. Acute childhood cystitis occurs with inflammation of the submucosal and mucous layers, is capable of accompanied by hemorrhagic and catarrhal changes in the wall. Chronic cystitis causes morphological transformations of the muscle layer, which can be granular, bullous, gangrenous, phlegmonous, interstitial, necrotic, polypous and inlaid.
According to the prevalence of inflammation, cystitis in a child is total (diffuse) and focal. If the neck of the bladder is involved , then this indicates cervical cystitis. With the localization of the pathology at the site of the Lietot triangle, we can talk about trigonitis.
Primary (that is, those appearing without functional and structural transformations of the bladder) and secondary cystitis (that is, those resulting from incomplete emptying of the bladder due to its functional or anatomical inferiority) are distinguished in form.
Children's cystitis can be uncomplicated or accompanied by the appearance of vesicoureteral reflux, urethritis, pyelonephritis, peritonitis, paracystitis, sclerosis of the bladder neck, etc.
Signs of cystitis in young patients
The clinical picture of acute cystitis in children is characterized by a rapid course and rapid development. The main manifestation of inflammation is urinary syndrome, which is accompanied by an imperative urge to empty the bladder, occurring approximately every 10-20 minutes.
Disorders of a dysuric nature are associated with increased reflex excitability of the bladder and subsequent irritation of the nerve endings. There are complaints of pain in the area above the pubis, radiating to the perineum and intensifying during palpation of the abdomen and a slightly filled bladder.
What are the symptoms of cystitis in children? Breasts and young children feel general anxiety, which intensifies during urination, refusal to eat, crying, lethargy or agitation, fever to febrile indicators. In young children, in some cases, there is a spasm of the external sphincter of the urethra, as well as reflex retention of urination.
When collecting children's urine in a glass container, you can see how its transparency and color change: the urine acquires a cloudy shade, often dark, it contains flakes and sediment, sometimes an unpleasant smell is felt.
With hemorrhagic childhood cystitis due to hematuria, the color of urine becomes similar to "meat slops." Acute cystitis is characterized by the fact that the well-being of a small patient improves on the third to fifth day, in a week or ten days a full recovery occurs.
The chronic form is most often secondary in its form. Inflammatory symptoms of cystitis in children intensify during an exacerbation. And most often represented by frequent urination, discomfort in the lower abdomen, daytime and night urinary incontinence.
How is cystitis treated in children? We will talk about this a bit later.
Diagnostics
When the first signs that suspect cystitis appeared, parents need to show the child to the pediatrician for an examination. The main indicators in the diagnosis will be the data of blood and urine tests. With an increased number of leukocytes, we can talk about the existing inflammation. Urine is examined to determine the type of pathogen and the correct selection of effective antibiotics.
To obtain a clear picture of the disease and to avoid distortion of the results, the collection of biomaterial should be correct and accurate. The dishes should be sterile. It is treated with boiling water for 10 minutes. You can also purchase special containers at the pharmacy.
Urine is collected in the morning. Preliminary thorough hygiene of the urogenital organs of the baby is carried out. Warm water with soap is used to wash the perineum in girls, in boys - the glans penis. Not all urine is needed for analysis.
For the purity of the result, an average portion is collected. They take it as follows: a little urine on the pot, another part of it - in the receiver, the rest again in the pot. If it is impossible to deliver the biomaterial in a timely manner, it is stored for no longer than a day in the refrigerator.
For more complete information about the disease, the doctor additionally prescribes ultrasound diagnostics.
Therapy of an acute ailment
The treatment of acute cystitis is most often carried out at home (under the supervision of a pediatrician or nephrologist). Only with complicated cystitis (when pyelonephritis develops or suspicion of it) and with cystitis in infants, hospitalization is necessary.
Therapy of pathology in acute form consists in prescribing a diet, an extended drinking regimen and taking medications.
How to get rid of cystitis in children at home is of interest to many.
Advanced Drinking Regime
To ensure a continuous flow of urine and leaching of microorganisms from the bladder cavity, a child needs to drink plenty of water (at least half a liter for children up to one year and more than one liter after a year; for schoolchildren - from two liters per day).
Drinks that have uroseptic (disinfecting and cleaning the urinary tract) and anti-inflammatory properties are recommended: decoctions, fruit drinks and fruit drinks from lingonberries, sea buckthorn, cranberries, freshly squeezed diluted juices (apple, carrot, watermelon, etc.), boiled water, still mineral water. Serve the drink should be in a warm form, all the time throughout the day (even at night).
Pediatricians recommend sedentary baths with decoctions of herbs for the treatment of cystitis. If you combine them with other methods, the result will be noticeable pretty soon. The most commonly used plants are chamomile, calendula and sage. It is important to observe the temperature of the infusion not higher than 37.5 degrees, and the procedure should be carried out for 20-30 minutes.
For a quick treatment of cystitis in children, a diet is indicated.
Diet
From the diet of a child with cystitis, foods that differ in the irritating effect on the mucous membrane of the bladder, increasing blood flow to it and aggravating signs of inflammation: smoked meats and marinades, spicy seasonings, mayonnaise, salty foods, chocolate, strong broths on meat, should be excluded. With cystitis in a child of 3 years old, if there are dysmetabolic defects, an appropriate dietary diet is prescribed:
- with uraturia and oxaluria, it is necessary to exclude spinach, sorrel, parsley and green onions, limit meat products - you need to eat it in a boiled form every other day; it is not recommended to eat offal, broths, sausages, smoked meats, cocoa, sausages, legumes and strong tea;
- with phosphaturia, milk should be limited; temporarily exclude sour-milk and dairy products; the diet should be enriched with acidifying drinks and products (fresh fruits, berries and juices).
Cystitis in a 5-year-old child occurs quite often.
Drug therapy
Most often, for the treatment of the acute form of cystitis, it is sufficient to prescribe uroseptics to the patient (Furamag, Monural, Furagin, Nevigramon). Sulfonamides (Biseptolum) are less commonly used. Taking antibiotics is not practical, but in some cases a specialist can recommend them (especially if pyelonephritis is supposed). The most commonly prescribed penicillin-type drugs (Flemoklav, Amoksiklav, Augmentin, Solutab) and second-third generation cephalosporins (Tseklor, Zinnat, Tsedeks, Alphacet). An antibiotic or uroseptic is prescribed for oral administration, from three to seven days, which depends on the severity of the pathology, the reaction to therapy and the dynamics of laboratory tests. The choice of a drug and the determination of the duration of treatment can only be carried out by a specialist.
To relieve pain in cystitis in a 2-year-old child, spasm and pain medications are used (Papaverine, No-shpa, Spazmalgon, Baralgin).
Features of the treatment of chronic cystitis
Children's chronic cystitis is best treated in a hospital setting, where there is much wider scope for a detailed examination of the condition of the child and the implementation of therapeutic procedures in full.
Chronic cystitis has the same treatment principles as acute: an extended drinking regimen, medications, and diet. An equally important role is played by the establishment of chronicity and the causes of the process, its elimination (strengthening immunity as a whole, therapy of vulvovaginitis, etc.).
Drug treatment most often involves the use of antibiotics and for a fairly long time - from two weeks or more, alternating two or three drugs. After this, you can assign the patient a long course of uroseptic in a low dosage to avoid relapse of the disease.
Due to the fact that the treatment is long and includes the use of antibiotics, children may develop dysbiosis, which requires individual prescription of pro- and prebiotics, as well as their combinations (Narine, Acipol, Linex, etc.) . P.).
The local use of antiseptics and uroseptics (installation of drug solutions in the bladder cavity), as well as physiotherapy (mud applications, UHF, antiseptic iontophoresis, drug electrophoresis, inductothermy) are widely used.
For cystitis that continues to recur, immunomodulating agents are prescribed (the course of "Genferon" or "Viferon").
When symptoms of cystitis in a child of 3 years pass , many parents ask what to do next.
It is important to adhere to the following care recommendations.
Features of caring for a child after a disease
The child should be observed in the clinic at his place of residence for a month after acute cystitis and for at least a year - after chronic therapy, periodically a general analysis of urine and other studies recommended by the attending physician should be performed. Vaccinations for children are allowed not earlier than one month after full recovery (from tetanus and diphtheria vaccinations can be given only after three months).
All parents should know about the symptoms and treatment of cystitis in children.
Cystitis Prevention
With this pathology, prevention comes down to general strengthening manipulations, avoiding hypothermia, careful hygiene of intimate places, frequent changes in underwear, timely treatment of inflammatory processes of the genital organs. It is also recommended to drink liquid all the time (mineral and plain water, fruit drinks, fruit drinks), especially for those children who have salt in their urine.
We examined how to treat cystitis in children.