What does irritable bladder syndrome mean. Treatment of irritable bladder syndrome. Diagnosis: examination and tests

Anatoly Shishigin

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Irritable bladder syndrome is one of the rather delicate problems that disturb patients of any gender, race and age. Often people are embarrassed by such symptoms and avoid visiting a doctor in order not to take antibiotics. Some even use urological pads for hygiene, embarrassed by the manifestation of this disease.

All this significantly reduces the quality of life, comfort in everyday life, and also brings a lot of problems in neurology. Let's take a closer look at irritable bladder syndrome, the symptoms and treatment of which will interest many people with problems in urology.

Organ irritation can be a symptom of a pathology occurring in the body (for example, urinary syndrome with pyelonephritis) or as an independent disease. Normal urination occurs with the complex work of the urinary canals, bladder, fascia and ligaments. In the event of a failure in the genitourinary system or other diseases in this area, it is possible, during the diagnosis, to identify the cause, which will determine the choice of treatment regimen by the doctor.

Anatomy disorders

The anatomical structure of the pelvic region can be disturbed, as well as an increase in the response from the receptors of the bladder to nerve impulses coming from the brain. This kind of anomaly can occur with the constant transfer of weights, intense sports or specific work. Quite often, this disease is observed in obese people or after surgery on the pelvic organs.

Prostate adenoma

Prostatic hyperplasia is often the cause of irritable bladder syndrome in male patients. In this case, nodes appear in the prostate that grow and squeeze the cavity of the urethra from all sides. Due to this, the walls of the urethral canal lose their elasticity, their work is disrupted and frequent urges to deurinate begin.

Patient's age

As a person ages, his hormonal background changes, there is a decrease in the activity of steroid production, the structure in the ligaments and muscles changes, as well as in the vascular walls of all organs of the small pelvis. All these factors together lead to urinary incontinence.

Failure in the central nervous system

When the glands responsible for internal secretion malfunction, this is most often characterized by the development of diabetes mellitus, the formation of malignant and benign tumors. In patients with identified pathologies of this type, urination is most often disturbed, and inflammation in one of the sections in the spinal cord provokes impaired blood flow in the pelvic area, which causes urinary syndrome.

Sometimes irritable bladder syndrome can be detected in patients without the above causes. In search of a feature that connects such patients, experts have discovered interesting facts. In particular, each of these patients had rather high nervous excitability, experienced frequent depressive states and sleep disorders. In most cases, urinary syndrome proceeded in conjunction with irritable bowel.

In a healthy person, about 2 liters of urine is produced per day in the body, which is consumed in 8 or less acts of urination. If the patient has to visit the toilet more than 10 times a day, then these are symptoms indicating an irritated organ. At the same time, a person experiences a very strong desire to immediately urinate, he does not even have the opportunity to wait for a visit to the toilet.

One of the symptoms can be the way of life that a person leads, when involuntarily he has to choose only those places where there is a toilet cubicle.

On the way to the toilet the patient cannot hold his urine;
Once deurination has begun, it cannot be stopped;
With laughter and coughing, involuntary urination begins;
It is impossible to start urinating when the bladder is full;
Urine flows at the sound of rain or running water;
There is always little fluid released;
There is a persistent feeling of incomplete deurination and residual urine inside.

Clinically, all the syndromes that characterize the urinary syndrome differ from the manifestation of infectious cystitis, the main symptom of which is sharp pain during urination.

Diagnostics of the urinary syndrome

The patient must provide an anamnesis of the disease, on the basis of which the specialist suggests the cause of the disease. If there are signs similar to the symptoms of cystitis, with glomerulonephritis and other diseases of the urinary tract, the doctor must definitely find out about them in order to take into account the symptoms in the diagnosis. The same applies to kidney problems in patients.

The doctor also interrogates the symptoms of the excreted urine, its volume, the sensation of deurination and its frequency. It is necessary to pass general analyzes of biomaterials, urine and blood, for clinical trials. Urine is also tested for cytology to detect cancer cells. The patient is also examined for the development of infections that may have been sexually transmitted.

For examination, urodynamic uroflowmetry or cystometry is prescribed when a small diameter catheter is used. An ultrasound examination of all organs of the genitourinary system can be effective. Before starting the manipulation, the patient needs to empty himself, and the ultrasound will find out the amount of residual urine and its compliance with the norm.

Conducted sonography also allows you to detect various formations and tumors that can cause irritable bladder syndrome. Computed tomography is often performed to clarify the diagnosis. If problems with the endocrine glands are found, an endocrinologist is involved for help. If these reasons were caused by a malfunction of the nervous system, a consultation with a neurologist will be required.

How to treat urinary syndrome?

If the overactive bladder syndrome is an independent disease, it arose for neurogenic reasons. Treatment should focus on bladder training, with the patient avoiding urination for 2 hours. It is important to keep a diary and note indicators for the effectiveness of observation by a doctor. Training consists in performing the prescribed physical set of exercises that strengthens all the muscles of the pelvis.

These exercises are very popular and have been around for over 100 years and have been used to treat incontinence. The author of the exercises is Kegel, who systematized them and deduced the necessary sequence. If irritable bladder syndrome is detected, treatment with such training will give the first results after a couple of weeks of daily exercise.

Physiotherapeutic procedures for the treatment of such diseases are effective when electromagnetic stimulation of the organ is performed. Experts recommend sticking to a diet that includes foods with a high concentration of coarse fiber, in particular, cereals or bran. Such a diet reduces the manifestations of the urinary syndrome, especially if you give up tobacco, alcohol, spices and salt. The drink most loved by many, coffee, is very irritating to the walls in the body, so it must be completely eliminated. It is possible to use vegetable chicory, which tastes like a coffee drink.

Medical treatment

The use of drugs for patients with urinary incontinence due to bladder weakness is the use of tricyclic antidepressants and mild sedative medications. The disease itself plunges the patient into stress, which only worsens the situation.

Three types of drugs have been identified that successfully fight the disease:

alpha-blockers or m-anticholinergics, reduce stimulation in the detrusor, the muscular membrane of the organ. These drugs are the first line in drug treatment, they are very effective and quite safe;
botox. The toxin is injected into the cavity of the bladder in the amount of 25 or 30 pieces. It relieves excessive muscle hypertonicity, regulates acetylcholine, which is excreted by nerve endings. The effectiveness of exposure is limited to 11 months, after which it is necessary to repeat the procedure;
vasopressin and its analogues, which reduce urine filtration and shift urination for the period of night time.

Research continues on the use of estrogens in the treatment of adult women who have been diagnosed with neurogenic bladder syndrome.

ethnoscience

The most effective prevention is the passage of an annual medical examination. If the pathology is "caught" at an early stage, complications and the occurrence of concomitant diseases can be avoided. When symptoms of this disease appear, it is important to restructure the diet, excluding alcohol, citrus fruits and all caffeinated products from it. These factors irritate the mucous walls of the organ, lead to frequent contractions due to increased sensitivity.

Depression, stress and neurosis can cause quite serious physiological disorders of the human body. They lead to sleep problems, irritability and high nervous excitability. Anxiety is often noted. All these psychological factors lead to irritation of the bladder and require the help of a neurologist.

Irritable bladder syndrome (IBS) is what doctors call a neurological problem rather than an abnormality in the genitourinary system. This is a serious disease in which a person involuntarily contracts the muscles of the bladder, which causes urination.

Naturally, this is a very delicate problem with which a person is forced to lead a special way of life - he can often feel uncomfortable, be afraid of long trips and important events.

Bladder hyperactivity is referred to as psychosomatic diseases that cause psychotraumatic circumstances for a person.

If you regularly experience a feeling of fullness in your bladder, wake up more often at night to go to the toilet, or urinate in small amounts, but not as usual, then most likely you can be diagnosed with irritable bladder syndrome. The same problem can also be signaled by a sharp unbearable pain during urination or the urge to this natural process, which cannot be restrained, as a result of which you often have to go to the toilet.

If you find these symptoms in yourself, contact a specialist as soon as possible to start treatment on time. You are unlikely to be able to cope with this disease on your own, since it is often caused by inorganic causes. This means that treating the symptoms in this case is counterproductive.

Sometimes serious diseases provoke the appearance of an overactive bladder. In this case, SRMP is only a symptom, which must be eliminated along with the root cause. An overactive bladder can be provoked by such causes of an organic nature.:

Tumors of the bladder and prostate, neoplasms in the brain or spinal cord;

Inflammation and infectious processes in the organs of the genitourinary system;

Deviations in the nervous system of the patient;

Postponed head injuries;

Spinal cord injury.

Usually, SRMP manifests itself due to a malfunction of the autonomic nervous system and is often combined with other manifestations.

The treatment of this difficult disease consists not only in eliminating problems with the bladder, but also in overcoming psychological disorders, a psychotraumatic situation, which became the cause of deviations.

Immediate consultation with a specialist is required in such cases.:

A very rapid increase in problems with the process of urination;

Sharp and severe pain during urination, after which a person cannot feel and move normally;

When urinary incontinence occurs without prior urge and is not controlled in any way, for example, with sudden movements, sneezing;

If a person feels the urge to urinate, however, this process is slowed down or interrupted for unknown reasons;

Numbness in the perineum or limbs during urination.

As a treatment, experts often recommend training the bladder - setting a urination schedule at intervals of, for example, two hours, and going to the toilet on an alarm clock, even if the person does not feel the urge to urinate. This technique can help control and contain your bladder.

In combination with the establishment of a urination regimen, special exercises help to strengthen the muscles of the pelvis. Kegel exercises have a good physiotherapeutic effect in combination with other types of treatment.

In particularly difficult cases that are not amenable to such treatment, the patient is prescribed a course of drug therapy.

From such a delicate problem as irritable bladder syndrome, many people on the planet suffer. A person may be embarrassed by this serious illness and put off a visit to the doctor for a long time. This is fraught with consequences: a decrease in the quality of life and neurological disorders.

Women suffer from this disease more often, since their genitourinary system, due to anatomical features, is more susceptible to pathogenic microbes. In addition, they give birth, and this is an additional provoking factor.

The occurrence of the syndrome can be associated with both physiological manifestations and neurogenic factors:

Heredity. Predisposition to this pathology is often transmitted from parents to children.
Age. Aging leads to changes in hormonal levels and reduced production of biologically active steroids. For this reason, the structure of the vascular walls, ligaments and muscles changes.
Congenital pathologies of development.
Prostate adenoma in men. The occurrence of nodes in the prostate is fraught with squeezing of the urethra. The walls of the bladder become less elastic, blood flow worsens, and there is an increased urge to urinate.
Urogenital infections, .
Osteochondrosis.
Strokes. Against their background, brain damage occurs.
Traumatic brain injury.
Anatomical disorders. They arise as a result of intense sports training or professional activities that involve lifting weights. The risk group includes people who are overweight and have undergone surgery on the pelvic organs.
Violation of the functioning of the nervous system. Frequent urination occurs due to the inflammatory process in the spinal cord, neoplasms of a benign and malignant nature, improper functioning of the endocrine glands (against the background of diabetes mellitus).
The use of medications that increase diuresis.
Abuse of caffeinated drinks.

Important! The disease can be diagnosed in patients with a history of none of the listed causes. Studies have been conducted on such patients in an attempt to find similar symptoms in them. It was found that the majority suffered from sleep inversions, nervous disorders, irritable bowel syndrome.

Symptoms

Symptoms may vary depending on the cause of the syndrome and the neglect of the disease. Among the main features are the following:

overactive bladder;
frequent urge to urinate (up to ten times a day);
soreness and itching in the urethra, perineum, bladder;
the volume of urine does not match the amount of fluid drunk;
weak, irregular urine stream;
involuntary urination when laughing, coughing;
long wait before emptying;
urges occur with extraneous stimuli: the sound of rain, the sound of pouring water;
urine is excreted in a small amount (pollakiuria);
unexpected attacks disrupt night sleep;
constant feeling of incomplete emptying of the bladder;
increased irritability;
depressive states;
digestive problems, stool disorders.

Learn more about overactive bladder in this video.

Diagnostics

When seeking help from a doctor, the patient should be told in detail about all the diseases he has. Each ailment, even transferred in the distant past, can be important in establishing the correct diagnosis. Also, it is necessary to describe in detail the present clinical symptoms. Similar signs are observed in the chronic form of cystitis, so it is necessary to differentiate these two diseases at an early stage.

Treatment of irritable bladder syndrome is done by neurologists, urologists, gynecologists.

Based on the collected medical history and symptoms, the doctor suggests the cause of the pathology and prescribes therapy.

general blood and urine tests to detect the inflammatory process;
urine cytology (for the detection of cancer cells);
biochemical tests to detect genital infections;
uroflowmetry to determine the speed and volume of urination;
cystometry allows you to measure the pressure of the urine flow, determine the tone and contractility of the muscle cells of the bladder;
gynecologist consultation (for women);
rectal examination of the prostate (in men);
Ultrasound of the abdominal cavity and pelvic organs;
computed tomography to detect the anatomical features of the urinary system.

Treatment

Irritable bladder syndrome is treated comprehensively, and largely depends on the etiology of the disease. In conservative therapy, medications, physiotherapy, diet, and special exercises are used.

Important! If the occurrence of the disease is associated with neurosis, then observation by a psychotherapist is mandatory. Overcoming mental disorders will help eliminate bladder dysfunction.

Medicines

Doctors prescribe drugs that affect the nervous system. The dose and type of the drug are determined by the specialist individually in accordance with the degree of development of the disease.

Commonly used medications include:

M-anticholinergics (Detrol, Detruzitol, Driptan);
sedatives (Novo-passit, Afobazol, Tenoten);
tricyclic antidepressants (imipramine).

With the infectious nature of the disease, antibacterial, antifungal or antiviral drugs are prescribed (in accordance with the nature of the infectious agent).

If necessary, antispasmodic and antihistamines are included in the therapeutic regimen.

In menopausal women, treatment can be supplemented, if necessary, with hormonal drugs. They are selected for patients exclusively by a gynecologist.

Botulinum toxin injections

Injections are made into the wall of the bladder and lead to a decrease in muscle tone. In this case, there is no damage to nerve receptors. This is a technically simple procedure that is easily tolerated by patients. For one course, from 20 to 30 injections of the drug are performed. The result is stored for one year, after which the manipulation must be repeated.

Physiotherapy treatment

Among the hardware techniques for eliminating the syndrome, the following options are used:

electrical stimulation of the bladder (stimulation of the contraction of the sphincter by electrical impulses);
ultrasound;
magnetotherapy.

Diet

Nutrition for irritable bladder syndrome implies compliance with the following rules:

Coffee, citrus fruits, chocolate, smoked meats, alcoholic and carbonated drinks are completely removed from the patient's diet.
The amount of salt is reduced.
The basis of the menu is products rich in vegetable fiber (cabbage, carrots, herbs, fruits, berries).
Two hours before bedtime, you should refrain from drinking liquids.

Note! This point of treatment is especially important for patients who also suffer from irritable bowel syndrome.

Setting the mode of urination and gymnastics

To train the bladder, experts advise going to the toilet at a certain interval (for example, every two hours). At the same time, it is important to visit the restroom, even if there is no urge. These intervals help to correct the formed pathological stereotype of urination.

Another effective method of treatment is the implementation of exercises aimed at strengthening the muscles of the pelvic floor. These workouts are called Kegel exercises. They are aimed at eliminating violations in the functioning of the organs of the genitourinary system. During exercise, the muscles that are responsible for the process of urination are activated. The whole complex consists of four exercises. They are convenient in that they can be performed anywhere and at any time. Regular exercise (5 times a day) will help to cope with the disease. A positive result will be noticeable after a month of classes.

Folk ways

At home, you can use herbal infusions to eliminate unpleasant symptoms. This is a good addition to traditional therapy.

Here are some examples:

Collection with thyme and elecampane. To prepare the broth, you need to mix two tablespoons of elecampane and one tablespoon of thyme, pour a liter of boiling water and insist for three hours. The resulting remedy should be drunk in one day.
Plantain. Dry leaves of the plant (a handful) are poured with boiling water and infused for one hour. Strained infusion is used in a third of a glass in the morning, afternoon and evening.
Collection with bearberry and St. John's wort. Both ingredients in equal quantities (one tablespoon each) are poured with a glass of hot water and infused for 8 hours. You need to drink a medicinal decoction during the day for three doses.
Dill. Dill seeds (2 teaspoons) are poured into 250 ml of hot water and infused for a couple of hours. The drink is drunk in one dose once a day. The course continues until the symptoms disappear.
kidney tea. Its main component is the stamen orthosiphon (leaves). To make an infusion, pour 20 g of raw materials into 120 ml of hot water. Healing tea is drunk throughout the day.
Cowberry. Dried lingonberry leaves in the amount of two tablespoons are poured into 800 ml of boiling water. Infusion time - one hour.

Berry decoctions and herbal infusions can cause allergies and neutralize the effect of certain medications, so they should be used only with the permission of the attending physician.

Operation

If conservative therapy is not successful, then surgical intervention is advisable. Types of surgical operations:

Enterocystoplasty. It is used if there is a need to reduce the capacity of the bladder and reduce its distensibility.
Detrusor myectomy. This intervention is aimed at reducing the contractility of the detrusor and involves its excision from the fornix of the bladder (while the intact mucous layer is preserved).

Prevention

To prevent illness, you need to monitor your health and follow a number of recommendations:

As the main preventive measure, experts advise to undergo an annual medical examination. All emerging ailments should be treated immediately, so as not to become a source of other unpleasant problems.
If possible, minimize stress and anxiety in your life.
Establish a full sleep so that the body has time to fully recover overnight.
Eat right, avoid coffee and alcohol.
Give up smoking.
Strengthen the muscles of the pelvic floor.

Statistics show that the actual number of patients with this syndrome is much higher than diagnosed cases. In no case should you hush up this problem or engage in self-treatment. Timely access to a doctor is the key to a quick and successful recovery.

Irritable bladder syndrome is a pathology that is accompanied by frequent urge to urinate. With this syndrome, a person fails to hold urine and this leads him to an awkward feeling, and in some situations even becomes a cause of stress.

In the event that a person develops a disease such as irritable bladder syndrome, then this situation leads to an involuntary contraction of the muscular membrane and uncontrolled excretion of urine, which is very often disproportionate to the strength of the urge.

Despite the fact that the disease is diagnosed in patients and treated for a long period of time, scientists have not yet identified the cause that would provoke the development of the disease. There are many different opinions about this, and all of them are true to one degree or another.

Currently, the following causes are distinguished that lead to the occurrence of the syndrome:

chronic infections of the genitourinary system;
autoimmune disorders;
traumatic brain injury;
features of the structure of the bladder;
diabetes;
spinal injury;
taking medications with a diuretic effect;
the systematic use of drinks rich in caffeine;
hereditary predisposition;
increased permeability of the urothelium;
decreased barrier functions of urothelial mucus;
psychosomatic disorders;
violation of blood circulation in the bladder;
endocrine pathologies;
lack of estrogen in the blood of a postmenopausal woman.

There are many reasons that lead to the occurrence of the syndrome.

In addition to all the above reasons, circumstances such as systematic stressful situations, as well as people suffering from memory and attention disorders, can lead to the occurrence of irritable bladder syndrome.

In fact, this pathology does not pose a serious danger, but if the disease is not treated, then quite serious complications can develop on the basis of it, such as insomnia, pain syndrome, which can manifest itself in varying degrees of severity, as well as cystitis.

In men, this pathology can still be caused by prostate adenoma, since during the period of the disease there is compression of the nodes of the urethra, resulting in frequent urge to urinate.

Based on statistics, bladder irritation is much more commonly diagnosed in women than in men. Especially often the development of pathology occurs during menopause. This is due primarily to hormonal changes in the female body.

As for the symptoms of the syndrome, it is almost identical in both the representatives of the stronger and the weaker sex.

The main symptoms of irritable bladder syndrome include:

intermittent urination;
sluggish stream during urination;
frequent urge to urinate;
uncontrolled release of urine during sneezing, coughing, laughing, or just a sudden movement;
constant feeling of incomplete emptying of the bladder;
long wait for emptying;
appearance;
inability to hold urine on the way to the toilet;
inability to stop urination after it has begun;
the release of urine may involuntarily begin at the sound of dripping water;
when urinating, a small amount of urine is excreted.

Frequent urge to urinate is one of the symptoms of the disease.

According to the symptoms listed above, even without examinations, it is possible to distinguish irritable bladder syndrome from. After all, cystitis is accompanied by strong and cutting pain during urination.

When the first symptoms of irritable bladder syndrome appear, you should immediately seek help from a medical institution in order to undergo research and find out an accurate diagnosis, as well as to prescribe effective treatment.

An accurate diagnosis with such a pathology is quite difficult to make, so the patient will have to undergo a series of surveys and various kinds of studies.

To make a diagnosis, the doctor must first of all talk confidentially with his patient. During the conversation, he needs to find out exactly under what circumstances and when the frequency of the urge to urinate increases. In addition, the patient must explain to the attending physician what quality the liquid is released in the process, as well as how much liquid the patient drinks in one day. According to these indicators, the doctor will be able to find out the correspondence between the fluid drunk and the excreted urine, while taking into account sweating and breathing.

The first symptoms of irritable bladder syndrome indicate an immediate visit to a specialist in a medical institution

But this will not be enough to make an accurate diagnosis. To confirm it, the doctor must observe the patient for five days, and in some cases for about one week. In addition to observation and the above calculations, the patient is assigned a series of examinations that will help to exclude the possibility of developing an infection, as well as congenital anomalies of the urinary system. As for women undergoing such an examination, they, among other things, are additionally sent to see a gynecologist, and men undergo a rectal examination of the prostate.

Note! In some cases, an ultrasound examination or computed tomography is prescribed for the patient to make an accurate diagnosis.

Only after all the examinations, the doctor will be able to determine the diagnosis and, accordingly, prescribe an effective treatment, which is selected individually in each case.

Irritable Bladder Syndrome is in every sense not only a serious disease, but also poorly diagnosed, and also without certain standards of treatment. In order for the treatment to be effective, the doctor needs to rely on the symptoms and constantly monitor the patient's condition. In this case, the most optimal treatment option is an integrated approach. Basically, the treatment of such a pathology includes the following methods:

mandatory drug therapy is prescribed;
neuromodulation;
a complex of gymnastics is selected aimed at the muscles of the pelvic floor;
electrical stimulation;
behavior correction.

First of all, you need to reconsider your lifestyle and diet. It is worth completely abandoning the consumption of table salt, fatty foods, smoked meats and spices. In addition, it is required to exclude all bad habits, such as smoking and drinking alcohol. An important role on the path to recovery is played by the correct drinking regimen. To do this, you need to drink at least two liters of purified or boiled water per day.

The specifics of the treatment of pathology includes drug therapy

Visiting the toilet should also be given close attention. It is best to go to the toilet every two hours, regardless of whether there are urges and desires for this or not. In order to control the process, patients are advised to set an alarm clock, so it will not be possible to miss the next visit.

A set of Kegel exercises has an excellent effect on the body. It helps to keep the pelvic floor muscles toned.

Only all procedures and the use of drugs in strict accordance with the recommendations of the doctor will be rewarded, and the patient will be able to get rid of the pathology.

Among other things, depending on the results of the study and the diagnosis made, the attending physician recommends consultations with narrow specialists, such as a gynecologist, neurologist, endocrinologist, nephrologist and psychoneurologist.

With irritable bladder syndrome, the use of alternative drugs is allowed as an additional therapy.

As for drugs, anticholinergic drugs are recommended for use, as well as antihistamine, antispasmodic and anti-inflammatory drugs. After examination by narrow specialists, additional antidepressants and sedative drugs may be included in the treatment complex.

With irritable bladder syndrome, the use of folk remedies is allowed as an additional therapy. But in no case should you start taking them without first consulting your doctor, as some of them can provoke the development of an allergic reaction or reduce the effect of medications taken.

Prevention methods

As we have all known for a long time, any disease is much easier to prevent than to get rid of it later. This rule also applies to irritable bowel syndrome. Of course, the best prevention is the annual passage of certain examinations. Thus, it becomes possible to diagnose the pathology at the initial stage and get rid of it in a short period of time without any adverse effects on the body.

In the event that a person has the first symptoms indicating such a pathology, it is immediately recommended to completely exclude from the diet all foods that contain caffeine, as well as alcoholic beverages and citrus fruits. They have the most negative impact on the condition of the bladder mucosa.

In addition, you should try to avoid stressful situations, depression and neuroses. All these situations not only have an adverse effect on the psycho-emotional state of a person, but also contribute to the development of various pathologies. During such periods, a person becomes irritable, his nervous excitability increases, and sleep is also disturbed. In this state, a person involuntarily provokes the development of irritable bowel syndrome. Therefore, in the event of stressful situations, it is recommended to immediately seek help from a neurologist.