One of the most common diseases of the urinary system in women is pyelonephritis, the symptoms and treatment of which require increased attention, because almost imperceptibly for the patient, it can lead to the development of dangerous complications.
Pyelonephritis - Causes
With this pathology, the kidney is involved in the inflammatory process - its bowl-pelvic apparatus and parenchyma, that is, the basic functional elements of the organ. Often, a bilateral lesion is caused by the penetration of an infection that can penetrate into the organ in one of the following ways:
- ascending - from the nearby organs (bladder, urethra, etc.);
- hematogenous - through the blood from an infectious focus located in any of the organs (gall bladder, middle ear, maxillary sinuses and so on);
- Lymphogenous - through the lymph vessels against the background of intestinal infections.
Renal pyelonephritis, due to its anatomical features, is predominantly a female disease, since the canal through which urine is excreted is shorter than that of men, and the genital tract and rectum are in close proximity. In addition, the female body is more prone to hormonal changes that cause a decrease in local immunity and a violation of the composition of the microflora. The following microorganisms are considered to be the most common pathogens of infection in this disease (many of them are representatives of the normal microflora of the body):
- E. coli ;
- Pseudomonas aeruginosa ;
- enterococci;
- Klebsiella;
- streptococci;
- staphylococci;
- Proteins;
- Candidates.
Adverse factors that can provoke the development of inflammation of the kidneys are:
- dysfunction of the bladder ("neurogenic bladder");
- nephrolithiasis;
- urinary tract tumors;
- vesical-pelvic-ureteral reflux;
- hyperplasticity of the kidneys;
- abnormal anatomical location of the kidneys;
- metabolic disorders associated with excess salt in the body (phosphates, urates, etc.);
- diabetes;
- instrumental examination of the urinary tract;
- taking certain medications (sulfonamides, cytostatics, etc.);
- exposure to radiation;
- intoxication of the body;
- supercooling;
- hormonal failure ;
- stress;
- inadequate hygiene of the genitals.
Acute pyelonephritis
In acute course of pyelonephritis in women is characterized by a sudden onset and a pronounced clinical picture with an increase in symptoms. Often this is the primary infectious process, which was not preceded by organ damage earlier, involving one of the kidneys. The duration of this form of the disease is about 10-20 days (with properly organized treatment).
Chronic pyelonephritis
Chronic pyelonephritis in women, whose symptoms and treatment are somewhat different from those in an acute process, is characterized by a slow flow with periodic relapses. Gradually, with this form of pathology, the normal tissue of the organ is replaced by a connective tissue that is not functional. Often, chronic pathology is a consequence of an incomplete acute pyelonephritis. In many cases, chronic pyelonephritis is diagnosed during pregnancy, which during this period is prone to exacerbation.
What is the danger of pyelonephritis?
In the absence of timely and proper treatment, the disease poses a serious health hazard. As a result of a prolonged course of the disease, the kidney may completely lose its ability to function, which, with bilateral damage, causes chronic renal failure with the need for hemodialysis. In addition, such complications can develop:
- acute renal insufficiency;
- paranephritis;
- persistent increase in blood pressure;
- necrotic papillitis;
- kidney abscess ;
- urosepsis;
- bacterial shock.
Separately it is worth noting what danger is borne by the gestational pyelonephritis - flowing during the bearing of the child. Pathology can develop even in healthy pregnant women with normally functioning kidneys, without structural changes in the urinary tract. In this case, often the disease attacks women who first become pregnant, in the second trimester and can cause a violation of the course of pregnancy, childbirth and postnatal recovery. Adverse effects are:
- premature delivery;
- gestosis;
- fetal hypotrophy;
- chronic placental insufficiency;
- intrauterine infection of the fetus;
- abortion.
Pyelonephritis - symptoms in women
Signs of pyelonephritis, which occurs in an acute form, are often the following:
- increased body temperature;
- chills, febrile condition;
- severe sweating;
- intense pain in the lumbar region from the side of the lesion, which can give back, subcostal area, inguinal region, become spilled;
- nausea, vomiting;
- frequent painful urination and urge to it;
- swelling in the limbs;
- general weakness;
- headache, muscle pain.
Chronic pyelonephritis, the symptoms of which in most patients erased, are often ignored. It is noted that:
- increased fatigue;
- weakness, lethargy;
- drowsiness;
- pain of unstable aching character from the side of defeat;
- malaise and increased pain after hypothermia, in wet weather;
- poor appetite;
- recurring headaches;
- frequent urination.
Temperature with pyelonephritis
The acute form of the disease and exacerbation of pyelonephritis is accompanied by an increase in temperature indicators, which can reach 38-40 ° C. Often the temperature jumps dramatically, accompanied by increased sweating, a change of heat and chills, a pronounced weakness. This indicates the intoxication of the body with the products of the disintegration of pathogens, which provoked the infectious process. After the start of treatment, the temperature drops, remaining for some time within 37-37.5 ° C.
Urine with pyelonephritis
If a woman develops pyelonephritis, urine changes its normal parameters, becoming turbid, sometimes - dark, acquiring a pronounced unpleasant odor. Often with the naked eye, it reveals inclusions of blood, sediment. During urination, marked, burning, soreness, many patients report such manifestations of the disease as urinary incontinence, frequent and false desires for emptying.
Pyelonephritis - diagnosis
To confirm the diagnosis of "pyelonephritis" in women, when the symptoms are pronounced and treatment is required immediately, an ultrasound diagnosis is prescribed. An experienced uuzist doctor will immediately detect pathological signs: uneven contour of the organ, increase in size, asymmetry, worsening of mobility, increased echogenicity of the parenchyma,
Indicative for this disease are laboratory tests, which reveal such indicators:
- a common blood test - an increase in ESR, leukocytosis ;
- general urine analysis - the presence of protein and bacteria;
- bacteriological analysis of urine - determination of the number and type of pathogens.
Another frequently used diagnostic method is urography. This is an X-ray study, which, in an acute process, does not give obvious signs of the disease, but with chronic course gives a picture of changes in the structure of the kidneys. If pyelonephritis is suspected in pregnant women, an X-ray examination is not carried out because of the risk of radiation exposure to the fetus. Other diagnostic methods may be prescribed less frequently:
- CT, MRI;
- kidney biopsy;
- pyelography;
- renal angiography, etc.
Pyelonephritis - treatment
How to treat pyelonephritis, the urologist or nephrologist will prompt after carrying out all necessary researches revealing features of course of illness. In severe cases, hospitalization is carried out. Often acute pyelonephritis treatment is conservative, based on medical treatment. In many cases, chronic pyelonephritis treatment is similar, but requires a longer duration.
Treatment of pyelonephritis - drugs
Carry out the treatment of pyelonephritis with antibiotics, which is the therapeutic basis. It is expedient to determine the sensitivity of causative pathogens to certain antibacterial drugs. Before receiving the results of the analysis, antibiotics for pyelonephritis are empirically prescribed, and often begin with drugs from the group of fluoroquinolones (Levofloxacin, Ofloxacin). In addition, antibiotics can be prescribed for treatment:
- aminopenicillins (Amoxicillin, Penicillin);
- cephalosporins (Cefalexin, Cefepime);
- aminoglycosides (Gentamicin, Amikacin);
- carbopenems (Imipenem, Meropenem);
- sulfonamides (Co-trimoxazole).
Dosing, treatment period, the route of administration of the drug is chosen individually. Also, pyelonephritis in women, the symptoms and treatment of which require a responsible attitude, is treated through the use of drugs from other groups:
- diuretics (Furosemide);
- non-steroidal anti-inflammatory drugs (Voltaren, Movalis);
- anticoagulants (Heparin, Troxevasin);
- vitamins, minerals (vitamins A, E, C, β-carotene, selenium, etc.).
Pyelonephritis - folk remedies
In addition to treatment, it is often recommended phytotherapy - the use of herbs and fruits that have antimicrobial, anti-inflammatory and diuretic effects. Treatment of pyelonephritis in women can be carried out with the help of decoctions of such plants:
- bearberry;
- yarrow;
- cranberry;
- rose hips;
- cranberries;
- chamomile;
- calendula;
- mint;
- a leaf of a birch and so forth.
Diet with pyelonephritis
Patients should know whether pyelonephritis can be used for certain products from the usual diet that are used before. Some dishes after pyelonephritis will have to be abandoned:
- spices, burning spices;
- smoking;
- pickling;
- baking;
- fatty foods;
- fried food;
- rich broths.
We recommend a vegetable-milk diet with the inclusion of eggs, lean meat and fish. The following vegetables and fruits are useful:
- potatoes;
- beet;
- zucchini;
- cucumbers;
- watermelons;
- apples;
- strawberries;
- melon;
- grenades, and others.