Hunner's ulcers, simply put are painful ulcers in your urinary bladder. These ulcers are inextricably linked to another disorder called the painful bladder syndrome or intestinal cystitis. They occur in 10 to 15 percent of people with interstitia cystitis. These, in fact, are red patches or lesions on the bladder wall which can stiffen tissue and cause reduced bladder capacity. Hunner s ulcers bleed, ooze pus and can be of different sizes. The ulcers in the bladder can be extremely painful and uncomfortable.

These are called Hunner s ulcers because they were first described by Dr. Guy LeRoy Hunner, a Johns Hopkins gynecologist, in 1915. Since Hunner s ulcers are seen only in people with intestinal cystitis, it s important to know more about this painful life-altering bladder disorder before we can even understand how to deal with them.

Interstitial cystitis (IC)
IC is also called painful bladder syndrome. Another important thing to know about IC is that it strikes more women than men. IC is a chronic disorder and there s no cure for it. It causes recurring bouts of pain and pressure in the urinary bladder and the pelvic area. This is often accompanied by an urgent and frequent need to urinate. Sufferers may have to rush to the  loo  as much as 40, 50, or 60 times a day.

Diagnosis
Hunner's ulcers can only be accurately diagnosed by doing a cytoscopy which involves inserting a fibre-optic tube through the urethra to look at the bladder wall closely. During this procedure, a tissue sample from the bladder wall is usually also taken to rule out bladder cancer. Cytoscopy is usually done with hydrodistention under local anesthesia. This involves filling the bladder with a liquid for stretching it to provide a closer view of the bladder wall. Usually, a urologist performs this surgery along with a gynaecologist. IC and also Hunner s ulcers are both a diagnosis of exclusion. This means that they re diagnosed only after a number of other conditions have been ruled out.

Hence, the urologist will first take your thorough medical history, followed by a physical exam and a pelvic exam for women patients and perform tests for ruling out infection, and other disorders like bladder stones and cancer, kidney disease, multiple sclerosis, endometriosis, sexually transmitted diseases amongst others. Only after these tests are inconclusive or uncertain and if there is blood in urine, will the urologist go for cystoscopy.

Treatment
There's no cure for IC, but Hunner s ulcers can be cured by burning them off the bladder wall. Called fulguration, the process uses electricity or laser to burn the ulcers on the bladder wall. Resection is also used in which skin from around the Hunner s ulcer is cut for removing both the ulcer and the inflamed tissue around it. The problem is that ulcers may recur in the same location.
So, managing IC becomes critical. Your doctor can try to treat the patient with one treatment or with a combination of treatment depending on the condition of the patient.

Pain medicines are the first line of treatment to manage Hunner s ulcers and IC both, and many patients do go in for this. Patients also find relief by modifying their diet to remove foods and drinks like caffeinated beverages- tea, coffee, colas etc. Sodas, artificial sugars and fruit juices, especially Cranberry juice can trigger intense pain and discomfort, so these are usually contraindicated. Another important aspect is patient education about normal bladder function and tips on self-care and behavioural modifications like stress control to manage Hunner s ulcers.

Hunner's Ulcer In Urinary Bladder - How They Can Be Treated?

Causes of bladder control problems in women

Urinary incontinence is the term used to describe bladder control problems that affect several people. Many think it only occurs among older, menopausal women but it actually isn't uncommon amid young and active women.

Inability to control the bladder accompanied by pain can be symptomatic of various disorders ranging from a minor infection to cancer. Fortunately, bladder cancer is rare, and bladder pain is usually not serious.

The varied causes of urinary incontinence in women are as follows:

1) Urinary Tract Infection - This is the most common cause of urinary incontinence and it affects women more than men due to anatomical factors. It can also happen at any age.

2) Medicinal Side Effect: The inability to control one's bladder may be a result of the administration of certain medicinal substances such as alpha-blockers, antidepressants, sleeping pills and various narcotics.

3) Changes in the Reproductive System - Pregnancy and fluctuations in hormone levels can cause bladder irritation, which leads to urinary incontinence.

4) Impacted Stool - When stool gets tightly packed in the lower end of the digestive system and rectum, bladder control is affected. Chronic constipation and constraint strain on the lower intestines leads to the weakening of bladder muscles and hampers the bladder control.

5) Surgical Side Effects - Temporary loss of control of the bladder is often a result of prior surgery and radiation therapy in the pelvic region.

6) Nerve Damage and Neurological Disorders - Strokes and spinal cord injuries have a heavy impact on bladder control and amount to urinary incontinence. Diseases such as Alzheimer's disease, Parkinson's disease and multiple sclerosis also lead to the same.

7) Health Complications - Disorders such as diabetes and obesity directly affect the bladder and the ability to exercise control over it.

8) Disability and Impaired Mobility - For women who are physically impaired and suffer from problems of arthritis, urinary incontinence is a major problem as they are unable to reach the toilet easily.

9) Bladder Cancer - Even though it is extremely rare, bladder cancer affects a number of women every year and is treated through surgery and chemotherapy.



What Causes Bladder Control Problems in Women?

Bladder cancer is characterized by irregular growth of abnormal tissue (tumor) on the lining of the bladder. This type of cancer may spread to the surrounding tissues or other body parts as well.

What are the causes?

Bladder cancer can be caused by environment-related factors and smoking. In fact, smoking tobacco is one of the major causes of bladder cancer around the world. The chemicals present in tobacco can irritate the bladder lining which ultimately leads to bladder cancer. It may also be caused by continuous exposure to chemicals such as dyes or leather dust and radiation. These chemicals tend to cause unusual changes in the cells of the bladder lining and causes cancer in the bladder.

It can also be caused by modifications in the dna in the cells of the bladder which may impair the functioning of the cells in the body. This can cause mutations in the bladder resulting in cancer.

What are the symptoms?

1. Presence of blood in the urine, often painless

2. Feeling of pain while passing urine

3. Back pain

4. Excessive urination

5. Infections in the urinary tract

6. Lower leg swelling

7. Pain in the bones, especially in the pelvic area

8. Weight loss

Treatment options

Treatments for bladder cancer depend on the stage of the cancer. The various treatment choices are:

Surgery - In some cases, these cancers are surgically removed by a surgeon. A type of surgery used is transurethral resection of bladder tumor (turbt) where the cancer cells are destroyed with laser by passing a thin fiber into the bladder.

Chemotherapy - In this method, medications are used to target and destroy cancer cells.

Radiation therapy - Radiation therapy uses rays such as x-ray or uv rays to destroy cancer cells in the body

Immunotherapy - This treatment boosts the immune system of the body so that it attacks the cancerous cells in the bladder.

Causes And Symptoms of Bladder Cancer

Second hand smoke may cause bladder cancer. True or false? Take this quiz to know more. 

People with the highest bladder cancer risk are those who?
  Smoke heavily
  Started smoking at a young age
  Have smoked for a long time
  All of the above - Right
Smoking cigarettes enhance the chances of an onset of the bladder cancer. As per studies over one-third of all bladder cancer cases have a link with smoking. Smokers are at increasing risk of getting bladder cancer, which may be up to 4 times that of someone who has never smoked. People who smoke may reduce their risk of getting cancer by passing urine more often. However, there is not enough evidence to support that this is true for everyone. The more you stay away from cigarettes, the better it is.

Which type of chemicals present in cigarette smoke may cause of bladder cancer?
  Formaldehyde
  Carcinogenic chemicals - Right
  Hydrogen cyanide
  All of the above
Cigarette smoke contains carcinogenic chemicals which are harmful to our body and known to cause cancer. When tobacco smoke is inhaled, these cancer-causing chemicals are absorbed into the blood stream. When the blood passes through your kidneys, these chemicals may often get deposited in the urine. As the urine waits in the bladder to be expelled, these harmful chemicals damage the cells lining the bladder, increasing your risk of bladder cancer. Experts believe that healthy eating habits may help in preventing bladder cancer.

Second hand smoke may cause bladder cancer.
  True - Right
  False
The health risks brought on by cigarette smoking are not restricted to smokers. Exposure to secondhand smoke or environmental tobacco smoke significantly increases the risk of cancer in nonsmokers, as well as also a few respiratory ailments in kids. Secondhand smoke is a combination of the smoke that is discharged from the end of a burning cigarette and the smoke emitted from the lungs of smokers. You may use medical masks when going outside, to protect yourself from second-hand smoke.

Aryl-amines present in tobacco decreases the risk of bladder cancer.
  True
  False - Right
As per medical research arylamines such as benzidine, 2-naphthylamine, and 4-aminobiphenyl which are present in tobacco smoke are associated with increasing the chances of getting bladder cancer. Aryl-amines use both an early and a late-stage activity, compatible with a two-mutation theory of bladder carcinogenesis. You may consult your doctor to educate yourself about these harmful effects.

Quitting smoking is a critical step in preventing bladder cancer.
  True - Right
  False
Quitting smoking has major and immediate health benefits for men and women of all ages. Quitting smoking not only decreases the risk of bladder cancer but also reduce the risk of getting a heart attack or chronic lung disease. As per research people who quit before reaching the age 50 reduce their chance of dying by half for the next fifteen years compared with those who continue to smoke. Smoking low-yield cigarettes, as compared to cigarettes with higher tar and nicotine, provides no clear benefit to health. The earlier a person quits, the greater the health benefit.


Bladder Cancer - How Smoking Can Cause It?

A large number of women visit the doctor for common ailments like involuntary urination or incontinence, which occurs due to weakening of the sphincter muscles around the urethra. An overactive bladder is an embarrassing as well as an annoying condition and it comes in forms like urinary urgency, urge incontinence, nocturia and frequency. Yes, there are solutions to this problem and the main solution that can be adapted is a change in lifestyle.

Imperative tips to follow to treat an overactive bladder

It is very important that the diet pattern be changed and food items as well as drinks that worsen the condition be avoided.
It is best to avoid spicy food, especially those that contain hot peppers. Citrus fruits like grapefruit, orange and tangerine must be avoided; tomato products and tomato paste must be avoided.
It is also best to avoid alcoholic beverages and even drinks that contain caffeine.
It is important to maintain a healthy diet. To improve bladder problems, it is obligatory that food products that contain more fiber are included in the diet.
These fibrous food items could include whole wheat bread, fresh fruits, cereals and beans. To maintain bowel regularity, it is very important that women follow a regular exercise program.
Women must take charge of their treatment and it is most important that before taking any medication, they must make behavioral modifications. It is important to record the input of the fluid consumed as well as to keep a check on the number of times they urinate. Women must not only maintain a healthy weight, but also quit smoking. Smoking cigarettes can irritate the muscles of the bladder and excess coughing can lead to leakage of urine. Non-irritating fluids that can improve the bladder condition can be taken 3-4 times in a day; so it is best to avoid beverages that are acidic or caffeinated. The techniques that would help you to control an overactive bladder can be learnt under the guidance of a doctor to decrease the urge to urinate.

Consult your doctor for medications to treat an overactive bladder. Some doctors even prescribe certain medications to treat an overactive bladder and these include anticholinergics. These drugs help to control the muscle spasms, which mainly lead to an overactive bladder. The most common anticholinergics recommended by doctors are solifenacin, oxybutynin, fesoterodine, propantheline and dicyclomine.

Overactive Bladder - Is There A Solution?

Bladder stones, not to be confused with kidney stones, are formed when substances such as calcium oxalate found in urine coalesce into solid lumps and form deposits in the bladder. Though usually small enough to be excreted during urination, sometimes they get trapped in the neck of the bladder. In such cases, as the residues continue to grow larger, they cause extreme pain, infections, and may need surgical attention.

What causes bladder stones?
The most common causes of bladder stones are-

A diet which is high in oxalic acid can cause bladder stones.
Dehydration and a reduced intake of water cause bladder stones.
A protracted use of a urinary catheter, infections of the urinary tract, or an injury that might have impaired bladder function can cause stones to form.
Most often, stones originate somewhere else in the urinary tract and move downwards obstructing the neck of the bladder. There are significant hereditary factors at play here.
Symptoms-

Blood in the urine usually apparent only in the last few drops.
Interruption of the stream of urine and an inability to do so except in certain positions.
Dark-coloured urine.
Diagnosis-

1.Physical Exam
The physician will physically examine to evaluate if the bladder or the rectum are enlarged.

2.Urinalysis
A sample of your urine will be tested for the presence of bacteria, blood and crystallized minerals.

3.CT scan
A CT scan to build a detailed image of the internal organs.

Treatment-

If the size of the bladder stones is small then a simple increase in water and fluid intake should be enough to excrete them out naturally.
If they are too large to flush out from the system naturally, they will either be broken down to smaller sizes using laser ray or similar other energies, or surgically removed.
In order to prevent bladder stones from recurring, here are 5 foolproof methods-

1.Increase the daily fluid intake
A sure-fire way to prevent bladder stones is to increase the amount of water you drink every day. The idea is to reduce the concentration of your urine. A minimum of 2-3 litres of water per day is absolutely necessary.

2.Urinate more often.
If you drink more water throughout the day, you are going to have to urinate more frequently anyway. Do not put it off because you are worried that you will be mocked for having an old lady s bladder.

3.Laxatives.
If you feel like you are constipated, use a laxative. There is no shame in wanting to regulate your bowel movements.

4.Regular Tests.
Get a sample of your urine tested regularly to ensure that your kidneys and bladder are functioning properly and there are no irregularities.

5.Eat fruits.
Get the essential sugar component of your diet from fresh fruits. Say no to saturated sugar and fizzy drinks. Opt for fruits with high water content like melons to add more fluids in your diet.

5 Full-Proof Methods To Prevent Bladder Stones!

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