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?

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?

Urinary Tract Infections are a group of diseases that affect one s urinary system such as the urethra, bladder, ureters or kidneys. Women are more prone to contracting UTIs than men. They may be accompanied by symptoms such as a constant urge to urinate frequently along with a burning sensation in the concerned parts and pelvic pain. The urine may have traces of blood in it. These infections are usually treated with antibiotics.

Causes behind Urinary Tract Infection:

Urinary Tract infection generally occurs when the bacteria enter the urinary tract via the urethra and begin to proliferate in the bladder. Although the urinary system is structured to ward off such invaders, at times, the defense mechanism fails. In that case, the bacteria may evolve into a full-blown infection in the urinary tract.

Few risk factors are:

Female anatomy: A woman s urethra is shorter as compared to a man s, thus lessening the distance the bacteria need to travel to the bladder. This increases the chances of UTIs in women.

Using diaphragms and spermicidal agents for birth controls

A dip in the levels of estrogen post menopause

Abnormalities in the urinary tract that hinder the discharge of urine or cause the urine to travel back into the urethra.

Enlarged prostate or kidney stones that cause the urine to be trapped in the bladder.

An impaired immune system because of diabetes and other ailments

Using catheters (tube) to urinate is one of the common risk factors because of the chances of infections.

Urinary Tract Infection - Reasons behind It

A bladder infection is a bacterial infection within the bladder. Some people call a bladder infection a urinary tract infection (UTI). This refers to a bacterial infection anywhere in the urinary tract, such as the bladder, kidneys, ureters, or the urethra. While most cases of bladder infection occur suddenly (acute), others may recur over the long term (chronic). Early treatment is key to preventing the spread of the infection.

What causes Bladder Infection?
Bacteria that enter through the urethra and travel into the bladder cause bladder infections. Normally, the body removes the bacteria by flushing them out during urination. Men have added protection with the prostate gland, which secretes protective hormones as a safeguard against bacteria. Still, sometimes bacteria can attach to the walls of the bladder and multiply quickly. This overwhelms the body s ability to destroy them, resulting in a bladder infection.
Bacteria that enter through the urethra and travel into the bladder cause bladder infections. Normally, the body removes the bacteria by flushing them out during urination. Men have added protection with the prostate gland, which secretes protective hormones as a safeguard against bacteria. Still, sometimes bacteria can attach to the walls of the bladder and multiply quickly.

Other factors can increase the risk of bladder infections for both men and women. These include:

Advanced age
Insufficient fluid intake
Surgical procedure within the urinary tract
A urinary catheter
Urinary obstruction, which is a blockage in the bladder or urethra
Urinary tract abnormality, which is caused by birth defects or injuries
Urinary retention, which means difficulty emptying the bladder
Narrowed urethra
Bowel incontinence
Pregnancy
Diabetes
Symptoms for Bladder Infections

Cloudy or bloody urine
Urinating more often than usual
Foul-smelling urine
Pain or burning when urinating
A frequent sensation of having to urinate, which is called urgency
Cramping or pressure in the lower abdomen or lower back
Bladder infections can also cause back pain. This pain is associated with pain in the kidneys. Unlike muscular back pain, you might experience pain on both sides of your back or the middle of your back. Such symptoms mean the bladder infection has likely spread to the kidneys. A kidney infection can also cause a low fever.

Bladder Infections - Decoding one of the Most Common Gynae Problem in Women

An overactive bladder is marked by problems with one s bladder storage system that results in sudden urge to urinate. Involuntary and leakage of urine is also a possibility in such a case.

The problem of an overactive bladder arises when the muscles of the bladder contract involuntarily. The conditions contributing to overactive bladder are:
1. Excessive production of urine due to diabetes, poor kidney function or excessive fluid intake
2. Medications that increase urine production by the bladder
3. Acute infections in the urinary tract
4. Abnormalities in the bladder, for instance, bladder stones or tumors
5. Factors hindering bladder outflow such as constipation, enlarged prostate or earlier treatments for incontinence (loss of bladder control)
6. Excessive intake of alcohol or caffeine
7. Decline in one s cognitive abilities due to factors such as ageing, thus making it hard for the bladder to comprehend the signals it gets from the brain
8. Incomplete emptying of the bladder, leaving only a little storage space for the urine
9. Constipation
10. Neurological disorders

How it can be treated?

Behavioral interventions help to manage overactive bladder effectively and without side-effects. They include-
Exercises to strengthen one s urinary sphincter and pelvic floor muscles
Maintaining a healthy weight
Regulating fluid consumption
Planning a schedule for trips to the toilet
Employing a catheter to empty the bladder entirely
Medications to alleviate the symptoms of incontinence and overactive bladder are-
Fesoterodine
Mirabegron
Darifenacin
Solifenacin
Trospium
Oxybutynin gel
Oxybutynin as a skin patch
Tolterodine
Injecting small doses of Botox (Botulinum toxin), protein-bacteria, directly into the bladder tissues to partially paralyze the bladder muscles, thus delaying urination.
Surgery to magnify bladder capacity
However, it is a must that you seek the guidance of a urologist on immediate basis. 

Overactive Bladder - Can Infection in Urinary Tract Lead To it?

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?

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