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?

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

The kidneys make urine, which is a fluid through which wastes from the body including urea are eliminated from the body. There are two kidneys on the right and left side, which make urine, and pass it down to the bladder through tubes known as ureter. The bladder acts as a reservoir of the urine that is formed in the kidneys. It is stored temporarily there before being excreted out of the body through the urethra. The urinary bladder is a highly muscular organ and has a rich connective tissue. 

Interstitial cystitis (IC) or painful bladder syndrome (PBS) is a very common condition, which affects females more than males. While the exact etiology is not known, it could be age-related and also lifestyle related. People who are used to controlling the urge to pass urine are highly likely to develop this condition. The simple logic is that there is additional pressure on the bladder from the urine that is contained for longer period of time. As such, the muscular wall stretches and begins to feel stressed.

When this habit continues over a period of time, the bladder wall may become irritated or inflamed or even scarred in severe cases. There is no role of bacteria in this condition, and antibiotics are of no help in managing this condition (though the name cystitis usually indicates infection).

The following symptoms are seen as a result of this constant irritation and inflammation.

One may suffer from pain and pressure in the bladder as it continues to collect more and more urine.
This pressure in the bladder also puts pressure on the surrounding tissues in the abdomen including the pelvis, urethra, abdominal organs, uterus, etc.
Women may experience pain in the vaginal tract including vulva and behind the vagina.
Men may experience pain in the area of the scrotum, testicles, prostate, and penis.
There is an increased urge to urinate, which may be as much as 9 to 10 times a day. As the condition progresses, there could be more visits, as many as 40 to 50 visits a day.
This tendency and urge to urinate increases during nighttime.
For women, this urge to urinate and other symptoms including pain are worse during menstruation.
There could be pain during intercourse for both men and women.
There could be pain even otherwise, which can range from a mild dull ache to a piercing pain.
At a structural level, this constant pressure leads to pinpoint bleeding (glomerulations) and sometimes even ulcers in the bladder wall.
There is no definitive treatment for IC or PBS. However, bladder distention and instillation are proven methods of increasing bladder capacity, which therefore helps in relieving symptoms.

Painful Bladder Syndrome - Know The Signs!

Cystitis is a condition which is characterized by bladder inflammation that is usually a result of bladder infection. This disorder is very common among women. The condition tends to get better in a few days without any treatment. In case of chronic cystitis, long term treatment may be required.

Symptoms
Common symptoms include excessive urination (may be dark in color) and a burning pain during urination. One might feel generally unwell, tired and may experience cramps in the lower abdomen. In case of children, there may be a rise in the body temperature, coupled with weakness and vomiting.

Causes

Engaging in sex (irrespective of whether one is using protection or not) can result in this condition.
Inserting objects such as tampons into the urethra to release the bladder can most definitely result in this condition.
Using contraceptive measures such as diaphragm.
It occurs when bacteria which is present in the bowel or on the skin comes in contact with the bladder via the urethra. Women are at an increased risk as their urethra is shorter and the anus is close to the urethra.
Homeopathy and Cystitis
Homeopathy is a system of treatment that is natural and holistic. It does not have any side effect like the other conventional treatments. The various homeopathic remedies for cystitis are  

Cantharis: Cantharis is a homeopathic remedy that is very effective in treating infections. In case of bladder inflammation and pain while urinating, this remedy is preferred. For cystitis with an inflamed bladder as the root cause, this remedy is very effective.
Apis Mellifica: In case of chronic bladder infection, Apis Mellifica is administered. It cures the inflammation and also gets rid of the swelling. This also helps in relieving any burning symptom that you may experience while passing urine.
Staphysgaria: Staphysgaria is a homeopathic remedy which is used to treat symptoms of cystitis that include a sharp pain in the urethra accompanied by involuntary discharge of urine. There may also be a constant urge to urinate.

Bladder Inflammation - Effective Homeopathic Treatment for 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?

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