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?

What is Diabetic Nephropathy?

Diabetic nephropathy (Diabetic Kidney Disease) is defined as the progressive damage to the kidneys caused by diabetes. It is characterised by the scarring of the glomeruli in the kidneys due to prolonged diabetes mellitus.

What Causes Diabetic Nephropathy?

Diabetes is a condition characterized by high concentration of blood sugar. Although the cause of Diabetes Nephropathy is not yet well defined, it is likely that the high sugar levels in the blood damage the blood vessels present in the kidneys that help to filter waste products, thus resulting in decreased kidney function and ultimately, kidney failure.

Not everyone with diabetes suffers from diabetic nephropathy. Although, factors that can increase your chances of getting diabetic neuropathy are-

Smoking

Poor control of blood glucose

High blood pressure

History of kidney diseases

What are the symptoms of diabetic nephropathy?

In the early stages, there may be no symptoms at all, but as the disease progresses, you may notice swelling in the extremities like your feet. Thus it is recommended to get your blood albumin levels tested on a regular basis. If it is diagnosed in early stages, the damage can be reversed. Other symptoms that can indicate damage to the kidneys are-

Severe malaise

Headaches

Nausea

Lack of appetite

Frequent voiding

Itchiness of skin

General feeling of illness

Diagnostic tests that can confirm diabetic nephropathy are-

Routine urine test (urinalysis) - Kidney diseases are detected by the presence of a protein in the urine called albumin and this condition is called albuminuria. Other parameters that must be regularly monitored are-

Blood pressure

Cholesterol levels in your blood

How can you treat/ manage diabetic nephropathy?

If this type of nephropathy is diagnosed in the early stages, the damage to the kidneys can be reversible. The key to managing diabetic nephropathy are-

Diet: Reduce the dietary intake of salt, phosphorous and potassium in the advanced stages.

Glycemic Control: Monitor your blood glucose levels regularly

Management of Hypertension: It is important to manage your blood pressure as it can have a direct effect on the coronary blood vessels which in turn pump blood to the various blood vessels of the body

Renal Replacement Therapy: In chronically ill patients, renal replacement therapy is the best option. This can include haemodialysis (a procedure to flush out toxins from the blood, such as urea), peritoneal dialysis or ultimately renal transplantation.

Diabetic Nephropathy - Causes, Symptoms and Treatments

A dialysis diet is a special diet that is customized for patients who are or will be starting dialysis within a short period of time. Such a diet is prepared to reduce the waste and fluid levels that keep on accumulating between the dialysis sessions so that the patient remains healthy for the process to be carried out seamlessly.

What can you eat?
Eat foods which are rich in high-quality proteins (poultry, fish, lean meat and egg whites).

What can t you eat?
Eat less of foods which are rich in sodium and phosphorus.

Foods high in Sodium
1. Use minimum salt in preparing the dishes; this helps control BP and probable weight gain that might happen between the dialysis sessions.
2. Make use of spices, herbs and other salt-flavored enhancers.

Meat
1. Patients on dialysis need to include more of high-quality protein foods in their diet. This will help regulate blood protein levels. Eat about 10 ounces of foods rich in high-quality protein every day.
2. 1 egg,   cup of ricotta cheese,   cup of tuna.

Salads/Vegetables

The potassium content of vegetables can be alarming for a patient on dialysis. Eat 3 servings of vegetables that are low in potassium every day. These include broccoli, cauliflower, cabbage, carrots, garlic, cucumber, eggplant, celery, radishes, etc.
Avoid vegetables such as beets, potatoes (in any form- wafers or wedges), winter squash, cooked spinach, pumpkin, asparagus and avocado.
Note:

Although seeds, nuts, peanut butter, lentils, dried beans and peas are rich in protein, they are generally struck off from the diet plan because of their high phosphorus and potassium content.
You can have moderate amounts of grains, bread and cereals.
Try and not have brown bread and other whole grains as they are loaded with phosphorus.
Usually, 5-10 servings of these are considered sufficient for patients on dialysis.
Also, limit intake of milk and other dairy products.
  cup yoghurt or   a cup of milk is considered safe. Also, remember that all varieties of milk- skim, whole and low fat, have the same amount of phosphorus.
All fruits contain some amount of potassium. However, some of them contain more potassium than the others. Limit your intake of fruit juices.
Avoid or limit fruits like: 
Orange juice and oranges
Kiwis
Prune juice and prunes
Dried fruit and raisins
Melons
Bananas

Dialysis - What To Eat & What To Avoid?

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?

When your kidney function falls below a certain point, it is referred to as a kidney failure or renal failure. Fortunately, you can still continue to lead a normal life with the right treatment for renal failure. Here are the three best treatments that you can choose depending on your condition and lifestyle:

1. Dialysis: Dialysis is the process that takes over the function of your kidneys to filter out the waste from your blood and maintain the proper balance of chemicals in the blood. You may use dialysis for many years or as a short-term treatment while waiting for a kidney transplant. Dialysis is not a cure for kidney disease, rather it helps you deal with renal failure. It is life-saving and without it, the kidneys will no longer function.

There are two types of dialysis treatments that you can choose from:

Hemodialysis   This type uses a machine to remove waste from the blood and sends it back to your body. It can be done at home or at a dialysis center.
Peritoneal Dialysis   This type uses the lining of your belly called the Peritoneum to do the work of your kidneys. A catheter and dialysis solution is used to carry out the function.
There are benefits and complications for each type of dialysis. The treatment decision will largely depend on the patient s illness and their past medical history. Discuss with your doctor to decide the best option for you.

2. Kidney Transplant: Kidney transplants can provide a better quality of life than dialysis and can be seen as a potential cure for kidney failure. A healthy kidney from a live donor or deceased donor is surgically placed in your body as a replacement to the failed kidneys. Although this may be a better option for you, it has certain shortcomings. There is an element of rejection and you may have to wait for a long time to get a donor. Extensive testing and anti-rejection medications are prescribed with this treatment.

3. Palliative Care: Rather than cure, it is the care that people with serious illness need. With so much to deal with, the patients have an array of tough questions and challenges to deal with. Patients need to take into account all medical options and care options based on their condition and severity of the renal failure.

Making the right treatment choice is difficult and that too when you are ill. It is normal to be fearful and worried about the risks involved. Get support from your family and doctor to help you make the right treatment choice. It may also be helpful to visit a dialysis or transplant center to talks to others who have been through these treatments.

3 Best Treatments for Renal Failure!

Kidneys are an important part of the human body. From filtering wastes from the blood to maintaining the blood pressure and red blood cell count in the body, the kidney does it all. Both the kidneys are essential organs and should there be any discomfort in the kidneys, one should consult a medical practitioner as soon as possible. Kidney failure is a common problem in people. This issue manifests itself with certain signs and symptoms. One should listen to these symptoms and act quickly before the condition worsens. Here are some of the signs and symptoms of kidney failure.

Interestingly, in the initial stages, kidney failure portrays no symptoms. It starts developing slowly and steadily causing discomfort in other parts of the body and hindering the working of other organs.

Weakness: If you are suffering from kidney failure, you will start feeling weak. Weakness is however not a symptom which can confirm a kidney failure. Weakness is caused due to many other health issues and thus, you need to verify with other symptoms to be sure of the fact that you are suffering from kidney failure only.

Shortness of Breath: You may start experiencing heavy breathing right after doing some rigorous work. In fact, you might feel shortness of breath or be panting for long moments after climbing just a set of stairs. Shortness of breath is quite common indicating that the body is getting tired after doing work. Such indication, more than once a day, calls for an immediate check up of the body.

Lethargy: While most people, especially the young generation to those in the early thirties jokingly declare themselves as lazy people; lethargy, however, is a symptom of many diseases. Various health issues develop if you feel lethargic of working. Apart from kidney failure, diabetes is also manifested in lethargic body movements. At times, just getting out of the bed in the morning seems very tiring and one continues to lie on the bed even after he/she is fully awake.

Stomach Pain: If you experience pain in the stomach, especially in the sides, then it should be immediately checked by a medical practitioner. Doctors say that kidney failure can bring about stomach pains.

Unusual Urine Discharges: This would include clear urine discharges which indicate that the kidney has stopped filtering the waste products.

Thus, these are some of the most important and common symptoms of kidney failure. If you notice any of these, it is advised to visit a doctor for a check up.

Symptoms of Kidney Failure

Don't wait any longer, manage your Home Hemodialysis Nurse online with a Lybrate doctor today

Consult for Home Hemodialysis Nurse - Online and Easy!

FilterClear All

COMMON SPECIALITIES

COMMON ISSUES