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?

Cystitis is a painful condition when due to the inflammation of the urinary bladder, an individual is unable to comfortably relieve himself/herself. Such conditions are often painful and cause irritation and frustration among the patients. But it should also be noted that cystitis is not an uncommon infection of the urinary tract and can be treated well. Furthermore, homeopathy tries to use the body s own defence to cure diseases and infections; thus this is a very natural form of treatment, which is used to cure cystitis.

The common symptoms of this disease include the urge to frequently relieve oneself, an increase in the number of times one goes to urinate, painful urination and at times all these are accompanied with vomiting and nausea.

Homeopathy treats the person as a whole. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homeopathic remedies for cystitis are selected after a full individualizing examination and case-analysis, which includes the medical history of the patient, physical and mental constitution etc. A miasmatic tendency (predisposition/susceptibility) is also often taken into account for the treatment of chronic conditions. The symptoms listed against each medicine may not be directly related to this disease because in homeopathy general symptoms and constitutional indications are also taken into account for selecting the homeopathic remedies for cystitis. 

Cantharis: When the main cause of your cystitis is an inflamed bladder, Cantharis is the best remedy. Such inflammations are often accompanied with burning sensations in the urinary tract apart from a frequent urge to relieve oneself. Cantharis seems to do wonders when it comes to treating any kind of inflammation or infection. As for the burning sensation, it provides immediate relief to this. It might take some time before the cystitis is completely cured with Cantharis, but at least the patient gets some relief, gradually leading to its complete cure. The urinary tract is a very sensitive area of the human body. Any infection or inflammation in the area should be dealt with carefully. Thus, an experienced homeopathic practitioner is the right person to come to your aid. Also, it needs to be seen first whether homeopathy suits you in general or not.

Apis Mellifica: Apis has more than one use when it comes to treating cystitis. First, it is seen that Apis helps in reducing pain and burning effect while urinating in this condition, which might give rise to corroded skin. Second, it is used to treat individuals of all ages. It can be administered in the right dosage to an infant who has problems in passing urine. It can also be given to young boys who have developed cystitis due to kidney infections. Moreover, it can be used to cure cystitis in any individual who is suffering from chronic inflammation of the bladder.

Thus, Cantharis and Apis are the two most effective homeopathic remedies to cure cystitis occurring in an individual. It is always recommended to consult a specialized homeopath before taking any medication.

How To Treat Cystitis With Homeopathy?

Treatment for Kidney stones varies depending on the size and type of the stone or the symptoms caused by it. In case of small stones, medication and simple changes in lifestyle can be enough to treat it, but surgeries and extensive treatments are required if symptoms are severe. 

Following are treatment options for kidney stones:

Small stones with minimal symptoms 
1. Drinking water
Drinking around 3 liters of water a day will regulate your urinary system and can effectively eliminate small stones. Unless your doctor advices otherwise, drinking ample amount of fluids, usually water, is one of the commonest way to get rid of small kidney stones. 

2. Pain relievers
There might be a considerable amount of pain and discomfort associated with passing the stone through urine. Your doctor may recommend pain killers like Ibuprofen, Naproxen sodium or acetaminophen. 

3. Medical therapy
In order to eliminate the kidney stone, your doctor may administer medical therapy. Medication like alpha blocker helps in passing the kidney stone with least pain and more quickly. It relaxes the muscles in the ureter and makes the process relatively easy. 

Large stones with severe symptoms
 
1. Using sound waves to break up stones 
In this technique, a procedure called Extracorporeal Shock Wave Lithotripsy (ESWL), is employed. ESWL uses the help of sound waves to create vibrations which breaks the stones in smaller pieces. This procedure takes about an hour and can cause mild pain and discomfort. Your doctor may administer sedatives to reduce your sensitivity. ESWL has side effects like blood in urine or bruising in the abdomen. 

2. Surgical removal of kidney stones 
Surgical removal of stones is done with the help of a procedure called nephrolithotomy. It uses small telescopes and other instruments which are inserted in your back through a small incision. It is generally done in case of large stones and when ESWL fails. 

3. Ureteric Calculi (Using a scope to remove stones) 
A thin illuminated tube called ureteroscope is used to remove a comparatively smaller stone in the kidney or ureter. The ureteroscope is equipped with a tiny camera which determines the location of the stone which is then broken into pieces with the help of other instruments. It may require general or regional anesthesia.

Treatments For Kidney Stones

It is an extremely embarrassing situation to have a bladder leakage. Social life could be altered, with reduced socialising for fear of losing control in the presence of others. Though not discussed frankly, it is an extremely common issue and about 25 million people in the United States suffer from this, with 75% of these being women.

Treatment depends on the type of incontinence, such as stress, urge, overflow, functional, or mixed. It starts with least invasive methods like lifestyle changes moving over to surgical approaches.

Ways to manage it

With trips to the toilet increasing considerably when you have urinary incontinence, simple measures can help manage leakage.

Bladder training: Train your bladder to control the urge for another 10 minutes. This happens by voluntarily contracting the muscles and holding up the urge to go to the toilet. Gradually, it will help increase the frequency of the visit to 4 to 6 hours.
Scheduled toilet trips: Whether or not there is an urge, visit the toilet every 4 to 6 hours.
Double emptying: Even after you have voided, force yourself to void one more time. The residual urine, which is almost always present in the bladder, also gets emptied.
Food/diet modifications: Stress incontinence is worsened by alcohol, spicy foods, acidic foods, and caffeine. Avoiding these can help reduce bladder leakage.
Kegel exercises: The simple repetition of contracting the pelvic floor muscles, holding it in place, and releasing it can do wonders for strengthening the pelvic floor. This can be done anywhere and any time of the day and is very effective for improving bladder control.
Catheters: These can be used if the incontinence is short-lived; the person would need to learn how to safely insert and remove it.
Absorbent pads and medical devices: The absorbent pads are helpful in preventing embarrassment during social situations. On the other hand, medical devices like pessary are inserted into the vagina to support the bladder neck and thereby prevent leakage from the bladder.
Drugs: Anticholinergics/antimuscarinics are useful to control a leaking bladder. Botox injections can help paralyse the overactive bladder muscles and provide a solution. Topical oestrogen may be used in small amounts to improve tone and reduce incontinence. Alpha blockers are also used in some people with good results. There are muscles that relax the bladder and increase the amount of urine it can contain.
Surgery: In the event that all these measures are not useful, surgical correction is possible. Sling procedure where an artificial mesh is used to support the urethra. Bladder neck suspension is where the bladder neck is given support to prevent leakage. If there is a pelvic organ prolapse, that is corrected to rectify the bladder leakage.

 Bladder Leakage - Solutions To Help You Manage It!

Often, early stages of kidney diseases do not come with specific signs and symptoms and most people will remain unaware of their condition. However, certain symptoms may be perceived that may indicate that a person is suffering from early stages of kidney failure. When you are diagnosed with kidney failure (also known as renal failure) in the initial stages, certain measures can be taken to retard the progression of the renal disease. This can also help reverse the condition and improve the quality of life of the patient. On the basis of a typical cause, the symptoms of kidney failure are grouped into specific categories that are given below. If you notice any of the specified renal failure symptoms, it is recommended to immediately fix up an appointment with your doctor and get your diagnostic tests done. 

Symptoms of Renal Failure from the accumulation of waste products in the body: 

Metallic taste in mouth 
Nausea and vomiting 
Facing difficulty in concentrating 
Loss of appetite 
Aversion towards meat (protein aversion) 
Itching or pruritus 
Symptoms of Renal Failure from the accumulation of fluid in the body: 

Dyspnoea or shortness of breath (this happens due to the accumulation of fluid in the lungs).
Swelling is seen in the feet, hands or face. 
Symptoms of Kidney Failure from damage to the kidneys: 

The amount of urine production changes, though it is not a reliable sign Haematuria or blood in the urine (usually in microscopic quantity). 
Frothiness or foam in the urine (usually happens when protein is present in the urine). 
Symptoms of Kidney Failure due to decreased blood production (anemia): 

Dyspnoea or shortness of breath. 
Fatigue Weakness. 
Confusion If you happen to feel cold all the time. 
The following diagnostic tests will be performed by your doctor in order to determine whether the symptoms are the manifestation of a kidney failure or not: 

Urine analysis - In this test, a sample of your urine is tested to find traces of blood, white blood cells or proteins which may indicate a problem in kidney function. 
Blood Tests - This includes tests for BUN and creatinine in the blood which are usually removed from the blood if the kidneys function properly. 
Actions must be taken when you show signs and symptoms of kidney failure: 

It is common that the symptoms of early renal failure are not always prominent, but if any of the above symptoms are witnessed, it is recommended to met a physician to determine whether they are caused by a kidney disease. You can pen-down the symptoms that you feel are related and bring it to the doctor when you fix up the next appointment. It is essential to know about your disease at the earliest as it will give you time and the ease of taking measures to retard the damage process and will decrease or delay the probability of undergoing dialysis or kidney transplant.

Kidney Failure - What Should You Know About it?

What you should know about urinary incontinence.

Urinary incontinence is the inability to hold urine in the bladder because of loss of control of the bladder. The severity may range from temporary to chronic, depending on the cause of this disease. Urinary incontinence is more common in women than men and can be categorized into three types.

Types and symptoms of urinary incontinence

Stress incontinence: this incontinence may occur while participating in any physical activity such as a sudden cough, laugh, sneezing or exercising. The stress here refers to the sudden physical pressure that a person experiences, leading him/her to urinate involuntarily.

Urge incontinence: a sudden, involuntary contraction of the muscular wall of the bladder causes an urgency to urinate. This urgency can be formed by a sudden change in position or sex.

Overflow incontinence: this is more common in men with prostate gland problems, damaged bladder or blocked urethra. The person has an urge to urinate frequently but in small amounts.

Causes of urinary incontinence

There are a number of causes of urinary incontinence ranging from aging to cancer and physical damage to the neurological disorder.

1. Aging: with age, the bladder muscle weakens and the chances of incontinence increases.

Damage: since the pelvic muscles support the bladder any damage to it (surgery or any procedure to remove the uterus) can lead to urinary incontinence.

2. Enlarged prostate: enlargement of the prostate gland in older men may give rise to this condition.

Cancer: urinary incontinence may be associated with untreated prostate cancer, which is a side effect of treatments for it.

3. Menopause: estrogen is a hormone that keeps the lining of bladder and urethra healthy. After menopause the production of estrogen is decreased, increasing the chances of urinary incontinence.

4. Prevention: urinary incontinence is not preventable but some steps can be taken to reduce the risk of it. Maintaining a healthy lifestyle, avoiding smoking, practicing pelvic floor exercises, avoiding caffeine and acidic foods and eating more fiber to prevent constipation can help decreasing the risk of it.


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Related Tip: Common Symptoms of Urinary Tract Infections Every Woman Should Know

What Makes One Lose Control of the Urinary Bladder?

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