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?

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!

Kidney is the most vital organ in the body as it eliminates the waste material from our blood. When kidneys fails to carry out its work effectively the waste materials gets accumulated in the blood and end up with many serious disease condition that affects the other vital structures in our body. The function of the kidney is carried out artificially by an external device called dialyser to purify the blood and remove the waste products from it. This procedure is called as dialysis. There are two types of dialysis they are haemodialysis and peritoneal dialysis. In Haemodialysis, the waste products are removed from the blood and there by the fluid and electrolyte balance is maintained.

Things a person should follow if they are undergoing haemodialysis

Love your heart: Patients undergoing dialysis are at more risk of getting cardiac problems. So it is best advised to follow few of the following measures to take care of their heart
Keep your blood pressure and cholesterol levels under control
Quit smoking
Reduce stress
Have healthy low fat and heart friendly diet
Get regular physical activity but avoid excessive strainers activity that may require extra effort from your heart
Maintain a healthy weight
Diet: Dialysis not only removes the waste matters from your blood but sometimes also the essential electrolytes and nutrients. Protein, potassium sodium and phosphorus are the major things that are to be noted.
Encourage the patient to take high quality protein rich foods like meat, fish, milk, egg and chicken which is essential to improve your muscle strength and immunity.
Have a check of your sodium level and take sodium rich foods accordingly, as excess sodium may increase the fluid intake.
Limit your fluid intake: Use ice cubes instead of water or use small cups of water. Make sure you measure every sip of water you take.
Don't Overeat: Slow down while eating and stop eating when you feel full. don t over load your stomach

Haemodialysis - 4 Things a Person Must Follow if Your Undergoing it

No Blood, No needle, No visit to hospital, you can do yourself at home with water. A thin layer of transparent screen like structure hangs in front of the abdominal muscles known as peritoneum. This peritoneum protects the abdominal structures and the muscle. This can also be used for performing dialysis which is carried out when the functioning of kidney gets affected. In peritoneal dialysis a thin and soft catheter is placed in the person s belly one week before performing the procedure.

The catheter has numerous holes in order to facilitate the transformation of fluids. Dialysis solution is prepared in a bag and the tubing is connected to the catheter placed in the abdomen thereby, the fluids absorb the waste materials from the body. The fluid is allowed to stay in your body for a particular period of time which is commonly referred as dwell time and later the fluid is drained out.

There are two types of peritoneal dialysis, continuous ambulatory peritoneal dialysis and automated peritoneal dialysis. This is the simple form of dialysis which anybody can perform after a short training period and this can be done anywhere in clean private place like hotels, home and even in office.

Procedure followed during Peritoneal Dialysis
All you need to perform a peritoneal dialysis is catheter and transfer set, cycler, dialysis solution and safety precautions materials to stay away from getting infections.
Step 1 - Perform a sterile aseptic technique. Wear a glove and surgical mask before connecting the catheters and transfer set. Clamp the tubing and remove the catheter once the dialysis solution enters your abdomen
Step 2 - Allow the solution to remain in your abdomen for a particular period of dwell time
Step 3 - Drain the fluid from the abdominal cavity into the drain bag. You may feel a mild tugging sensation when adequate amount of fluid is drained.
Step 4 - After drain close or clamp the transfer set and later flush a fresh solution directly to drain bag so as to remove the air from the tubing.
Step 5 - Close your drain bag and open your transfer set and refill your belly with fresh solution.

Make sure you perform without giving way for infection and excess fluid and dextrose absorption.

Peritoneal Dialysis - Procedure to be Followed!

An overactive bladder is a condition that is characterized by a problem in the bladder storage function; a problem that eggs one on to urinate frequently. This condition can cause problems in your social and work life. You may isolate yourself from others and feel embarrassed about the situation.

Symptoms
If you have an overactive bladder, you may exhibit symptoms of frequent urination, involuntary leakage of urine and frequent urge to urinate. These symptoms might disrupt your daily life; so it is important to seek advice from a medical practitioner.

Causes
To better understand what causes an overactive bladder, you need to know how the urination process works. Urine is produced by the kidneys, which flows to the bladder. During urination, the urine is excreted from an opening in the bladder and flows out via the urethra. As the kidneys secrete urine, the bladder starts to fill up. During this stage, nerve signals are sent to the brain; signals that trigger your body to urinate. The bladder muscles tighten that pushes the urine out of the body.

An overactive bladder results from the involuntarily contraction of the bladder, which might happen even if the content of urine in the bladder is low. These contractions create the urge to urinate. The various causes of an overactive bladder are:

Excessive fluid intake, if your fluid intake is high, then you may have the tendency to urinate frequently.
Presence of tumors or stones in the bladder can make the bladder overactive as well.
Excessive alcohol or caffeine consumption has the same effect as an excessive intake of fluids has.
Urinary tract infections may interfere with the entire process of urination, thus causing your bladder to swell up and become overactive.
Other diseases and conditions such as constipation and an enlarged prostate can hamper bladder functioning.
Treatment
There are multiple approaches to treat an overactive bladder; your doctor may use one or a combination of multiple methods.

Medications: Medications such as Trospium and Tolterodine help in relaxing the bladder. These medications help treat symptoms of frequent urination.
Bladder injections: Botox is a protein that is injected into the bladder that causes partial paralysis of the bladder muscles. This helps in treating the constant urge to urinate. However, its effects are temporary as they last for 6-9 months.
Lifestyle modifications: Certain lifestyle modifications such as incorporating exercises to strengthen the pelvic muscles, maintaining optimal weight levels and bladder training to control its functioning can help with managing an overactive bladder.
Surgery: If the other treatments do not produce the desired results, then surgery is usually recommended. The aim of the surgery is to enhance the storage capacity of the bladder and reduce bladder pressure.

Frequent Urination - Is It A Symptom of An Overactive Bladder?

Located right under the rib cage, kidneys are a very important organ of the body. They are not only responsible for purifying your blood from wastes and excess fluid but are also involved in maintaining electrolyte balance, regulating blood pressure and producing red blood cell in the body.

In many cases, due to some medical condition, one or both kidneys may stop functioning properly. If not treated in time, it may lead to complete kidney failure and if the kidneys fail completely, dialysis or transplant may be the only treatment options available.

Dialysis is a treatment in which the blood is filtered and purified artificially using machines. This process is beneficial for those whose kidneys are not able to do their job properly.

Need for dialysis

A functioning kidney prevents the accumulation of excess water, impurities, and wastes inside the body. They also work to maintain the blood pressure level and control the presence of certain chemicals like sodium and potassium.

When the kidneys fail to perform these critical functions, maybe because of some disease or injury, dialysis helps to keep up the healthy functioning of the body as much as possible. As without dialysis all the wastes and fluids will accumulate and poison the body, resulting even in death. However, it must be kept in mind that dialysis is not a cure for kidney diseases; it is just an alternative to their functions.

Types of dialysis
Dialysis is an artificial process of purifying your blood using machines. There are two types of dialysis:

Hemodialysis
This is one of the most common types of dialysis, where an artificial kidney, known as a hemodialyzer, is used to remove waste and chemicals from the blood. The doctor surgically creates a vascular access into the blood vessels allowing the artificial kidney to perform.

Peritoneal Dialysis
This is a surgical procedure, where a catheter is implanted in the belly area. The treatment involves a special fluid called dialysate which is flowed into the abdomen to clean the blood. Once the blood is cleaned, the fluid is drained from the abdomen. The benefit of this treatment is that you can perform it in your home, without going to a hospital.

Risks in Dialysis
Even though either of these two treatment procedures is life-saving and there is hardly any alternative, these two can also come with risks. The risks include peritonitis, abdominal muscle weakening, high blood sugar level, weight gain, low blood pressure anemia, muscle cramping, insomnia, itching, depression, increased potassium level and pericarditis. If you experience any of these symptoms of the risks involved, then immediately consult your doctor and explain in details.

A patient who is going through dialysis for a long time also has a chance of succumbing to the medical condition called amyloidosis. When the amyloid proteins, which are produced in bone marrow, collects in kidneys, hearts, liver and other organs, amyloidosis occurs. This results in joint pain, stiffness and even swelling. 

Dialysis May Save Your Life!

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