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?

Acute kidney failure is the kidney's inability to filter waste from the blood. As soon as the kidney loses the filtering ability, a humungous amount of body waste gets accumulated in the kidney and the chemical makeup of the body goes out of balance. Kidney or renal failure can progress tremendously from hours to days. This is a condition that is mostly witnessed in critical patients who are already hospitalized. This condition can prove to be fatal but can be reversed with treatment and medication. Here is a list of things one should do whilst suffer from kidney failure:

Lifestyle and dietary adjustments
During the phase of recovery, the medical team might assist a patient to go a special diet and limit the activity of the kidney so that they get the required time to heal. A nephrologist often routes this cases to a dietician or carefully analyses the present diet to lock up on the diet required for a speedy recovery:
Lower amount of potassium in food: Food with low potassium content is often recommended by the doctor. It ensures that kidney does not stress itself. Foods to avoid include spinach, bananas, oranges, tomato and potato. Some of the foods that need to be included in the diet are cabbage, strawberries, apples and grapes. Furthermore, food must be consumed in small quantities but in multiple servings.
Limit the amount of phosphorus in food: Phosphorus is found in abundant quantities in food items such as peanut butter, milk, dried beans, cheese and nuts. Along with skin itchiness, phosphorus can weaken the bone as well. A dietitian might share special instructions on how to cut down the amount of phosphorus and the substitute food to counter the effect of the above-mentioned ones.
Avoid salty products: It is extremely necessary to cut down food items that contain an excess amount of salt in it. Food products such as the canned soup, frozen dinner, and fast food are the major culprits in worsening the condition. Processed meats and cheese are equally bad.

Preventive measures to avoid kidney failure:

OTC pain medications: It is necessary to check the label of over the counter pain medications. Consumption of too many OTC medications can result in kidney failure. A pre-existing kidney condition can further aggravate this condition.
A healthy lifestyle: A sensible lifestyle with simple diet can do wonders for a kidney to be healthy in the long-term. Some of the other things to keep in mind include doing regular exercise, refrain from alcohol or drug abuse and remain active throughout the day.
Consult a doctor: Even a hint of a kidney problem should be discussed with a doctor to ensure that even the smallest of problems can be addressed at the earliest. 

Acute Kidney Failure - What Should You Do In Such A Case?

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

Severe disorders in one or more kidneys can be debilitating since the quality of life is severely affected. If you suffer from such a condition, you may already be undergoing dialysis. But, have you considered kidney transplant yet? 

Here is a look at some benefits of kidney transplant over dialysis.

1.Increased life expectancy

You may not know this, but dialysis restricts your life expectancy. For instance, a person undergoing dialysis at 30 will have a life expectancy of 15 more years. However, with a transplant, you can go on to lead a full life. The same 30-year old person will have a life expectancy of 30 additional years in case of a transplant from a brain-dead donor. If the donor is a healthy individual, life expectancy may extend to 40 years as well.
Therefore, if you want to live longer, you need to seek a kidney transplant.
2. Enhanced quality of life
Not only does severe kidney disorder mean relying on dialysis, but it also imposes other major restrictions in regards to diet and lifestyle. However, the kidney transplant is a more permanent solution to the problem. Once the transplant is completed and you recover from the surgery, you can resume a normal life. Additionally, some of the dietary restrictions are also lifted in such a case. 

Why dialysis is more common?
Dialysis is more common for the following reasons-
    The kidney to be transplanted may not be readily available. You would be placed on a list and it may take a while for a suitable kidney to arrive. During this period, you would need to undergo dialysis.
    Since dialysis is a minimally invasive procedure, it is often preferred by patients. However, kidney transplantation is better in the long-term.



Why Should You Opt For Kidney Transplant Instead Of Dialysis?

3 Causes of Acute Kidney Failure

You're said to suffer from the problem of acute kidney failure if your kidneys suddenly stop working and lose their ability to eliminate waste materials including excess fluids and salts from the blood. The condition usually develops quickly over a few days or even a few hours. When this happens, waste materials accumulate in your blood, disrupting the chemical balance of your bloodstream.

So, what causes this problem?

Acute kidney failure can occur because of any one of these reasons:

1. A drop or slowdown of blood flow to the kidneys - Adequate blood circulation to the kidneys is of great importance as without it the kidneys may end malfunctioning. If blood flow to the kidney is hampered, a part of or the entire kidney may die. You may suffer from acute kidney failure if blood flow to the kidneys gets impaired due to conditions like

-Heavy blood loss
-Sepsis (body's inflammatory reaction to an infection, which can bring about organ failure, tissue damage, and death)
-Injury
-Use of certain drugs
-Dehydration
-Burns
-Heart disease

2. Urinary obstructions - A sudden blockage that hampers your kidney's ability to eliminate urine can also bring about acute kidney failure. When this happens, it leads to a build up of toxins in the body, causing an overload of the kidneys. Conditions that bring about this urinary obstruction include:

-Cervical cancer
-Colon cancer
-Bladder cancer
-Kidney stones
-Enlarged prostate
-Prostate cancer

3. Disease within the kidneys - Even instances of clotting within the blood vessels of the kidneys can lead to acute kidney failure. This is because if the movement of blood cells within the blood vessels gets hampered, kidneys are not able to filter out toxins from the body. The conditions and diseases that may cause clotting, and subsequently damage to the kidneys include:

-Scleroderma (an autoimmune disease that affects connective tissues and skin)
-Build-up of cholesterol deposits
-Glomerulonephritis (an inflammatory condition of the kidney's ball-shaped structures called glomeruli)
-Hemolytic uremic syndrome (a condition that occurs due to untimely death of red blood cells)
-Lupus (a disorder of the body's immune system that brings about damage to the body's own organs and tissues)



3 Causes of Acute Kidney Failure

Most people would panic on seeing slightly red urine being passed. A common urologic condition, this happens because blood cells are leaking into the urine. There are multiple reasons which can cause it, and not all of them are major causes for concern.

Read on to know more about some common causes, and how to manage this.

Urinary tract infections: There could be an infection of the entire urinary tract including the kidneys, the ureters, the bladder, and the urethra. In addition to blood in the urine, there could also be an urge to urinate, pain with urination, fever, and flank pain.
Enlarged or infected prostate: The prostate naturally enlarges with age and can obstruct the urethra, causing pain and blood in the urine. There is a constant urge to urinate and difficulty initiating the stream. Infection of the prostate also produces similar symptoms along with fever and pain.
Kidney diseases: In addition to infections, other kidney diseases including glomerulonephritis, which can also lead to hematuria. Kidney stones, which are quite common, are also another reason, and this will be characterised by the sudden sharp pain around the flank which is very diagnostic of kidney stones. Injury to the kidneys from trauma or sports is another reason for hematuria.
Cancers/tumours: Cancers in the kidney, bladder, or prostate can cause blood to appear in the urine, but this would happen once cancer has reached some advanced stage, not very early in the process.
Listed below are some risk factors for hematuria.

Age: Men older than 50 are more prone to hematuria
Sex: While men are more likely to have stones or prostate infections, UTIs are quite common in women below 50s.
Family history: though not hereditary, if kidney stones or cancers or infections are in the family, chances of developing hematuria also goes up.
Medications: Aspirin, blood thinners, NSAIDs, and some antibiotics increase the chances of hematuria.
Exercise: Long distance runners are shown to be more prone to developing hematuria.
Diagnosis: In addition to a physical exam, blood tests, imaging (CT scans and/or MRI) and cystoscopy might be required to confirm the diagnosis. Identifying the cause is extremely important as treatment would depend completely on the causative agent. Though hematuria is just one of the symptom, the underlying cause could have severe adverse effects on the whole body system.

Treatment: Whether it is an infection or enlarged prostate or kidney stone or tumour, once the cause is identified treatment is customised accordingly. Antibiotics for the infections, laser treatment for the stones, etc. are recommended.

If you see your urine turning slightly pink in colour, talk to your doctor immediately. Identifying the underlying cause and treating it will help solve the problem of hematuria.

In case you have a concern or query you can always consult an expert & get answers to your questions!


Blood In Urine - Is It Actually Serious?

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