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?

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?

Causes of bladder control problems in women

Urinary incontinence is the term used to describe bladder control problems that affect several people. Many think it only occurs among older, menopausal women but it actually isn't uncommon amid young and active women.

Inability to control the bladder accompanied by pain can be symptomatic of various disorders ranging from a minor infection to cancer. Fortunately, bladder cancer is rare, and bladder pain is usually not serious.

The varied causes of urinary incontinence in women are as follows:

1) Urinary Tract Infection - This is the most common cause of urinary incontinence and it affects women more than men due to anatomical factors. It can also happen at any age.

2) Medicinal Side Effect: The inability to control one's bladder may be a result of the administration of certain medicinal substances such as alpha-blockers, antidepressants, sleeping pills and various narcotics.

3) Changes in the Reproductive System - Pregnancy and fluctuations in hormone levels can cause bladder irritation, which leads to urinary incontinence.

4) Impacted Stool - When stool gets tightly packed in the lower end of the digestive system and rectum, bladder control is affected. Chronic constipation and constraint strain on the lower intestines leads to the weakening of bladder muscles and hampers the bladder control.

5) Surgical Side Effects - Temporary loss of control of the bladder is often a result of prior surgery and radiation therapy in the pelvic region.

6) Nerve Damage and Neurological Disorders - Strokes and spinal cord injuries have a heavy impact on bladder control and amount to urinary incontinence. Diseases such as Alzheimer's disease, Parkinson's disease and multiple sclerosis also lead to the same.

7) Health Complications - Disorders such as diabetes and obesity directly affect the bladder and the ability to exercise control over it.

8) Disability and Impaired Mobility - For women who are physically impaired and suffer from problems of arthritis, urinary incontinence is a major problem as they are unable to reach the toilet easily.

9) Bladder Cancer - Even though it is extremely rare, bladder cancer affects a number of women every year and is treated through surgery and chemotherapy.



What Causes Bladder Control Problems in Women?

The bladder is a muscular sac that is seated just above the pubic bone. The organ stores urine produced by the kidneys allows us the control the frequency of urination by the expansion and contraction of its muscles. Pain in the bladder is usually caused due to one of three reasons:

Interstitial cystitis: This is a chronic condition which affects more women than men. It makes the bladder inflamed and irritated. The bladder walls turn stiff because of this which makes it difficult for the bladder to expand. Interstitial cystitis may be caused by a defect in the lining of the bladder.

Urinary tract infection: Urinary tract infections can affect a person at any age and may develop in the ureter, urethra, bladder or kidneys. However, it is most commonly seen in the bladder. This infection is caused by bacteria that enter the body through the urinary tract.

Bladder cancer: Cancer that develops in the bladder is known as bladder cancer. Transitional cell carcinoma is the most common type of bladder cancer cell. This begins in the innermost layer of the bladder lining. Pain during urination and discomfort in the lower pelvic region are common symptoms of this disease. Once the cause is diagnosed, antibiotic medication can help treat bladder pain. Along with that, there are a few things you could do at home as well.

Drink plenty of fluids: Ideally, we should drink 8-10 glasses of water a day. Water keeps the body hydrated and helps flush toxins from the body. It also helps dilute the urine. This can make urination less painful as concentrated urine may be acidic and difficult to pass. Water also helps prevent the formation of kidney stones and thus helps the kidneys function optimally.
Urinate frequently: Do not try to control your urine. Holding urine in for extended periods of time allows bacteria to multiply within the body. It is also important to urinate after intercourse as sexual activities can push the bacteria present on the skin deeper into your body. This is important for both men and women.
Dress comfortably: Avoid synthetic, tight fitting underwear and clothes. Instead wear, loose, comfortable clothes that are preferably made out of cotton. These clothes will help keep your skin dry and not allow bacteria to breed.
Pain relievers and heating pads: Sometimes, antibiotics can take a day or two before addressing bladder pain. In such cases, pain relievers can help deal with the discomfort and cramps. Heating pads can also help soothe abdominal and lower back pain that results from bladder infections.

Painful Bladder - What Should You Know About It?

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!

Bladder is an organ of the lower abdomen which stores urine. Though it is a problem common to both men and women, women are two times more prone to be affected than men. 

The following are some of the causes that give rise to bladder pain.

Bacterial infection or urinary tract infection is one of the common causes of bladder pain. Women are more likely to encounter uninary tract infection. It occurs if bacteria sneak in through the urethra leading to develop an infection in the urinary tract, which in turn affects the urinary bladder.
Sometimes bladder stones can also give rise to bladder pain.
Painful Bladder Syndrome is yet another cause, wherein your bladder holds pee after your kidneys have filtered it but before you pee it out. This condition causes pain and pressure below your belly button, causing pain in the bladder.
Chronic pelvic pain is pain in the area below your bellybutton and between your hips that lasts six months or longer. There are multiple causes for such pain.
Bladder cancer is another possible cause of bladder pain. If uncontrolled cancer cells are formed in the bladder, then it gives rise to bladder cancer. Bladder cancer is one of the most common cancers and generates unbearable pain in the bladder.
Interstitial cystitis is another condition which gives rise to severe bladder pain. This condition is more commonly seen in women. The bladder becomes inflamed and irritated and the pain gets worse when the bladder is full or during menstruation. It is a chronic condition.
Urethral stricture is another cause of bladder pain. Men are likely to be more affected by this condition. In this case, the urethra becomes inflamed and narrow creating difficulties to pass urine.
Yeast infection also known as, Torulopsis is another cause of bladder pain.
Bladder pain can vary from being mild to severe. But, no matter what the degree of pain is, it requires serious medical attention. It is highly recommended that if you are suffering from bladder pain you must consult and seek a doctor's advice right from the beginning.

Bladder Pain - 8 Reasons Behind it 

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