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?

Urinary Tract Infections are a group of diseases that affect one s urinary system such as the urethra, bladder, ureters or kidneys. Women are more prone to contracting UTIs than men. They may be accompanied by symptoms such as a constant urge to urinate frequently along with a burning sensation in the concerned parts and pelvic pain. The urine may have traces of blood in it. These infections are usually treated with antibiotics.

Causes behind Urinary Tract Infection:

Urinary Tract infection generally occurs when the bacteria enter the urinary tract via the urethra and begin to proliferate in the bladder. Although the urinary system is structured to ward off such invaders, at times, the defense mechanism fails. In that case, the bacteria may evolve into a full-blown infection in the urinary tract.

Few risk factors are:

Female anatomy: A woman s urethra is shorter as compared to a man s, thus lessening the distance the bacteria need to travel to the bladder. This increases the chances of UTIs in women.

Using diaphragms and spermicidal agents for birth controls

A dip in the levels of estrogen post menopause

Abnormalities in the urinary tract that hinder the discharge of urine or cause the urine to travel back into the urethra.

Enlarged prostate or kidney stones that cause the urine to be trapped in the bladder.

An impaired immune system because of diabetes and other ailments

Using catheters (tube) to urinate is one of the common risk factors because of the chances of infections.

Urinary Tract Infection - Reasons behind It

There are many types of cancer that may affect the human body. Bladder cancer is one such cancer that is caused when there is an abnormal growth and accumulation of the cells in the bladder. This kind of growth may cause mutations which can then manifest into tumours that may or may not be malignant. 

Let us find out more about the causes and risk factors of bladder cancer.

Transitional cell carcinoma: In this kind of bladder cancer, the transitional cells that line the inner region of the uterus and urethra will expand when the bladder is full. Further, these cells will end up contracting when the bladder is empty. This will lead to numerous complications which can cause the formation of tumours as an end result.
Squamous cell carcinoma: The squamous cells are those that are usually found in the bladder as a response to any kind of infection or even irritation in the area. These cells become cancerous over a certain period of time. This is also one of the most common types of bladder cancer in the US, as per various medical reports.
Adenocarcinoma: This kind of cancer usually starts in the cells that make mucus and form glands for the production of the same, in the bladder. This is a rather rare form of bladder cancer.
Risk factors: There are a number of risk factors that may affect the manifestation of the abnormal cell growth which can lead to any one of the above types of bladder cancer. Let us learn more about these risk factors.
Smoking: Smoking does not merely cause lung cancer, but it is also capable of causing chemicals from tobacco to accumulate in your urine and lead to several complications, including the increase of abnormal cell growth in the bladder. These chemicals may also cause widespread damage to the lining of your bladder.
Diabetes medication: One of the side effects of taking certain types of diabetes medication may be seen in the bladder and its cells. Pioglitazone is one such medicine which can cause these kinds of complications.
Chronic bladder inflammation: Repeated bladder infections may cause an unhealthy amount of persistent inflammation, which can lead to the growth of cells in an abnormal manner. This can lead to damage of the bladder s inner lining. In such a case, bladder cancer becomes a risk for the patient.
Family history: A family history of the condition also leaves the person susceptible to this disease. Colorectal cancer instances or Lynch syndrome cases in the family can increase the risk of contracting bladder cancer. This is due to the fact that the faulty gene can affect the various organs of the urinary area.

Bladder Cancer - Risk Factors Associated With it!

The bladder is a hollow storage organ that collects urine from the kidneys and stores it until it can be passed out of the body through the urethra during the process of micturition or urination. It has a thin inner lining of cells called urothelial cells and a thick muscular wall, which exerts pressure to push the urine out of the body.

Causes of Bladder Tumors

In most cases, the bladder tumor develops on the inner layer due to a combination of some of the following factors.

1. Hereditary: A strong family history of cancer predisposes a person to cancer.
2. Gender: Men are 3 times more prone for bladder cancer than women.
3. Ethnicity: White people are more prone for bladder cancer black people.
4. Smoking: Smokers develop bladder cancer 2-6 times more frequently than non-smokers. cigarettes contain toxic, carcinogenic substances which reach the kidney and are stored in the bladder, leading to their damage.
5. Occupational hazards: Some workplaces have a higher likelihood of causing bladder cancers, especially dye and rubber industries. The effects can be damaging, and the person may develop cancers years after the exposure has happened.
6. Recurrent bladder infections: In some people, this can also lead to bladder cancer in the long run.

Types of Bladder Tumor

Depending on the extent of the cancerous spread, it can be of two types:

1. Non-muscle-invasive bladder tumors: The tumor spread is limited to the inner part of the bladder (urothelial cells)
2. Muscle-invasive bladder tumor: The tumor has spread to the thick muscular outer layer. This is more advanced and prognosis is poor compared to the noninvasive type.

The most common and diagnostic symptom of bladder cancer is the presence of blood in the urine, known as hematuria. This will be intermittent and happens whenever the tumor bleeding happens. Other symptoms include pain in the lower abdomen and frequent urination.

Diagnosis

From the most noninvasive to the most invasive diagnostic test, these include:

1. Urine microscopy to detect cancer cells in the urine
2. Cystoscopy A tube inserted into the urethra to look into the inner wall of the bladder is highly diagnostic
3. Ultrasound, CT Scan, and biopsy can also be further used to identify severity of the tumor.

Treatment

Once the tumor is diagnosed, treatment would depend on the severity of the tumor. For both invasive and noninvasive tumors, definitive therapy is surgery, known as transurethral resection of the bladder tumor (TURBT). The cancerous bladder tissue is removed through a cystoscope as done for diagnosis. The bladder is then flushed with chemotherapy agent to kill any residual cancer cells in the bladder. This is then followed by BCG vaccine, which is again done 1 to 4 weeks for several months to avoid recurrence. In some cases, radiotherapy may also be included.

Bladder Tumor and Its Common Causes

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?

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