Monday, 2 December 2013

Cystitis Diagnosis and treatment in Convention medicine perspective

Cystitis is defined as a condition of urinary bladder inflammation

Diagnosis and treatment in convention medicine perspective
1.  Acute uncomplicated cystitis

In the diagnosis and treatment of acute uncomplicated cystitis, researchers at the University of Maryland School of Medicine, Baltimore, showed that Most urinary tract infections are acute uncomplicated cystitis. Identifiers of acute uncomplicated cystitis are frequency and dysuria in an immunocompetent woman of childbearing age who has no comorbidities or urologic abnormalities. Physical examination is typically normal or positive for suprapubic tenderness. A urinalysis, but not urine culture, is recommended in making the diagnosis. Guidelines recommend three options for first-line treatment of acute uncomplicated cystitis: fosfomycin, nitrofurantoin, and trimethoprim/sulfamethoxazole (in regions where the prevalence of Escherichia coli resistance does not exceed 20 percent). Beta-lactam antibiotics, amoxicillin/clavulanate, cefaclor, cefdinir, and cefpodoxime are not recommended for initial treatment because of concerns about resistance. Urine cultures are recommended in women with suspected pyelonephritis, women with symptoms that do not resolve or that recur within two to four weeks after completing treatment, and women who present with atypical symptoms(16).

2. Interstitial cystitis

In the study of Interstitial cystitis/painful bladder syndrome, researchers at the University of Toledo College of Medicine, indicated that tests and tools commonly used to diagnose interstitial cystitis/painful bladder syndrome include specific questionnaires developed to assess the condition, the potassium sensitivity test, the anesthetic bladder challenge, and cystoscopy with hydrodistension. Treatment options include oral medications, intravesical instillations, and dietary changes and supplements. Oral medications include pentosan polysulfate sodium, antihistamines, tricyclic antidepressants, and immune modulators. Intravesical medications include dimethyl sulfoxide, pentosan polysulfate sodium, and heparin. Pentosan polysulfate sodium is the only oral therapy and dimethyl sulfoxide is the only intravesical therapy with U.S. Food and Drug Administration approval for the treatment of interstitial cystitis/painful bladder syndrome(17). 
Other researchers also suggested the use of intravesical pentosan polysulfate sodium simultaneously with oral pentosan polysulfate sodium is a safe and effective therapeutic option. It will open a new option for patients with interstitial cystitis to reduce their severely devastating symptoms and to improve their quality of life and well-being(18).  
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Sources

(15) http://www.ncbi.nlm.nih.gov/pubmed/9258082
(16) http://www.ncbi.nlm.nih.gov/pubmed/22010614
(17) http://www.ncbi.nlm.nih.gov/pubmed/21568251
(18) http://www.ncbi.nlm.nih.gov/pubmed/18001798

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