Bladder problems can range from acute infections and irritation to chronic issues such as interstitial cystitis, overactive bladder and incontinence. Bacteria cause many of these issues either directly, by infection or indirectly, by causing scarring, irritation or increased bladder irritability. Left untreated, bladder issues can damage overall health. For example, overactive bladder is associated with a 60 percent risk of depression and an increased rate of heart failure, according to faculty at the University of North Carolina.
Irritation and Infection
Bladder irritation, known as cystitis, or bladder infections can feel the same, with urgency, frequency of urination, bladder spasms or pain, but their causes are different. Irritation can result from the membranes lining the urethra or the bladder being damaged by friction, something a woman may experience after having sexual intercourse without sufficient lubrication, after childbirth or at menopause, when estrogen levels drop and the tissues become thinner. It can also happen chemically, because of medications, spicy foods or excess acids.
Infection occurs when bacteria not normally found in the bladder migrate there from the rectum or outside the body. These infections are more common in people with diabetes and diabetes testing is indicated in cases of recurrent infections. Sexually transmitted infections can also cause urinary tract infections.
Interstitial Cystitis
Interstitial cystitis is also called painful bladder syndrome or PBS. Interstitial cystitis symptoms include the presence of pain related to the bladder, usually accompanied by frequency and urgency of urination and the absence of other diseases that could cause the symptoms. Over 1 million Americans are diagnosed with the disorder and the vast majority of them are women, according to statistics from the National Kidney and Urologic Diseases Information Clearinghouse. The cause of PBS is believed to be an autoimmune process that either damages the bladder wall or does not adequately protect it from being injured and repaired, according to the National Women's Health Information Center. This supports the finding that PBS is seen more frequently is people with fibromyalgia and allergies, two other autoimmune processes. (see reference in notes to editor)
Overactive Bladder
MayoClinic.com defines overactive bladder, or OAB, as having a strong, sudden urge to urinate and urinating eight or more times a day, commonly with nighttime waking as well.
In men, prostate enlargement was found to be responsible for 74 percent of OAB cases in a study reported in the December 2009 issue of the "Journal of Urology." Researchers were able to identify a cause in all but 5 percent of the men they studied. OAB in women may be the result of injury to the pelvic floor muscles during childbirth or it may stem from infection. In both genders, obesity, diabetes and medications that increase the amount of urine are other known causes.
In 2002, William D. Steers, M.D. noted in an article in "Reviews in Urology" that an imbalance of neurotransmitters, especially serotonin, can cause both depression and OAB. In addition, he states that chronic inflammation throughout the body may be a contributing factor to OAB.
References
- "Journal of Urology"; Urinary incontinence and overactive Bladder in Patients with Heart Failure; M.H. Palmer, R.N. et al; July 2009
- National Kidney and Urologic Diseases Information Clearinghouse: Urinary Tract Infections in Adults
- "Reviews in Urology": Pathophysiology of Overactive Bladder and Urge Urinary Incontinence
- MayoClinic.com: Overactive Bladder
- National Institutes of Health: Clinical Impact of Overactive Bladder
