There are situations in which you can cope with the ailment on your own: a slight runny nose in the worst case will leave you at home for a couple of days, an intestinal upset will most likely go away after taking the sorbent and following a diet, a headache - a frequent accompaniment of overwork and lack of sleep - will cease to bother you thanks to a full-fledged rest and sleep. When symptoms of cystitis break into your daily rhythm, you should not postpone a visit to the doctor. But which specialist should I contact? We'll tell you which doctor treats cystitis in women and men.
Every year in Russia the diagnosis “Cystitis” appears in medical records more than 26 million times. Most often, representatives of the fair sex make complaints. This predisposition is dictated by the anatomical structure and variable hormonal background of the female body. This sad figure includes both primary and repeated cases of cystitis. People most often turn to a doctor for the first time with unpleasant symptoms around the age of 25–30; a third of those who apply will return to a specialist’s office within a year with a relapse of the disease. At the age of menopause, the percentage increases: up to 60% of women experience cystitis for the first time or again [1].
Which doctor treats cystitis?
Most likely, the administrator of the clinic or medical center will clarify your symptoms and, based on them, will make an appointment with one of the doctors.
Therapist
A general practitioner is quite capable of dealing with uncomplicated cystitis. He is well aware of the symptoms, possible causes and treatments for the disease. If your case requires the intervention of a specialist, the therapist will refer you to the right doctor, write out directions for general urine and blood tests, and advise on how to relieve your symptoms while waiting for your appointment. By the time of your visit, you will already have the results of the examinations in your hands: this will make it easier to make a final diagnosis.
Urologist
The specialization of this doctor is the diagnosis, treatment and prevention of diseases of the kidneys, bladder, ureters, glands of the genitourinary system, etc. If necessary, and based on test results, the specialist will prescribe additional examinations for you: urine analysis according to Nechiporenko, bacteriological culture, ultrasound examination of the bladder and kidneys, smears on the microflora of the urethra, vagina, and cervical canal. With the help of these and many other diagnostic measures, the doctor will be able to determine what caused the disease and prescribe the correct treatment.
Gynecologist
Often, both primary and recurrent cystitis are caused by gynecological problems. Colpitis, sexually transmitted diseases, vaginosis and other conditions can cause inflammation and painful symptoms. And although the specialization of a gynecologist is, albeit in a related, but still different plane, this specialist can also help cope with the disease.
Immunologist
If you have cystitis, you may also need his help: studies have shown that with correctly selected immunomodulatory therapy, the frequency of relapses of bladder inflammation decreases. This effect is achieved by stimulating the bactericidal properties of neutrophils [2].
The most common questions about the functioning of the endocrine system
How often do you need to visit an endocrinologist?
If your body works without failures, then you can limit yourself to a preventive dose once a year.
At what age is it better to start visiting an endocrinologist?
A visit to an endocrinologist is necessary at any age if you are overweight or underweight; you are actively losing hair or, conversely, hair has begun to grow in unexpected places; other “oddities” in the functioning of your body. In childhood, you should visit a doctor if the child is stunted or, conversely, has excessive height and weight. Women are advised to be monitored by an endocrinologist during pregnancy and breastfeeding. Regular visits should be included in the checklist from the age of 35.
I'm 20 years old and can't get rid of acne. I visit a cosmetologist who does cleansing, but it hardly helps. What should I do?
Visit an endocrinologist, get tested, and check your hormonal levels. Based on the test results, the endocrinologist will prescribe treatment.
My thyroid gland has been removed. I take L-thyroxine, Eutirox, but I can’t lose weight. What should I do?
You may need to adjust your treatment. Come see us for an appointment.
Recommendations before visiting a doctor
A visit to the doctor for cystitis does not require special preparation. Before going to the clinic:
- Collect all examination results and expert opinions related to the treatment of cystitis and other urological or gynecological diseases for which you have been treated during the last six months.
- Try to find out a possible hereditary predisposition to the disease and do not forget to tell your doctor about it [3].
- Formulate the questions you want to ask. Remember, or better yet, write down the symptoms, the time of their appearance, possible causes (hypothermia, sexual intercourse, taking medications) that you associate with their occurrence. Remember if you have recently suffered any genital or extragenital infection (sore throat, flu, ARVI, rhinitis, caries) due to insufficient fluid intake [4].
- Carry out normal hygiene procedures. You should not use local medications - suppositories, ointments, gels: they can distort the results of studies prescribed by the doctor.
- Try to refrain from urinating for several hours before your appointment. The doctor may find it necessary to take a swab from the urethra, and a stream of urine can completely wash away or reduce the concentration of pathogenic microflora. In addition, the ultrasound requires that the bladder be full.
Causes of back pain
Back pain can be caused by various reasons. Only an experienced doctor, based on an examination of the patient and data from laboratory and instrumental studies prescribed by him, can correctly diagnose and prescribe an effective course of treatment.
Back pain can be caused by:
- neurological diseases: spinal osteochondrosis (degenerative damage to the intervertebral discs);
- spondyloarthrosis (degenerative changes in the intervertebral joints);
- spondylosis (deformation of the vertebrae due to the proliferation of bone tissue);
- herniated intervertebral discs;
Such a variety of possible causes makes a person think about which doctor to contact for back pain. But this should not be turned into an obstacle to the help that professional medicine can provide.
What tests need to be taken
- General urine analysis. After toileting the perineum, collect the full morning portion of urine in a sterile container and deliver it to the clinic no later than 1-2 hours later.
- Urinalysis according to Nechiporenko. The collection of material for analysis also takes place in the morning: after hygiene procedures, pour the initial portion of urine into the toilet, collect the main part into a container, and the rest back into the toilet. This way you only collect the average volume into the container.
- The collection of urine for bacterial culture is carried out according to the same rules as for analysis according to Nechiporenko.
Before collecting material, you should give up alcohol, salty, spicy and sour foods, and douching for 2-3 days. 15-20 hours before collection, refrain from sexual intercourse.
This is the minimum program required to determine the cause of cystitis. Additional examinations, as well as the rules for preparing for them, will be described by the specialist who will be involved in the treatment. In addition, he may suggest that you take a rapid test to determine nitrites, leukocytes, protein or a special enzyme in the urine - esterase, which accumulates if there is pus in the urine [4].
What to do to prevent back pain? Prevention of back pain
In order to reduce the risk of diseases that can cause back pain, Family Doctor doctors recommend:
- sleep on a comfortable bed with an elastic and hard mattress;
- try to maintain correct posture;
- do not stay in one position for a long time. When working at a computer or driving a car, you need to take breaks that give you the opportunity to stretch, warm up, and move around;
- When working while sitting, organize your workplace correctly. The chair should have a back, preferably with armrests and a headrest, so that you can lean back and relax the muscles of your back and neck. The forearms should not be suspended; it is necessary to ensure that they lie completely on the table;
- do not walk in high-heeled shoes for more than two hours at a time;
- Avoid sudden turns and bends of the body. If you need to pick something up from the floor, it is advisable to sit down and not bend over;
- when standing for a long time (when traveling on public transport or waiting in a public place), find a point of support (lean on something with your hand or lean your back);
- do not gain excess weight;
- avoid lifting heavy objects;
- engage in physical therapy, swimming or fitness.
How is cystitis treated?
Treatment of cystitis will most likely be complex. Thus, doctor’s prescriptions may include different methods of therapy.
Medicines
When treating cystitis, the doctor prescribes a wide range of drugs: from antibiotics and uroseptics to painkillers and anti-inflammatory drugs. Instillations can also be used - introducing medications directly into the bladder. The choice of one remedy or another will depend on the identified cause of the disease.
One of the medications used in the treatment of cystitis is the drug Fitolysin® Paste with herbal ingredients. The composition of the paste for the preparation of a suspension for oral administration of Phytolysin® includes a condensed extract of a mixture of 9 types of plant materials, as well as 4 essential oils and other components. It acts on both the source of inflammation and pain, relieves spasms and increases urination so that the body can get rid of bacteria mechanically [5].
Physiotherapy
Magneto- and electrophoresis, laser and EHF therapy, inducto- and hyperthermia: all these methods relieve symptoms and simplify the delivery of drugs to their destination. In addition, the therapeutic effect of magnetic therapy can last up to six months and prevents relapses [6].
If the examination reveals other diseases that could cause cystitis (for example, inflammatory processes in the genital organs, kidney problems, etc.), the doctor will recommend treating them. He will also prescribe a diet that excludes foods that can cause deterioration in health: sweets, pickles, hot and sour foods.
Cystitis is an infectious-inflammatory process in the wall of the bladder, localized mainly in its mucous membrane [3], and with timely initiation and correct treatment, it resolves within 6-8 days. You can avoid recurrence of the disease if you follow simple rules: follow a diet that excludes foods that irritate the bladder mucosa, drink enough fluid to maintain diuresis (2000–2500 ml) [3]. Perhaps, when treating chronic cystitis, your doctor will recommend that you initially keep a urination diary, in which you will note the amount of fluid and urine you drink.
- Russian clinical guidelines Urology Edited by Yu.G. Alyaeva, P.V. Glybochko, D.Yu. Pushkar, Moscow 2021 - (date of access: 04/15/2021).
- Streltsova O.S., Krupin V.N. Immunomodeling therapy of chronic recurrent cystitis in women. Journal of Urology. 2014;(4):35-47. (access date: 06/03/2021).
- Bacterial cystitis in adults. Clinical recommendations of the Ministry of Health of the Russian Federation. - Ed. group: Perepanova T.S., Sinyakova L.A., Lokshin K.L. — (date of access: 06/03/2021).
- Khalilova U.A., Skvortsov V.V., Ismailov I.Ya., Lugovkina A.A., Proleyskaya N.A., Kalinchenko E.I. Cystitis. Nurse. 2018; 20 (6): 6–11. (access date 06/03/2021).
- Instructions for use of the drug PHYTOLYSIN® Paste for the preparation of suspension for oral administration
- Maisumova N.S. Evaluation of the effectiveness of magnetic therapy in the treatment of patients suffering from interstitial cystitis. (access date 06/03/2021).
Treatment of the lower back at the Neurology Center in St. Petersburg
Our clinic employs qualified specialists who have extensive experience in treating the back and spine. And most importantly, this medical institution was founded by two professors who specialize in the back: Professor Zhulev Nikolai Mikhailovich and Zhulev Sergey Nikolaevich. Examination and treatment are carried out exclusively by themselves. This is the uniqueness of the clinic. The clinic uses modern methods of diagnosing and treating neurological diseases.
Thanks to effective treatment, lower back pain will no longer bother you. If the discomfort is caused by other diseases, the center’s specialists will refer you to the appropriate doctors. The sooner you seek help, the more effective the treatment will be, especially in serious cases. When visiting the clinic, clients receive qualified advice and an examination and treatment plan is drawn up.
Causes of eating disorder
An eating disorder is a psychological pathology and can be activated for various reasons. This could be stress, hereditary factors, psychological trauma in children, aspects of upbringing, or promoted beauty standards imposed by society.
There is also a professional risk area. These are professions that involve maintaining an impeccable appearance - models, actors, ballerinas, athletes, flight attendants, television presenters.
The task of the psychotherapist is to find the causes of the eating disorder in the process of consultations and psychological work with the patient, and then treat them, minimizing the risk of relapse.
It will be difficult for an ordinary person without special experience and education to figure out what exactly caused the mental disorder of his loved one, but he can notice the alarming symptoms and begin to act.
Diagnostics
To diagnose asthmatic manifestations, it is necessary to conduct a thorough examination of the body. The medical clinic in Mytishchi has equipment and reagents to perform allergy tests at any time of the year, regardless of the intensity of the disease.
Allergy tests are a diagnostic method for identifying the allergen to which the patient’s body reacts.
To determine the allergic status, it is necessary to conduct laboratory tests - tests for sensitivity to various allergens - fungal, pollen and household.
A study of respiratory function - spirography - allows you to estimate tidal volumes.
The doctor will prescribe a number of laboratory tests:
- General and biochemical blood test;
- Antibody test;
- Examination of stool for the presence of helminths;
- CT
Causes and types of bronchial asthma
The main impetus for the development of asthma is an increase in bronchial reactivity during allergic manifestations. Often allergens are:
- Dust;
- Pollen;
- Animal wool;
- Household chemicals;
- Selected food products.
A number of allergists believe that the root cause of allergies in the vast majority of cases is taking medications.
There are three types of asthma.
- Drug-induced, developing while taking medications. It is the body's reaction to certain drugs.
- Infectious-allergic form. The cause of development is the presence of infection in the respiratory tract. The cause may be untreated tonsillitis, sinusitis or bronchitis. The presence of foreign bacteria in the body causes changes in the bronchi and subsequently asthma attacks.
- The atypical form is the body’s reaction to allergens, most often to those that a person inhales. Usually, in the absence of such contacts, a person feels completely healthy. This form of the disease can be combined with dermatitis or allergic rhinitis.
Treatment and relief
It is important to eliminate contact with allergens. During an attack, compression should be eliminated by clothing and the chest should be freed as much as possible. Self-treatment is impossible. The use of antiallergic drugs will relieve the exacerbation, but this is a temporary measure. You need to see a doctor. The specialist will prescribe a course of drug treatment, including various types of therapy:
- Bronchodilator;
- Detoxification;
- Anti-inflammatory;
- Antihistamine;
- Symptomatic.
It is recommended to use the air purifier in the room where an asthma patient is located.
The disease requires constant monitoring. Therapy is aimed at normalizing the functioning of the upper respiratory tract and eliminating the inflammatory process.
It is important to determine the cause of the attacks and get rid of it:
- Do not contact with allergens;
- Eliminate infection in the respiratory tract;
- DO NOT use non-steroidal anti-inflammatory drugs.
It must be taken into account that bronchial asthma cannot be completely cured, but it can be weakened - stable remission.
As preventive measures you should:
- Maintain lung functionality;
- Take care of a good quality of life.
Positive dynamics can be achieved; it requires the desire of the patient himself, his active and competent participation in the treatment process. It is important to maintain close communication with your doctor.
Who should you turn to for help when your heart beats unevenly?
Every person has had cases in his life when his heart beat unevenly. Every third patient at an appointment with a cardiologist complains of heart rhythm disturbances. They can be different - rare and frequent, long-term and short-term. But in any case, the patient feels them and worries about his health. Calmly! Arrhythmologists are guarding your rhythm. Who are they and how can they help patients with arrhythmia, we asked Maria Sergeevna Kharlap, cardiologist-arrhythmologist, candidate of medical sciences, employee of the Arrhythmological Ministry of Health of Russia.
Hello, dear Maria Sergeevna. Please tell us what kind of doctor this is – an arrhythmologist?
An arrhythmologist is a specialized specialist, initially a cardiologist or cardiac surgeon, who deals with the electrical activity of the heart, studies and corrects the electrical conduction system of the heart.
Patients come to us with any rhythm disturbance. We conduct diagnostics to understand why a person’s heart is beating abnormally. If necessary, we carry out treatment - medicinal or interventional, using a special catheter inserted into the heart through a vein.
Tell us in more detail about the mechanism of arrhythmias.
Our heart cannot beat without electrical activity. First, an electrical impulse is generated and transmitted to the myocardium, which contracts. And the heart carries out its main function - it supplies organs and tissues with blood.
The electrical conduction system is made up of special cells responsible for electrical activity. It is located inside the heart.
Disturbances in the process of formation and conduction of an electrical impulse cause arrhythmia.
Does any arrhythmia require treatment?
No. Some rhythm disturbances may be normal and do not require treatment. Depends on various factors, including the nervous system and environmental influences.
But there are also dangerous, life-threatening arrhythmias.
Arrhythmologists help to figure out in what cases medical care is needed.
What are these dangerous arrhythmias?
There are a number of arrhythmias that are associated with a rare heart rhythm. Electrical activity fails and assistance from an external source is required. In this case, the patient is implanted with a device that stimulates the functioning of one or more chambers of the heart, depending on the diagnosis.
The device is placed under the skin, under the pectoral muscle, and the electrodes are passed into the heart through the venous system and remain there for life. During pauses in the heart's work, they perform stimulation, simulating the heart's own electrical activity.
Does the operation of such devices need to be monitored?
Yes, definitely. In the future, such patients should come for a consultation with an arrhythmologist to check the operation of the devices. We use special programmers for this.
Sometimes patients are implanted with complex devices that have the ability not only to deliver electrical impulses, but also an electrical shock in the event of a dangerous, life-threatening arrhythmia. Such devices are supplied with remote monitoring and a home monitoring system, which allows the doctor to remotely read the activity of the device and control its operation.
Can the patient come to your appointment on his own or does he need to see a cardiologist first?
Yes, the patient can come on his own if he has complaints about rhythm disturbances. But it is better if he first undergoes a diagnostic examination.
What tests can you order?
Ideally, the patient comes with an already registered electrocardiogram. An ECG reflects the electrical activity of the heart at a specific period of time. We are especially interested in ECGs when you feel unwell. But complaints do not always last long enough for the patient to get to the clinic.
For such patients, we recommend purchasing a home ECG recorder. This, of course, is not a full-fledged ECG, but the device records the rhythm at the time of the complaint and helps us in diagnosis.
In our clinic, we can also prescribe 24-hour 12-lead monitoring to record an ECG. It allows you to study arrhythmia in more detail. But there are situations when nothing bothers the patient on the scheduled day of the study. Then we prescribe multi-day monitoring.
Maria Sergeevna, tell us what are the advantages of the Arrhythmology Ministry of Health of Russia?
Our most important advantage is experience. Our arrhythmology service was created at the Center 8 years ago. But in fact, my colleagues and I have been studying cardiac rhythm and conduction disorders for more than 20 years.
We were lucky that we stood at the very beginning of the formation of arrhythmology in Russia. This area, especially interventional treatment of cardiac rhythm and conduction disorders, is a young field of medicine. The first opportunity to evaluate the electrical conductivity of the heart from the inside, using catheter technologies and implanted devices, appeared about 30 years ago.
In the late 90s, my colleagues and I, then employees of other institutions, began our professional activities as cardiologists and cardiovascular surgeons specifically in the field of studying arrhythmias.
Almost all employees of our Arrhythmology Center have European certificates in cardiac electrophysiology. Our experience has been accumulated both in Russia and among leading arrhythmologists and electrophysiologists abroad.
Another advantage is our experience in the study of cellular electrophysiology and molecular genetic methods. For example, I am a specialist in the field of molecular genetics of arrhythmias; using genetic methods it is also possible to clarify the cause of disturbances in the electrical activity of the heart. Some arrhythmias have a hereditary etiology.
Together with pediatric cardiologists, I supervise families with various familial forms of cardiac rhythm and conduction disorders.
This allows us to monitor arrhythmias in the early stages and take control of the disease.
Our experience allows us to differentiate arrhythmias, separating dangerous from safe.
We have also been teaching young specialists in the field of cardiac electrophysiology for several years, which speaks in favor of our professional experience. And there is the opportunity to conduct hands-on training in the operating room.
What treatment methods do you use in your work?
Our arrhythmology service consists of an outpatient and inpatient unit. We have our own operating rooms, modern and fully equipped. They have X-ray units for visualizing parts of the heart during interventional treatment, and systems for mapping - determining the exact localization of the source of arrhythmia.
To eliminate the source of the arrhythmia, cauterization or freezing of the area of increased electrical activity can be used. We also perform left atrial appendage occlusion for non-drug prevention of thromboembolic complications in atrial fibrillation, implant cardioverter defibrillators, and successfully use other latest technologies for the treatment of arrhythmias.
You can make an appointment at the Arrhythmology Center by calling: +7(495)790-71-72
Types of Eating Disorders
Food is a source of existence and energy only if it is rationally consumed in the required quantity. Any deviation from the norm is harmful to the psyche and physical health.
An eating disorder is, in fact, a mental illness, and not just a diet or lifestyle, and this illness can manifest itself in the form of partial refusal to eat, alternating periods of overeating with periods of diligent fasting, all sorts of purging - from specially induced vomiting to laxatives.
The most common and at the same time dangerous eating disorders are:
- Anorexia nervosa is a mental illness that is more common in young people and adolescents, predominantly female. This pathology is characterized by non-acceptance of one’s external image, conscious refusal of food and the deliberate creation of obstacles to its absorption by the body. The result is a critical weight loss, but even then it seems to the patient that his body weighs unforgivably much and the fight against non-existent volumes must be continued. In some difficult cases, the disease becomes irreversible and leads to death. Note that the signs of the disease are easy to recognize, because anorexics do not notice their problem and, accordingly, do not hide.
- Bulimia is the opposite disorder of anorexia, it is much more difficult to recognize. The disease is characterized by uncontrolled attacks of appetite and overeating, after which the person feels an acute sense of guilt and gets rid of what he has eaten through vomiting or laxatives. People suffering from bulimia most often weigh within the normal range and in their behavior during the period without attacks do not differ from healthy people.
- Binge eating disorder is an eating disorder that involves episodic binge eating. Unlike patients with bulimia, those suffering from this type of eating disorder do not accompany bouts of gluttony with purging the gastrointestinal tract or fasting, but experience psychological discomfort, guilt and self-dislike.
- Orthorexia is an eating disorder in which proper nutrition becomes the meaning of life. People stop enjoying delicious food and limit their choice of products, focusing only on their beneficial qualities. If this desire had a measure, it would be worthy of praise. But patients are in constant fear of the possibility of breaking the rules and experience self-hatred when consuming prohibited foods.
Photo: PhotoMIX-Company/Pixabay
How exactly can you help a loved one with an eating disorder?
The following recommendations will help you take care of the health of your loved ones and help them overcome their illness:
- Give your loved one the confidence that you care about their problems, that you are always there and ready to listen and support. The very opportunity to consult with someone will give you confidence and activate the desire to start treatment. In conversation, try to avoid criticism and instructions - patients constantly feel guilty and reproach themselves for their weaknesses and behavior.
- Be patient. Your hysterics and anger will not help in solving the problem. And a loved one has already brought forward punitive accusations and a sentence against him without you.
- Don't push or insist on immediate action. It must be remembered that a sick person needs a significant period of time to accept the fact of his illness and want to be treated. Persistence will only cause aggression and frighten away the positive tendencies of trust between you.
- Never try to analyze the patient's appearance. It will also make the path to healing more difficult and undermine your loved one's confidence even more. Instead of talking about weight and figure, it’s better to tell him how worried you are about his health and want to help correct his mood.
- Encourage conversations about nutrition control. Let the person close to you understand that you are at the same time and feel your support. Believe in success and constantly encourage the patient with assurances that everything will definitely work out.
- Try to persuade your loved one to see a specialist. An eating disorder is a real illness, not a loss of control over your diet. It is important to find the cause of the disease, adjust self-perception and self-esteem. Such actions can only be performed by an experienced doctor.
What signs should you be wary of?
It is quite easy to detect alarming symptoms in your loved ones, especially if you live together.
Here are the most common signs that a person has an eating disorder.
Anorexia.
- Abnormally low weight of a person - 15% error from the normal value.
- Absence of three or more menstruation in girls.
- Objective perception of your mass and figure.
- Obsession with the topic of food.
- Denial of the violation itself.
- Suicidal thoughts.
- Daily weighing on scales.
- Avoiding eating in public.
- Rituals during meals (for example, chewing food thoroughly).
Bulimia.
- Uncontrolled amount of food consumed.
- Systematic use of methods to cleanse the body of food - taking laxatives and diuretics, inducing vomiting, intense physical activity, fasting or dieting.
- Low self-esteem is directly related to your own body weight.
- Blood vessels often burst and the eyes turn red.
- The habit of eating alone.
- Deterioration of relationships with friends and loved ones.
- Disappointment after eating.
- Stomach pain.
- Poor condition of teeth (stomach juice during vomiting thins tooth enamel).
Binge eating.
- Excessive amounts of food consumed uncontrollably.
- Inability to control appetite.
- During eating, food is practically not chewed.
- Preoccupation with the proportions of your figure.
- Low self-esteem, tendency to blame oneself for weakness and depression.
- Constraint from overeating.
- A person hides food from other family members.
- Problems with the gastrointestinal tract - pain, constipation.
- Frequent diets that end in failure.
- The cult of food (for example, carefully setting the table or separating food according to color).
If you see similar behavior in your loved ones, under no circumstances choose the position of blame. Try to reassure the patient, tell him that you are worried about his poor sleep or poor quality nutrition and would like to help.