• Jun Yoshimura

Cystitis which has been occurring frequently has been improved without antibiotics, but why?

Female office worker, 40s

Subjective: Rosacea comes out in winter time. Also, feel left arm dull as well at the same time


*Rosacea: Chronic inflammatory diseases characterized by flushed face, telangiectasia, erythema, papule etc.

Observations:

Left upper abdomen wad very taut. It was speculated that digestive problems (especially stomach) may cause decreased blood flow in the left arm, leading to dullness.

Also, when I touched her lower abdomen, there was a peculiar lump and tension (it was difficult to put into words). When I asked her whether she has been suffering from cystitis, she answered it has been frequent since she was young. Even now her bladder wad not in good condition.

To take antibiotics may lead to be worsening the environment of stomach and deteriorating its function. It generated the tension in the upper left abdomen and dullness in the left arm.

Considering the above situation, I decide to improve the tension of her upper abdomen as the axis of treatment.

Treatment content:

Manipulation: Stomach and bladder massage

used acupuncture point: LI4, SJ9, ST37, KI10, LV8, etc.


The left arm was not shiny in the beginning, but it was improved throughout treatment. Also, her stomach was gained more flexibility (there was no gap between the stomach and the diaphragm.)


Second treatment (1 week later)

She was pleased that dullness on her left arm and rosacea was improved, but she was happier that her lower abdomen was in good condition so that she may avoid using antibiotics for cystitis.

When I asked her in detail, she complained that blood was often mixed in urine, and it was improved.


Treatment content

Manipulation: I focused deeper layer as the lower abdomen was flexible more than before. Also approached genitofemoral nerve, which is not directly related but it nourishes the genitals.


Use acupuncture points: Basically same as before.

3rd-4th: Basically same


Consideration

In addition to the original complaints, she was really happy that cystitis was improved because it was stared since long time ago and occurred continuously. I think she has given up to improve its condition.

The common point between rosacea and cystitis is "inflammation". In other words, rosacea and cystitis are same phenomenon in terms of the reaction that inflammation is occurring in the body, and It was natural to say that both would be improved if I aimed to relieve underlying inflammation.

On the other hand, I was wondering whether inflammation would be improved so quickly. When I examine cystitis, acute cystitis is caused by mainly Escherichia coli and we use antibiotics. But not all types of cystitis comes from bacteria, for example, cystitis that is triggered by functional causes (or something that feels like cystitis) could be improved by manual therapy.

I wondered what the functional symptoms of cystitis are and listed up.

Reference: Wikipedia etc.


1. pollakiuria: Urination every 1 to 2 hours. some patients go to bathroom more than 30 times a day.

2. Feeling of residual urine: feeling like I don't urinate immediately after urinating.

3. Urinary urgency: I understand that I don't urinate, but I always feel like having urine.

4. Pain while urination: Pain runs from the urethra at the end or immediately after urination.

5. Lower abdominal pain: Severe pain around the pubis.

6. Vulva pain: Dull or sharp pain between genital and anus area.

7. Middle ~ lower back pain: Dull pain from middle to lower back.

8. Lower limb discomfort: Pain or numbness on inside of the thighs or soles of the feet.

9. Urinary incontinence, etc.

It has written in Japanese Wikipedia that the cause of functional cystitis is hypersensitivity of the spinal cord between T10 and S4 that control the bladder.


Examples of the causes of hypersensitivity are

1) Frequent bacterial cystitis trigger that the nerves which control the bladder react hyper sensitively.

2) Adhesion due to inflammation of cystitis, surgery such as appendicitis, childbirth etc. gives pressure to the nerves connect to the bladder, resulting in excessive decreased / excited activity of nervous systems.

3) Disturbance of autonomic nerves affects motor / sensory nerves connect to bladder, leading to excessive decreased / excited activity of nervous systems.


*If you read and think of other causes, please let me know. I appreciate it.


Causes between 1-3 may trigger Symptoms between 1-9.

I write that the point of this patient is "inflammation".

If we believe in the symptoms listed in Wikipedia, inflammation is caused by bacteria and not by nervous dysfunction. Of course I think so. That's probably why hematuria isn't listed in the symptoms. (Because hematuria occurs as a result of inflammation. Blood vessel is damaged by bacteria(=inflammation) and we will have hematuria.)

However, we can say that nervous dysfunction create a situation for causing inflammation (ex: weakening of the motor nerves that control urination actually leaves urine in urethra, making it more susceptible to bacterial infection). And if the inflammation causes hematuria, hematuria can also be improved by recovering the dysfunction that relates with bladder.


I personally think that people who have complained cystitis from a young age continuously have a mixture of bacterial and dysfunctional causes.

In this patient’s case, rosacea was also a complaint caused by inflammation, and I think this case was the case that the factor of nervous dysfunction was stronger than other factors that caused inflammation in her body. That’s why both of her complaints were improved.

Can we really peel off the adhesions by manual therapy? I honestly don't know. However, I believe that it is possible to release our peritoneum rolled up by adhesions and distribute nutrition to the tissues that have been peeled off from the experience of seeing the fascia that was almost raw when I squeezed and dressed a chicken.

I can’t cure “cystitis” because I'm not Jesus, but if patient’s complaints were derived from functional damages, I believe I am able to improve various conditions.

Also, the combination of antibiotics and manual therapy may be able to cure the repeated cystitis.

What we can and cannot do without medicine or surgery? I want to be a person who can consider calmly and treat.






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