Pas på dine nyrer og din blære

 

 

Mange, især kvinder, har mødt den stærkt sviende smerte ved vandladning, og meget ofte er det tegn på blærebetændelse. Enkelte får blot en enkelt blærebetændelse, mange andre får det alt for hyppigt.
Her er råd til forebyggelse, til lindring og til behandling. Vi løber fra blærens slimhinder direkte op i nyrerne for lige at slå et slag for, at du skal gå til læge, selvom du ikke har tid, lyst eller tænker, at det er unødvendigt.
Det er nødvendigt. For en banal blærebetændelse kan blive til et problem for nyrerne. Bliv klogere på et af kroppens meget specielle organsystemer.

 

Af Torunn Laksafoss og Marianne Palm
Artiklen blev bragt i magasinet sund-forskning – april/maj 2019

 

Betændelse i de nedre urinveje vil involvere blæren og urinrøret. Symptomerne er svie og smerte, når man skal tisse, samt en trykkende fornemmelse ved skambenet. Der kan være mange årsager til blærebetændelse, og de kan både være akutte og kroniske. Irritationen i blæren gør, at muskulaturen trækker sig sammen, hvilket skaber en øget tissetrang. Selvfølgelig skal du gå til læge for at sikre dig, hvad det handler om. Dernæst er der meget, du kan gøre både forebyggende, lindrende og endog helbredende. Og det er nødvendigt, ikke kun fordi det er irriterende at skulle tage medicin, men også for at undgå, at der opstår større kroniske problemer i selve blæren eller problemer med nyrerne.

 

Med alderen bliver bækkenbunden hos os alle mere slap. Især hos kvinder, der har født flere børn og/eller har lav østrogen, kan det medføre inkontinens samt problemer med at tømme blæren ordentligt. Det sidste kan medføre en øget tendens til blærebetændelse. Træn blæren, find tips på nettet, eller spørg din læge, en osteopat eller en anden specialist i bækkenbundsøvelser. 

 

Ikke mindre end 180 liter blod går gennem nyrerne i døgnet, det er dog kun 1 % der bliver til urin, og vi tisser i gennemsnit 1 til 2 L i døgnet, alt efter hvor meget vi drikker. Resten af væsken cirkulerer (reabsorberes) ind i kroppen igen.

Blæren kan rumme mellem 300 og 500 ml urin. De fleste vil dog mærke en tissetrang, allerede når blæren indeholder 250 ml urin.

Farven på din urin fortæller dig en del om, hvor hydreret du er, altså om du har drukket lidt eller meget. Morgenurin må gerne være gul, men den må ikke være orange eller mørk – i så fald drikker du for lidt væske – eller har blod i urinen – eller har spist B-vitaminer, der kan gøre urinen helt grønlig. Er du en flittig rødbedespiser, har du sikkert også opdaget, at den røde farve kan genkendes i toiletkummen.

 

I 1700-tallet skrev lægen Thomas Willes, at urinen fra en diabetiker smagte sødt af honning – og nej, det gør nutidens læger ikke, men det er jo et tegn på, at du udskiller sukker i blodet, urinvejene vil afgifte det – og ja, det er et vigtigt tegn på en mulig diabetes. Gå til læge.

 

Kvinder har et kortere urinrør end mænd, og der er kun kort afstand til mavetarmkanalen, hvor bakterier fra tarmen let kan vandre op i urinrøret.

En af de mest hyppige årsager til blærebetændelse er, at blæren ikke bliver tømt ordentlig eller ikke hyppigt nok.

For mænd, der har et langt urinrør, vil årsagen til en forstørret prostata, der kan forhindre ordentlig tømning af blæren. Den sjat urin, som står tilbage, vil efterhånden få opformeret en god koloni af bakterier, som vil irritere blæreslimhinden.

Blærebetændelse hos kvinder kan opstå, hvis man får tørret sig “fremad” fra endetarmen, hvor bakterierne skubbes op mod åbningen af urinrøret. Tarmbakterierne kan dog selv finde vej uden hjælp fra toiletpapiret.

 

  1. Via nyrearterien strømmer blodet ind i nyren. Trykket er højt, da blodet kommer direkte for vores hovedpulsåre aorta.
  2. Blodet føres via Bowmans kapsel ind i filtreringsenheden kaldet glomerulus, som ligger i nyrebarken. Blodets væskedel filtreres fra og kaldes præurin. Vi danner 180 L præurin pr. døgn.
  3. Præurinen koncentreres især i Henles slynge, der ligger inde i nyremarvens pyramideformer. Nu er der allerede genoptaget ca. 178 L væske ind i kroppen igen. Den sidste rest præurin tilsættes affaldsstoffer fra fx medicin eller kroppens metabolisme og lukkes ud i samlerørene.
  4. Samlerøret fører urinen videre ned gennem pyramideformen og ud i nyrepapilen, som er den første del af nyrebækkenet.
  5. Fra nyrebækkenet vil muskelsammentrækninger skubbe urinen videre til urinlederen, der så skubber videre ned i blæren.

 

Urin har som regel en pH fra 5 til 7. Under 5 er for surt, mens over 7 ikke er surt nok. For høj eller for lav pH giver begge en øget risiko for dannelse af nyresten. Indtager du medicin, kan det godt påvirke surhedsgraden af din urin.

Sammen med lungerne sørger nyrerne for at regulere blodets syre-basebalance. Er der nedsat lunge eller nyrefunktion, kan det resultere i hhv. respiratorisk og metabolisk acidose. Acidose kan være livstruende.

Vil du måle pH i din urin, skal du bruge morgenurinen. Den giver det mest klare billede af, hvordan din krop har det efter otte timers faste.

Dine nyrer danner tre vigtige produkter: hormonet EPO (erythropoietin), som øger dannelsen af røde blodlegemer, aktivering af D-vitamin samt frigivelse af enzymet renin, der så af omveje sørger for, at binyrerne frigiver hormonet angiotensin, som så via blodbanen når tilbage til nyren og sørger for, at nyren tilbageholder mere salt end ellers – og dermed også mere vand.

 

  • Vi har ca. 1 million nefrons samt 10-18 pyramideformer pr. nyre.
  • Nyrerne gennemstrømmes af 1800 L blod/døgn, hvoraf der dannes 180 L præurin.
  • Næsten al væsken og rigtig mange af saltene genoptages, og vi tisser kun overskydende salte ud.
  • Vi danner ca. 1-2 L urin/døgn.
  • Sammen med leveren er nyrerne kroppens vigtigste udskillelsesorgan for affaldsstoffer.
  • Man kan godt klare sig med en enkelt nyre, hvis den ellers er sund og rask.
  • En sund nyre tager ikke skade af, at man spiser meget protein.
  • Din urin indeholder affaldsstoffer fra kroppens metabolisme og kan give et billede af resterne fra det, der er foregået inde i din krop.
  • Nyrebækken, urinleder, blære og urinrør er alle dækket af en slimhinde med glatmuskulatur bag.
  • Når du skal tisse, er det strækreceptorer i blæremusklen, som bliver aktiveret, alt efter hvor fyldt blæren er. Som voksne kan vi undertrykke tissetrangen, det samme skal et lille barn lære for at være renlig.

 

FOREBYGGENDE STØTTETERAPI

Det er som bekendt lettere at forebygge end at helbrede, og er man først i kategorien ”jeg får tit blærebetændelse”, er der her en række tips, du kan være opmærksom på og inddrage i din hverdag.

 

En supersund smoothie til slimhinderne fra Heidi Hviid og Sundhedshåndbogen
Heidis nemme havtornssmoothie

 

Det skal du bruge til to store glas:

  • 4 dl nøddemælk fx mandeldrik (eller alm. mælk)
  • 2 ½ dl havtorn, fra frost
  • 2 stk. bananer, gerne frosne
  • 2 spsk. Proteinpulver
  • ½ tsk. vaniljepulver
  • 2 spsk. hampefrøolie (eller anden god planteolie)

Alt undtagen olien blendes sammen til en ensartet konsistens og herefter røres olien i. (mixet og skabt af Heidi Hviid http://kostkropogbalance.dk/)

 

Du kan finde mange opskrifter til alverdens mad i Sundhedshåndbogen, Kend din krop, sundhed, sygdom, mad og religion.

 

Den syrlige smag i havtornene komplementerer den søde smag fra banan og vaniljepulver perfekt, og du får masser af vitaminer og omega 7- og 9-fedtsyrer til dine slimhinder i blæren. Har du mange og mere kroniske problemer med dine slimhinder, fx i øjne og blære, kan du også supplere med kosttilskuddet Membrasin, hvor der er en stabil mængde af især omega 7 og omega 9.

Slimhinder, immunforsvar, karvæggene fx i nyrernes kredsløb, i blæren og i urinleder og urinrør har brug for de rette næringsstoffer – og nok af dem. De har også brug for ro til at restituere sig mellem to infektioner, nøjagtig som vi gør, når vi har motioneret hård og inderligt. Du skaber ro, stabilitet og fremgang ved at booste med vitaminer, mineraler og fedtsyrer. Vælg et godt vitamin- og mineralprodukt, hvor producenten lægger vægt på optagelighed og styrke, og pas i det hele taget din krop. Et godt kredsløb handler ikke kun om hjertesundhed, det handler om at styrke alle de små blodkar helt ud i blærevæggen eller nyrerenes meget fine filtreringssystem.

Derfor er der brug for fedtsyrer overalt, der skal skabe muligheden for at danne sunde cellevægge i hele kroppen. Hormoner dannes af fedtstoffer, og selvom man næppe kan forstå det, er kolesterol ikke bare en fjende, men et vigtigt fedtstof til cellevæggene.

 

Vidste du, at de lavere niveauer af østrogen grundet overgangsalderen hos kvinder giver tyndere slimhinder. De tynde slimhinder giver bedre adgangsforhold for bakterierne i urinrøret, så de kan kravle op i blæren og formere sig. Sørg derfor for en god østrogenbalance med Herrens Marks Rødkløverekstrakt, og spis masser af nødder og kerner hver dag.

 

Scanalka, Danmarks ældste mineralprodukt, har utallige gange bevist sin effektivitet, når en krop trænger til opbygning. Det kan være immunsystemet, der skranter, og det kan være både i tarme, luftveje og blæren. Slimhinder har brug for mineralerne, fx silicium og zink, og bindevævet, altså alt det væv, der er rundt om organerne, er også helt afhængig af den rette mængde mineraler. Hvis du ikke spiser ualmindeligt sundt, så kan Scanalka være din trofaste følgesvend. Ikke som en undskyldning for at spise usundt, men for at optimere kroppens funktioner overalt.

 

En kronisk form for blærebetændelse er interstitiel cystitis, hvor indersiden af blæren er betændt og irriteret. Irritationen kan være alt fra en let trykken mod kønsbenet og et øget behov for at tisse, til kraftige smerter, der bliver mere intensive jo mere urin, der samles i blæren. Tissetrangen stiger, og behovet for at gå på toilettet kan være op til 50-60 gange daglig i de svære tilfælde.

 

Travlhed og manglende blæretømning vil være et godt grundlag for en begyndende blærebetændelse. Sørg for at give dig tid til at tisse færdigt – evt. ved at rejse dig op og sætte dig ned en ekstra gang.

Honeymoon-effekt kan hos nogle kvinder opstå efter samleje, hvor tryk fra penis får skubbet bakterier fra urinrøret op mod blæren. Undlader kvinden at tisse efter samlejet, vil bakterierne kunne formere sig i blæren og forårsage blærebetændelse.

Vidste du, at blærebetændelse ikke nødvendigvis giver særligt mange symptomer? Betændelsen konstateres ved, at urinen indeholder bakterier, men er ikke altid behandlingskrævende. Den findes især hos piger i førskolealderen samt hos ældre.

 

Hos gravide kan trykket på blæren medføre, at mængden af urin ikke kan være i blæren, hvorfor urinen løber tilbage mod nyren. Tilstanden kan udvikle sig til blærebetændelse, der kan sprede sig til nyrebækkenbetændelse. Betændelsen kan være med eller uden symptomer. Nyrebækkenbetændelsen kan i værste fald medføre blodforgiftning for moderen og komplikationer for barnet.

 

At drikke for lidt, gør også at man får tisset for lidt – til stor glæde for alle bakterierne, som får fri adgang til at genere blærens slimhinde og gøre den betændt og smertefuld. (Bonusinfo og klask en myte: Du får ikke hævede ben af mere væske…)

 

Derfor skal du (også) gå til lægen

Vidste du, at en blærebetændelse kan udvikle sig til nyrebækkenbetændelse? Risikoen øges, hvis der er forhindringer for at tømme blæren som fx ved en forstørret prostata, forsnævringer af urinrøret og lignende. Bakterierne fra blæren kravler ganske enkelt op gennem urinlederen op til nyrebækkenet.

 

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