- 1 What is prostatitis?
- 2 Prostatitis causes
- 3 Prostatitis symptoms
- 4 How to treat prostatitis?
- 5 Prostatitis treatment. Best antibiotic for prostatitis
- 6 Prostatitis remedies. How do you treat prostatitis?
- 7 Acute prostatitis treatment guidelines
- 8 Alpha blockers for prostatitis (BPH). Alpha-1-adrenoblockers
- 9 Bioregulatory peptides. Bacterial prostatitis treatment
- 10 NSAIDs and antispasmodics in prostatitis treatment
- 11 Can Viagra, Cialis and Levitra be taken for prostatitis?
- 12 How does Viagra affect the treatment of prostatitis? Sildenafil for BPH
- 13 Cialis for prostatitis. Low dose Cialis for BPH
- 14 Levitra for prostatitis. How does Levitra (Vardenafil) affect the prostate gland?
- 15 Tablets and capsules to increase potency
How to cure prostatitis in men with pills? This question arose, perhaps, for every guy suffering from prostate inflammation.
To cure prostatitis and improve the quality of life, the patient will need to take alpha-1-adrenoblockers, antibiotics, antispasmodics, nonsteroidal anti-inflammatory drugs, bioregulatory peptides and phytopreparations.
In the treatment of prostatitis, not only tablets can be used. Often, injections and suppositories for rectal administration are prescribed. Let us consider in more detail which preparations will be used for prostatitis, and also what medications are most effective.
What is prostatitis?
Prostatitis is one of the most common urological diseases in men after 30 years.
Prostatitis is an inflammation of the prostate gland, which is treated not only with the help of drugs, but also with some folk remedies that have been tested by time. In turn, the prostate gland or prostate is a glandular-muscular organ in men, which is located in the region of the bladder and controls urination, and also secretes a special substance that gives the sperm a fluid consistency.
Depending on the origin, prostatitis can be bacterial or non-bacterial, and by the nature of the course – acute or chronic. Acute prostatitis is most often caused by gram-negative bacteria, easily recognized and treated with antibiotics.
The main symptoms of prostatitis include pain, difficulty and painful urination, sexual disorders. Symptomatology is very unpleasant, so you need to treat prostatitis when you detect the first signs.
The main cause of prostatitis is the penetration of an infection into the gland, which is largely due to the location of the prostate in the pelvis.
The main ways of infection in the prostate:
1. Descending – the infection enters the prostate with urine.
2. Ascending – the infection enters the prostate gland through the urethra.
3. Hematogenous – the infection enters the prostate gland with blood.
4. Lymphogenous – the infection enters the prostate gland with a current of lymph.
The main causes and risk factors for the development of prostatitis in men:
1. Sedentary lifestyle, lack of exercise (blood stasis in the prostate gland).
2. Violations of the normal rhythm of sexual activity – irregular sex, prolonged abstinence.
3. Hypothermia in childhood, adolescence or adulthood (especially the corresponding part of the body).
4. Sexually transmitted diseases (chlamydia, trichomoniasis, gardnerella, or gonorrhea).
5. Another reason could be trauma to the tissues and organs of the small pelvis.
6. Reduced immunity in boys and men.
7. Unbalanced diet (fried, fatty, sweet food makes up 70% of the diet). Excessive alcohol intake.
All of these conditions can both contribute to the penetration of microbes into the prostate gland, and lead to stagnant processes, deterioration of the blood supply to the pelvic organs, which in turn leads to an increase in the number of microorganisms and the progression of inflammation. In this regard, it is necessary to cure prostatitis on time, then complications will not bother you.
Frequent urination with weak urine pressure and cutting during the process, a rise in body temperature, a burning sensation in the perineal region, painful defecation are the first signs of acute prostatitis in men.
You should also pay attention to the following clinical symptoms:
- intermittent and difficult urination;
- violation of the mechanism of erection;
the appearance of a burning sensation in the urethra and in the perineum;
- increased imperative urge to defecate;
- lingering discharge from the urethra;
- floating fibers in the composition of urine;
- prolonged erections, accelerated ejaculation;
- manifestation of orgasm in erased form;
- increase overall body fatigue;
- anxiety, mental depression;
- significant reduction in potency.
It is worth noting that in the chronic form of prostatitis, the symptoms may not appear at all, and additional signs are added.
In most cases, acute prostatitis begins with symptoms of an increase in body temperature to 39–40 C, fever and chills. Urination is difficult and painful. Edema develops in the prostate gland, which can cause acute urinary retention. In addition, the pain in the perineum, which is given to the inguinal region, is also quite bright.
As for chronic prostatitis, in rare cases it becomes the outcome of an acute process, however, as a rule, primary chronic prostatitis develops with a worn symptom. Chronic is distinguished from the acute form by the fact that it proceeds without pronounced signs, that is, latently, without noticeable symptoms.
In the period of exacerbation of prostatitis, patients are disturbed by the symptoms of pressure sensation in the perineal region and anus, dull pain extending to the sacrum, perineum, rectum, and inguinal region.
Signs of chronic prostatitis in men:
- significant deterioration of erection;
- decreased libido;
- weakening of the stream during urination;
- aching pains in the perineum, sacrum, rectum;
- discomfort and burning in the urethra;
Sometimes patients neglect the symptoms of prostatitis, relying on the presence of prostate adenoma. This should never be allowed, since the treatment of adenoma is fundamentally different from how to treat prostatitis.
Can prostatitis be cured?
In severe intoxication, suspected purulent process, hospitalization is indicated. Patients with uncomplicated acute prostatitis undergo outpatient treatment by a urologist or andrologist.
To cure prostatitis, you need to adhere to a whole range of special events that successively replace each other.
How to treat prostatitis?
The drugs that are prescribed in the first place are antibiotics, especially when it comes to the infectious origin of the disease.
How to cure prostatitis?
Drug treatment consists of the appointment of such drugs:
1. Antibacterial drugs – treatment is carried out to destroy the infection;
2. Anti-inflammatory drugs are used to relieve inflammation, which is characteristic of this disease;
3. Preparations that improve blood circulation;
4. Preparations removing the spasm of the urethra.
As an additional measure, prostate gland massage is often prescribed. It contributes to the accelerated recovery, as well as reducing pain. According to reviews, this is a very useful procedure. The intervention of surgeons is recommended if the urogenital canal is narrowed and prostate adenoma removal is required.
How to treat prostatitis in the complex?
For this, doctors use all possible methods and prescribe to patients:
- diet, lifestyle changes;
- drug treatment;
- prostate massage and exercise therapy;
- symptomatic treatment;
- folk remedies for prostatitis
treatment of comorbidities;
Also, do not forget that the treatment of prostatitis folk remedies gives good results only in conjunction with the main therapy. Therefore, it is recommended not to self-medicate at home.
Prostatitis treatment. Best antibiotic for prostatitis
Antibiotics are necessary for acute and chronic bacterial prostatitis, even proceeding poorly for symptoms, and also as a trial therapy for the non-infectious nature of the occurrence of prostatitis, as a test therapy. Therefore, before starting a course of therapy, it is necessary to undergo an examination and determine the type of pathogen.
Drug treatment of prostatitis includes the use of various antibiotics with a wide range of actions.
What antibiotics treat prostatitis?
Antibiotics are prescribed to kill the pathogenic bacteria that caused the disease, and to relieve an acute or chronic inflammatory process. The form of release of these drugs can be tablets, capsules, injections, rectal suppositories.
In men, the treatment of acute prostatitis can be made by the following antibacterial drugs from the group of fluoroquinolones, which have a wide spectrum of action:
– Lomefloxacin and others.
For the treatment of prostatitis in the chronic form, it is more advisable to use antibiotics from the tetracycline group or macrolides:
– Doxycycline and others.
The average course of antibiotics is 2 -3 weeks.
Antibiotics used for acute bacterial prostatitis:
|Common Antibiotic||Regimens for Acute Bacterial Prostatitis|
|Ciprofloxacin (Cipro)||500 mg twice a day|
|Doxycycline (Vibramycin)||100 mg twice a day|
|Trimethoprim-sulfamethoxazole (Bactrim, Septra)||1 DS tablet (160/800 mg) twice a day|
|Norfloxacin (Noroxin)||400 mg twice a day|
|Ofloxacin (Floxin)||400 mg twice a day|
It is worth remembering that the treatment regimen is prescribed strictly by a specialist, where the use of antibiotics occupies one of the leading links in the chain.
Prostatitis remedies. How do you treat prostatitis?
How to treat prostatitis in men? The fight against prostatitis is conducted in several directions. Comprehensive treatment of prostate inflammation in men is aimed at eliminating the causes of the disease, relieving symptoms and increasing immunity.
Against prostatitis can be applied physiotherapy. They include a combination of various methods and are very widely used.
The type of procedures is selected individually for each case. The course of physiotherapy has a positive effect not only on the underlying disease, but also on the entire body.
There are several types of physiotherapy:
1. Galvanization. The impact of direct current.
2. Electrophoresis is a variant of galvanization, with taking medication.
3. Ultrasound. It acts through a rectal radiator.
4. Magnetotherapy. Almost no contraindications.
5. High frequency and high voltage current. For this purpose, special devices are used. Exposure occurs through a rectal emitter installed in the device.
It is possible to apply procedures simultaneously with any drug therapy, without worrying about the compatibility of the methods. Physiotherapy procedures do not have any side effects, with the exception of only rare cases of individual intolerance.
You can also use the apparatus for the treatment of prostatitis at home.
How to treat prostate inflammation in men?
Prostate massage – an effective method of treating prostatitis, time-tested. With its help one of the most important medical tasks is achieved – removal of the stagnant secret of the prostate gland.
Stimulation of the prostate also improves blood circulation in the tissues of the prostate gland. This method of treatment of prostatitis is made through the anus. The prostate gland is massaged through the wall of the rectum. At the same time, it is necessary to monitor whether the secret is highlighted. The lack of excreted fluid may indicate serious complications. The course of massage consists, as a rule, of 10 sessions.
REFERENCE: prostate massage can be performed independently, but it is necessary to be careful and have an idea about the physiology. Improper action can lead to rectal injury.
Do not forget about physical activity. There are specially designed medical gymnastics complexes for the treatment of prostatitis, allowing to improve blood circulation in the affected organ and normalize metabolic processes.
Buy Prostatitis treatment antibiotics
Doctors use antibiotics to treat prostatitis. But, if they are of general effect, they may not bring the desired effect; specially developed drugs are used to treat infectious prostatitis.
How to treat prostatitis? It is important to remember that drug treatment depends on the type of prostatitis.
Universal for the acute and chronic forms of the disease are:
- Augmentin (you can order HERE);
To combat viruses that are deep inside the affected organ, macrolide tablets and injections are used:
- Azithromycin (you can order HERE);
Effective antibiotics without side effects for injections:
Antibiotics with immunostimulating effect:
It is worth remembering that the scheme of treatment of prostatitis in men is prescribed strictly by the attending physician. Medicines in the form of tablets are taken, of course, independently, but if injections were prescribed in the treatment of prostatitis, then an outpatient clinic visit is necessary. At home, the injection can be performed only by a person who has at least an elementary medical education.
Acute prostatitis treatment guidelines
Acute prostatitis develops over a long time and leads to a significant decrease in the level of moral and physical comfort of patients. Therefore, it is recommended to follow certain treatment rules in order to alleviate suffering, prevent recurrence and accelerate recovery:
1. Overcooling. Even short-term hypothermia (for example, sitting on a cold bench) can cause severe pain in subsequent hours. Therefore, it is very important to minimize the possibility of hypothermia. Men who work outdoors or in unheated rooms are advised to wear warm underwear. Also beneficial effects have warm baths and showers that can ease the pain.
2. Diet. Alcohol, spicy foods and coffee are known to have an irritating effect on the prostate gland and can exacerbate the symptoms of chronic prostatitis. The diet should include low-fat varieties of fish and meat, cereals, dairy products, fresh vegetables and fruits and dried fruits, seafood, honey, juices and compotes. Limit, and it is better to completely abandon alcohol, carbonated drinks, fatty and smoked dishes, pastries, garlic and onions, mushrooms, by-products.
3. Underwear. The epididymis in patients with chronic prostatitis is usually very painful, therefore it is necessary to minimize its irritation. In order to reduce the load on the epididymis, it is recommended to wear tight underwear that would bring the testes closer to the groin. In addition to removing the extension of the epididymis, narrow underwear will help retain heat and protect the testicles from hypothermia.
4. Recreation and relaxation. Good rest and full sleep, largely contribute to improving the flow of all body processes, including the healing process. Because it is recommended to relax more. It is necessary to avoid physical overwork and emotional overload, which can cause exacerbation of the symptoms of prostatitis.
5. Ejaculation and erection. If ejaculation and an erection are painful for you, then it is worth keeping a measured sex life, without aggravating the pain with frequent intercourse. Well, if ejaculation eases suffering, then it is not necessary to limit the number of sexual intercourses.
6. Urination. In case urination gives you relief, try to drink plenty of fluids and go to the toilet more often. On the contrary, if urination is painful, it is worth reducing the amount of fluid consumed, especially before bedtime. In either case, urinary retention should be strictly avoided and the bladder should be emptied at the first urge – urinary retention is one of the factors supporting chronic inflammation in the urinary tract.
Considering that the factor causing the disease is stagnation of blood in the pelvis, and it arises due to a sedentary life and a long stay in a sitting position, for the prevention of prostatitis should move more. It should be more walking, running, swimming, playing beach sports, and in winter – skiing and skating.
Alpha blockers for prostatitis (BPH). Alpha-1-adrenoblockers
Alpha-1-adrenoblockers are drugs that are necessarily used in the treatment of inflammatory processes in the prostate. These medications help to improve urodynamics, that is, to normalize the passage of urine.
The principle of the drugs is simple. Medications block alpha-1-adrenergic receptors, thereby causing relaxation of the smooth-muscular structure of the urethra, the neck of the bladder and the prostate.
As a result of the use of alpha-1-adrenoblockers, the urinary retention normalizes, severe pain disappears during urination, the risk of acute urinary retention is significantly reduced. By the way, these medications are used not only for prostatitis, but also for prostate adenoma.
Take alpha-1-adrenoblockers followed by long courses. To get rid of dysuric disorders, you need to drink tablets for at least a month. If necessary, a longer course of therapy is prescribed.
On the modern pharmacological market, there are many effective medicines of this segment. There are many alpha-1-adrenoblockers of Russian origin.
If you believe the reviews, the best pills for prostatitis are:
- Omnic (Flomax)*;
- Omnic Ocas;
- Alfuzosin (Uroxatral)*;
- Dalfaz Retard (France);
- Tamsulosin (Flomax)*;
- Hytrin (Setegis)*;
- Terazosin (Hytrin)*.
*Preparations marked in blue can be purchased HERE
If you use the above medicines, your blood pressure may decrease. Before taking alpha-1-adrenergic blockers, a consultation with a doctor is mandatory.
Bioregulatory peptides. Bacterial prostatitis treatment
In the treatment of prostatitis it is recommended to use bioregulatory peptides. These drugs help to level the signs of the inflammatory process and significantly improve the patient’s quality of life.
The active component of such preparations is a complex of peptides derived from the prostate gland of cattle. Additionally, the composition may include zinc, vitamin E and other micronutrients useful for men’s health.
- Increase the potency. This action of drugs is very important, since with inflammation of the pancreatitis, erectile dysfunction often develops.
- Prevent stagnation of blood in the small pelvis, prevent the formation of blood clots.
- They help to improve the quality of sperm, improve the blood circulation in the vessels of the prostate, normalize the coagulability of the blood.
- Prevent stagnation of the prostatic secretion.
- Take off the edema.
- They stop the pain syndrome, improve the flow of urine.
The list of the best bioregulatory peptides includes Prostacor, Samprost, Vitaprost, Prostatilen, Prostatilen Zinc, Uroprost. Medicines are given in the form of tablets, injections and rectal suppositories.
Medications can be taken for both treatment and prevention of prostate diseases.
NSAIDs and antispasmodics in prostatitis treatment
Leveling manifestations of prostatitis is not bad helped by antispasmodics and NSAIDs. Spasmolytic medications are prescribed for the purpose of arresting spasms in the prostate. Such medications also help to improve the flow of urine.
The most popular and effective antispasmodics are No-Spa, Drotaverine hydrochloride and Baralgin. These drugs are available in the form of tablets and injection solutions. You can not use the funds for a long time. The optimal duration of use of antispasmodics is 5-10 days.
NSAIDs (non-steroidal anti-inflammatory drugs) are a group of drugs that are widely used for inflammation of the prostate. Medications help to stop the inflammatory process, eliminate pain in the perineum and even lower the temperature of the body.
Rapid-acting and effective NSAIDs:
- Ibuprofen (Motrin)*;
- Naproxen (Naprosyn)*;
- Ketorolac (Toradol)*;
- Indomethacin (Indocin);
*Preparations marked in blue can be purchased HERE.
The duration of NSAID intake is determined strictly on an individual basis.
Can Viagra, Cialis and Levitra be taken for prostatitis?
An urologist for therapeutic purposes may recommend taking Viagra, Cialis and Levitra for prostate diseases. Each of the drugs is considered exclusively symptomatic and does not cure inflammation or hyperplasia. Preparations are ranked as PDE5 group or phosphodiesterase inhibitors. Medicines are not shown absolutely to all patients. In addition, their use has a number of contraindications and side effects. Reception begin only on the recommendation of the urologist, subject to the availability of direct indications for use.
Benign prostatic hyperplasia (BPH) and inflammation do not suddenly appear. Pathologies preceded by long-term structural and functional tissue changes. Gradually worsened blood flow. Vessels and ducts clog cholesterol plaques, calcinates.
The lack of microcirculation leads to the appearance of a number of symptomatic manifestations accompanying prostate adenoma and inflammation of its tissues:
- dysuric disorders;
- erectile dysfunction;
- pain syndrome.
These symptoms are especially evident in chronic prostatitis and advanced hyperplasia. A good measure that prevents blood stasis, as well as restoring the function of the prostate are regular sex with a regular partner.
With a full orgasm, the gland walls are reduced, a kind of massage takes place, which contributes to a decrease in the volume of stagnation and, as a result, the patient’s recovery or, at least, the transition of prostatitis to remission.
The target of the urologist in the period of drug treatment of prostatitis and during recovery after surgery, to help the patient regain lost sexual and reproductive functions.
For this reason, a selective inhibitor of specific phosphodiesterase type 5 (Viagra, Cialis or Levitra) is prescribed for convalescent patients to increase potency, in order to restore normal sexual relations. The consequences of the use of these drugs – persistent erection, sufficient for natural coitus and full ejaculation.
The therapeutic effect of PDE5 drugs is based on the release of nitric oxide inside the cavernous body. It is this process that starts when a man is sexually aroused. In fact, the drugs repeat the natural reaction of the body, strengthening and accelerating it several times.
While taking PDE5, it should be remembered that the pills themselves do not cure erectile dysfunction, giving only a temporary effect. In addition, medications are ineffective for chronic impotence.
The most common drugs belonging to the PDE5 group are: Viagra, Cialis, Levitra. These drugs are most often recommended for the restoration of blood supply to the penis and the normalization of microcirculation in cases of extensive stagnation.
Indications for prescribing drugs of this group:
- violations of potency caused by congestion and other pathological changes (diabetes, changes in hormonal levels);
- disruptions of erectile function due to surgery and excision of prostate tissue.
The use of these drugs is allowed after removal of the prostate gland. They can be taken for adenoma and malignant hyperplasia.
If a surgical intervention is planned, long-term abstinence from PDE5 is required, since the drug affects the intensity of blood circulation.
Experience with prostate resection unequivocally proves the use of these drugs to overcome the psychological impotence caused by the stress from prostatectomy. Although the effect of PDE5 leads to vasodilation, it is allowed to use them in case of complications caused by prostatitis: varicocele, hormonal shifts.
There are contraindications, among which are:
- deformation of the penis;
- arterial hypertension;
- severe heart and vascular diseases;
- renal and hepatic failure;
- peptic ulcer disease of the gastrointestinal tract in the acute period.
Some studies have shown that taking drugs like Viagra, Cialis and Levitra leads to an exacerbation of prostatitis. The probability of complications is in the case of an infectious disease. With regular use, due to blood flow, inflammation increases significantly. It is strictly forbidden to use PDE5 in the period of exacerbation of any form of prostatitis.
How does Viagra affect the treatment of prostatitis? Sildenafil for BPH
Viagra (Sildenafil) remains one of the most popular medicines used to restore potency. The active substance is Sildenafil, stimulating resistant erection in a natural way.
Acceptance of Viagra with prostatitis and prostate adenoma is limited to a single dosage of 50 mg. Depending on the existing contraindications and complications of the underlying disease, the volume is increased to 100 mg, or vice versa reduced to 25 mg.
Viagra is not prescribed for the examined patients who have identified serious pathologies of the cardiovascular system, as well as those who have recently had a heart attack or stroke.
Direct contraindication – the patient’s age. Erectile dysfunction in men younger than 18 and older than 70 years is treated with other medicines.
The direct effect of Viagra on the prostate gland is absent. Sildenafil affects the cavernous vessels of the penis. Enhanced plasma influx leads to relaxation of smooth muscles, elimination of spasm, which leads to persistent erection. Viagra helps to achieve orgasm. Full ejaculation, in turn, leads to the elimination of stagnant phenomena.
Sildenafil itself does not cure the prostate, therefore it is not included in the classical scheme of therapy. Urologists prescribe it exclusively as a temporary means to enhance potency.
Sildenafil for prostate cancer
With regard to cancer, the results of recent research in this area point to the undoubted benefit of Sildenafil when it is included in the course of rehabilitation after chemotherapy.
Viagra can be taken for prostate cancer, provided it is combined with Doxorubicin. During the interaction of two active drugs, reactive oxygen compounds are produced that actively fight cancer formations.
Cialis for prostatitis. Low dose Cialis for BPH
As part of Cialis, there is an inhibitor of phosphodiesterase. Combination with other active ingredients enhances the effectiveness of Cialis.
Regular intake of tadalafil has a positive effect on the entire urogenital system. In the treatment of inflammation and prostatic hyperplasia, Cialis is used exclusively as a symptomatic remedy that enhances the potency, stimulates the blood supply and, as a result, eliminates puffiness.
The use of Cialis for prostatitis is limited in the presence of the following disorders:
- intolerance to tadalafil, the main active substance;
- ischemic neuropathy;
- taking nitroglycerin;
- combination with other inhibitors;
- contraindications to sexual relations due to injuries or surgery.
The effect of Cialis is not limited to the impact solely on the prostate gland. Urologists indicate that there is a general effect on the entire urogenital system. The drug is recommended to combat the complications of chronic prolonged inflammation.
Levitra for prostatitis. How does Levitra (Vardenafil) affect the prostate gland?
Levitra is an analogue of Viagra with an enhanced effect on the function of the prostate gland. The impact of Levitra differs by the duration of the effect, the speed of the first results.
Taking Levitra is recommended to achieve the following therapeutic effect:
- restore potency;
- removal of psycho-emotional barrier, self-suggestion and fear of failure during sexual intercourse;
- increased blood supply to the pelvic organs;
- elimination of stagnation.
The use of Levitra for prostatitis is not allowed in the case of internal bleeding, in the early postoperative period. The expediency of using vardenafil will be determined by the urologist after a full examination of the patient.
Tablets and capsules to increase potency
At men of elderly and young age potency owing to inflammatory process in a prostate gland is quite often decreased. Even after the transition of prostatitis to the stage of persistent remission, there may be a flaccid erection or a complete absence of a riser.
There is a way out. With impotence, you can use sexual stimulants. There are many tablets, powders and capsules that help in the shortest possible time to stabilize the erectile function.
What drugs are optimal for inflammation of the prostate is shown in the table.
|Name||Instructions for use||Duration of admission|
|Cialis||Take 20-40 mg for 20-40 minutes before sexual activity||The periodic reception is shown|
|Viagra and analogues based on sildenafil (Sildenafil SZ, Eroton, Kamagra, Eregra, Dynamico, Viatine, Erexel, Maxigra)||Drink 50-100 mg an hour before coition||Periodic reception is provided|
|Yarsagumba Forte||Drink 1 capsule per day||Month|
|Impaza||To dissolve on 1-2 tablets a day||Twelve weeks|
|Levitra||Take 20-40 mg for 20-40 minutes before sexual activity||Use as needed|
Let’s sum up. Cure prostatitis medically under the power of each patient. The main thing is not to postpone the problem to the “remote box” and when the first signs appear, contact the urologist. If the therapy is carried out in a timely manner, the man can quickly cure the disease and live a full life.
It is necessary to take into account the fact that prostatitis requires complex treatment. The patient will have to follow all the doctor’s recommendations. To quickly get rid of the disease, you need to be balanced eating, giving up bad habits, attending physiotherapy procedures, leading an active lifestyle. An integrated approach to the problem is the key to the success of therapeutic interventions.