Urinary infections - must be treated promptly

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Urinary tract infections must always be taken seriously and treated promptly, otherwise one risks a kidney infection and possible permanent kidney damage.

The symptoms may be one or more of:

  • Burning sensation on peeing (called cystitis);
  • Desire to pee all the time (strangury);
  • Fever;
  • Feeling unwell (malaise);
  • Pain over the bladder, or to one side, or extending up to the back - Classically loin to groin pain;
  • Foul smelling urine;
  • Blood in urine.

Children and older people may present with non-specific symptoms such as:

  • Failure to thrive;
  • Fatigue;
  • Fever;
  • Mood change;
  • Acute confusion.

Diagnosis

The urine should be tested with Multistix (available at my online shop here ) which may show protein, blood, white cells and/or nitrites - these Multistix come together with an interpretation sheet to explain the colour changes which may be observed, and any action which should be taken. If any are positive, a urine sample (an "MSU" - Please see here for the Patient.co.uk page on Midstream Specimen of Urine, MSU) should be sent off and an antibiotic started at once. This can be checked later against the result of the MSU to see that the bacteria causing the infection is sensitive to that antibiotic. In addition, 1 tsp of sodium bicarbonate per pint of water taken by mouth relieves symptoms but is not a cure.

Next, one must ask why an infection has arisen? Women who have just started sexual intercourse are "allowed" to have one infection. All others require investigation which usually involves ultrasound, IVP and possibly cystoscopy - these all require referral to a specialist. Please see WebMD article on Intravenous Pyelogram - IVP and also WebMD article on Cystoscopy

Some people are prone to UTI for no clear reason. There are two possible routes of infection:

1. The majority of infection comes from bacteria in the outside world gaining access via the urethra. Because women have short urethras compared to men they are more susceptible to urinary tract infections. Sexual intercourse is an obvious trigger for infection in women. For others reflux of bath water into the bladder can cause infection and these women are better off showering instead of bathing.

In men the commonest cause of urinary tract infection is outflow obstruction and the commonest cause of this is either an enlarged prostate or urethral stricture. If the bladder isn't emptied fully this will result in stagnation of urine, so that the numbers of bacteria can build up rapidly.

2. Another possible source of infection is from the gut. Actually the gut is teeming with friendly bacteria, many of which spill over into the blood stream, get into the urinary tract and cause no problems at all. However if there is abnormal gut flora and pathogenic bacteria spill over into the bloods and the urinary tract then that may cause problems. The first thing that bugs have to do is to adhere to the lining of the tract. The commonest bacteria that causes urinary tract infection is e-coli and this requires a sugar in order to stick to the urinary tract. This sugar is D-mannose. So if the urinary tract is saturated with D-mannose bugs stick to this instead and are therefore simply washed out. This makes D-mannose very useful in the management of urinary tract infections caused by e-coli - indeed it is the perfect antibiotic with no side-effects. Cranberry juice has a similar affect. D-mannose can be bought from my online shop here

Preventing urinary tract infections therefore can be helped by attention to the gut flora, and for further recommendations with respect to this see Yeast problems and candida

Finally high dose vitamin C is directly toxic to bacteria and sometimes urinary tract infections can be cleared by taking vitamin C to bowel tolerance during the early stages of infection.

All the symptoms of infection can be mimicked by allergy and if tests fail to show infection, allergy should be considered. The commonest food causing this is yeast. Allergy can be due to yeast in the diet, or yeast in the gut, in which case anti-fungals may be required. You will need a doctor to prescribe this - see Irritable Bladder Syndrome or Allergic Bladder

Related Tests

Related Articles

Urine analysis

References


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