Sunday 22 September 2019

Dear Dr Nina: Why am I getting recurrent UTIs?

Ask the Doctor

A low-dose antibiotic to be taken at night may be prescribed
A low-dose antibiotic to be taken at night may be prescribed

Nina Byrnes

Q I am a 34-year-old woman and I am have a tendency to get urinary tract infections.

I usually try and treat these by drinking lots of water and cranberry juice, as I'd prefer to not take antibiotics. However, the infections have been increasing in regularity and are lasting longer. Is there anything I can do to help prevent them, or do I need to see a doctor?

Answer: Urinary tract infections ( UTI's) are the second most common type of infection in the body. The lifetime risk of having a UTI is 50pc in women.

A UTI may increase the urge to urinate but only a small amount may be passed each time. There may be pain or stinging passing urine and urine may appear cloudy, foul smelling or blood tinged. Other symptoms can include back pain, fever, nausea or pressure or pain in the lower stomach.

Interstitial cystitis is a condition in which the bladder wall becomes irritated or inflamed. It may cause many of the same symptoms as a urinary infection but bacteria are not the cause. There is no specific treatment for interstitial cystitis. Some 90pc of cases occur in women and the cause isn't fully understood.

Potential triggers include smoking, alcohol, caffeinated drinks, fizzy or citrus drinks and especially dark-coloured drinks such as tea, coffee, cola and red wine. Chocolate, spices or highly acidic foods may all also be bladder irritants.

Sex creates friction and facilitates the transfer of bacteria in the genital area. Most women will have some bacteria in their urine post-intercourse but this usually clears itself within 24 hours. In some women, this may trigger a UTI.

If a bacterial UTI is confirmed, an antibiotic will be needed. About 20pc of young women who experience a UTI will have a recurrent infection. If you have had more than one UTI, the chance of recurring infection increases. Women may experience a year or two where they have more frequent infections after which these may stop.

For those with recurrent infections, a low dose of antibiotic taken at night may be prescribed for several months.

Another remedy may include taking a single dose of antibiotic after sexual intercourse or taking a short course of antibiotics as soon as symptoms appear.

Cranberry juice or vitamin C make the urine more acidic and so make it harder for bacteria to grow. They are good at preventing a UTI but will not normally cure one once it occurs.

It is essential to drink plenty of water to keep the urinary tract flushed through. This makes it more difficult for bacteria to grow. Pass urine when the urge occurs and avoid resisting the urge to go.

Passing urine after intercourse is a simple remedy that will help flush out any bacteria that may have entered the body. Wiping from the front to the back helps prevent the transfer of bacteria from the anal area.

If simple measures above don't help and infections are increasing and reoccurring, it may be worth seeing your GP for further tests.

Vaginal infections should be ruled out as they may cause similar symptoms. A renal and pelvic ultrasound will help rule out any kidney, bladder, womb or ovarian issues that may be causing the symptoms.

⬤ If you have any queries, email askthedoctor@independent.ie

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