cystitis

Your Health - Dr. Gita Mathai

http://www.telegraphindia.com/1160606/jsp/knowhow/story_89487.jsp

---

• 

Sometimes, without warning, people (mainly women) develop a burning sensation while urinating and a heaviness in the lower abdomen. They have to run to the toilet frequently but pass small quantities of high coloured or blood stained urine. They may or may not have fever. The agony is apparently indescribable! In children, the symptoms may be subtle - with vomiting or sudden loss of bladder control.

These are the classical symptoms of cystitis, the medical term for inflammation of the urinary bladder. Cystitis is usually due to a bacterial infection. It is annoying and debilitating, and can become a serious problem if the infection ascends from the bladder to the kidneys.

All cystitis is not due to infection. It may be a complication of another illness, such as catheterisation or radiation treatment for cancer. It may be due to allergy to feminine hygiene sprays, harsh soap or some other chemicals used on the private parts.

Women are more prone to UTIs than men. Around 85 per cent of medical consultations by women are for UTI or related symptoms. By the age of 30, 30 per cent of women and in a lifetime, 50 per cent will experience at least one episode of UTI. Young men are 30 times less prone to infection than women. The disparity is due to the shorter length of the female urethra, its proximity to the anus, and hormonal changes that occur with pregnancy and menopause.

A thorough examination should be done if UTI is suspected. This includes a general check up and a pelvic examination. In men, an enlarged prostate can cause an impediment to the free flow of urine. In women it can be fibroids or some other growth in the uterus and ovaries. In both sexes, stones in the urinary tract (kidney, ureter, bladder) can be responsible for obstruction. People who are catheterised, have diabetes, are on steroids or are immune-compromised are prone to UTI. These conditions need to be treated for the UTI to respond to treatment.

In addition, the urine needs to be examined and cultured so that the choice of antibiotics is appropriate. Pelvic ultrasound scans, X-rays, CT scans and MRIs may be needed. Sometimes the inside of the bladder may need to be visualised using a scope.

Most UTIs are caused by a bacteria called Escherichia coli. It has little protrusions called pili with which it attaches itself firmly to the bladder wall. Initially, E.coli were responsive to treatment. Taking mild antibiotics for only three days was sufficient to cure it. Now stronger antibiotics may need to be used as the organism has become resilient and resistant. The duration of therapy also has to be seven or 14 days. It is important to follow your physician's advice about the choice of antibiotic and the length of treatment. A medicine that worked for one individual may not be suitable for another. Even if UTIs are recurrent, self-treatment with OTC (over the counter) drugs should be avoided.

Drinking cranberry juice regularly has shown some benefit in UTI. This is because it contains active natural chemicals like condensed tannins and proanthocyanidins, which prevent E.coli and other bacteria from attaching themselves to the bladder wall.

To prevent UTI

♦ Drink 2.5 -3 litres of water a day depending on the climate and the level of physical activity. Do not wait for thirst to develop.

♦ Lean backwards (women) while passing urine.

♦ Clean the area after passing motion from front to back. This is very important in children.

♦ Pass urine before and after intercourse.

♦ Gently wash the skin in the genital area with a mild soap. Do not use perfumes and sprays.
 

Dr Gita Mathai is a paediatrician with a family practice at Vellore and author of Staying Healthy in Modern India. If you have any questions on health issues please write toyourhealthgm@yahoo.co.in