The Myth Of Interstitial Cystitis And Bladder Syndromes
IC and bladder syndromes are known as diagnoses by exclusion. They dont identify a reason for a patients symptoms, they simply describe collections of symptoms. For example, the NHS Choices website describes IC as a poorly understood, incurable condition.
There is no agreed cause or cure for IC and bladder syndromes. But there is a view among many doctors based on tests which are known to be ineffective that they are not caused by bacteria. Sufferers are offered surgery or prescribed painkillers, including opiates, bladder relaxants and bladder instillations to alleviate symptoms.
Bladder instillations had no more effect than a placebo, a recent large-scale study found. A growing body of evidence suggests that long-term bladder and urinary pain may be caused by infections missed by tests that dont work.
You Eat A Lot Of Sugar
Bacteria that cause UTIs love feeding on sugar, so you run the risk of providing a feast for them whenever your sweet tooth strikes. Kalas V, et al. Structure-based discovery of glycomimetic FmlH ligands as inhibitors of bacterial adhesion during urinary tract infection. DOI: 10.1073/pnas.1720140115
If you eat tons of added sugars and get a real surge in your blood sugar, you may end up with some of that sugar in your urine, says Mary Jane Minkin, MD, a clinical professor of obstetrics and gynecology at the Yale School of Medicine.
Some foods and beverages, like coffee, booze, and chocolate, can also irritate your delicate urinary tract and exacerbate an existing UTI.
Check If It’s A Urinary Tract Infection
Symptoms of a UTI may include:
- pain or a burning sensation when peeing
- needing to pee more often than usual during the night
- pee that looks cloudy
- needing to pee suddenly or more urgently than usual
- needing to pee more often than usual
- lower tummy pain or pain in your back, just under the ribs
- a high temperature, or feeling hot and shivery
- a very low temperature below 36C
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What Causes Chronic Urinary Tract Infection
This is where the science gets a little more complicated.
Weve talked elsewhere about what causes UTIs. And above, we explained that recurrent UTIs can be attributed to a persistent bladder infection that is not properly eradicated by treatment.
A persistent bladder infection can last for years in the form of a chronic urinary tract infection. For many females, the cycle of acute and symptom-free periods is never broken, and some move on to be diagnosed with the conditions mentioned above, such as Interstitial Cystitis , or Painful Bladder Syndrome . More on that later.
Why has it been so difficult to detect and treat these infections?
There is a culprit here, so lets take a closer look. Behind the misdiagnosis of hundreds of thousands of people, are embedded chronic urinary tract infections that involve biofilms.
Seek Medical Attention For Utis
It is important to seek medical attention if you think you may have a UTI particularly if you think you may have a bladder or kidney infection, both of which are very serious conditions. Early treatment of urinary infection can help to prevent infection spreading to the bladder or kidneys.
Your doctor will test your urine to check which micro-organism is present. Urinary tract infections usually respond quickly and well to antibiotics.
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Urinary Tract Infection Diagnosis
Bladder infections are sometimes difficult to diagnose in elders because of uncommon symptoms that might occur. If a bladder infection is suspected, the easiest way to get a diagnosis is to go to the doctors and have a urinalysis done.
With a simple urine culture a doctor is able to tell whether you have an infection or not, what kind of bacteria caused your UTI and what antibiotic should be used to treat it.
What Causes Chronic Bladder Infection
Chronic bladder infection is a type of urinary tract of infection . It is recurrent and keeps on reoccurring. Antibiotics can help in relieving the symptoms. However, the symptoms can come back even after the treatment. Women are more prone to this type of UTI than men are. The reasons may include the following-
- Changing the level of estrogen during menopause
- Stones in the bladder or kidney
- Family history
- Presence of bacteria in the urethra
- The irregular shape or the function of the urinary tract
There can be certain reasons that result in causing the chronic bladder infection. One of them is bacteria in the urethra. The bacteria may find a way in the bladder through the urethra. This may lead to cause infection.
In addition, sexually transmitted diseases can spread from one person to another through sexual contact. Bacterial infections like Chlamydia, gonorrhea, and syphilis can reach the bladder and cause chronic bladder infections.
How does this infection symptomize?
It may show similar symptoms like other types of urinary tract infections .
- Pain in the lower back
- Frequent urges to go for urination
- Bladder pain
- A scorching sensation while urinating
- Dark-colored urine often accompanied by blood
If you notice any of these symptoms, consult with your doctor. He or she may diagnose your condition and prescribe suitable medications to address your problem.
How can I prevent chronic bladder infection?
To prevent the UTIs, you should-
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Chronic Urinary Tract Infection Causes
Urinary tract infections result from bacteria finding its way into your urine. Although urine is normally bacteria-free, there are many ways bacteria can enter your urinary tract. Causes and risk factors include:
- Sexual intercourse
- Certain types of birth control
- Low estrogen levels
- Holding in urine or not emptying your bladder completely
- Not drinking enough water
Why Does My Uti Keep Coming Back
Chronic or recurring UTIs may keep coming back due to one of the risk factors listed above. Use of spermicides for birth control, for instance, may kill off beneficial bacteria in and around the vagina, making it easier for harmful bacteria to enter the urinary tract.
In some cases, what seem like recurrent UTIs may actually be another condition, such as kidney stones or interstitial cystitis, a painful bladder condition with no infection. If you think youre getting recurrent UTIs, see your provider, who can help rule out another condition, notes ACOG.
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Classification Of Urinary Tract Infections
UTIs are classified into 6 categories. The first category is an uncomplicated infection this is when the urinary tract is normal, both structurally and physiologically, and there is no associated disorder that impairs the host defense mechanisms. The second category is an complicated infection this is when infection occurs within an abnormal urinary tract, such as when there is ureteric obstruction, renal calculi, or vesicoureteric reflux. The third category, an isolated infection, is when it is the first episode of UTI, or the episodes are 6 months apart. Isolated infections affect 2540% of young females. The fourth category, an unresolved infection, is when therapy fails because of bacterial resistance or due to infection by two different bacteria with equally limited susceptibilities. The fifth category, reinfection, occurs where there has been no growth after a treated infection, but then the same organism regrows two weeks after therapy, or when a different microorganism grows during any period of time., This accounts for 95% of RUTIs in women. Bacterial persistence happens when therapy is impaired by the accumulation of bacteria in a location that cannot be reached by antibiotics, such as infected stones, urethral diverticula and infected paraurethral glands. The sixth category, relapse, is when the same microorganism causes a UTI within two weeks of therapy however, it is usually difficult to distinguish a reinfection from a relapse.
You Dont Drink Enough Water
Guzzling H2O will make you go pretty often. And thats a good thing. When you do this, the bacteria gets flushed out before they have a chance to grab hold, Minkin says.
Consider that your cue to make a giant water bottle your BFF. Hooton TM, et al. . Effect of increased daily water intake in premenopausal women with recurrent urinary tract infections: A randomized clinical trial. DOI: 10.1001/jamainternmed.2018.4204
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How Do I Talk To My Gp About Chronic Urinary Tract Infections
Unfortunately currently guidelines for GPs dont even mention chronic UTI. We know it can be difficult to explain all this and describe your symptoms in a short doctors appointment.
Write down all your symptoms as we outlined above and take them with you to your appointment.
Your doctor may well investigate if your UTIs are related to your prostate. But if these investigations come back negative ask your GP to consider chronic UTI.
No detail is too small when visiting the doctor about urinary problems. It may help to write down a list of symptoms, no matter how small, and take them with you to your appointment. For example an unusual smell, abnormal amounts of foam, or persistently darker urine than usual may seem unimportant to you, but to a doctor these can be the characteristic symptoms required to diagnose a given condition.
Can I Prevent Recurrent Utis
There are steps you can take to help reduce UTIs. The most basic is to drink plenty of fluids. This encourages frequent urination and helps flush out bacteria.
For women, following good hygiene practices is especially important:
- After a bowel movement, wipe from front to back to reduce the chance of moving E. coli bacteria from the rectal area to the urethra.
- Pee immediately before and after sex.
- Dont douche or use feminine deodorants on your genitals.
- Wear cotton underwear.
For older adults, take care to deal with retention problems, which are especially an issue as you age.
I tell them to double-void urinate and then go back and urinate again, Dr. Vasavada says.
What about drinking cranberry juice to fight UTIs?
Thats one of the most commonly asked questions, Dr. Vasavada says. Theres conflicting data. Its not going to cure an infection, but it could help prevent one, so we dont discourage it.
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Remedies For Chronic Bladder Infections
Fortunately, there are some actions you and your doctors can take to get rid of chronic bladder infections once and for all.
Antibiotics: Antibiotics can be prescribed to kill the bacteria causing your UTIs and prevent new bacteria from entering.
Drinking Water: Drinking more water can help you pee more often to flush out any bad bacteria in your urinary tract.
Unsweetened Cranberry Juice: Adding unsweetened cranberry juice to your diet has been proven to help prevent and treat bladder infections.
Good Hygiene: Prevent bacteria from causing infections by wiping properly, urinating as soon as you need to, peeing all the way, and washing your genitals every day with the appropriate soaps.
Surgery: Surgery can be used to remove medical conditions such as kidney stones that contribute to chronic bladder infections.
Causes Of Bladder Infection In Men
Cystitis is less common among men. In men, a common cause is bacterial infection of the prostate Prostatitis Prostatitis is pain and swelling, inflammation, or both of the prostate gland. The cause is sometimes a bacterial infection. Pain can occur in the area between the scrotum and anus or in the… read more that causes repeated episodes of cystitis and urethritis. Urethritis Urethritis is infection of the urethra, the tube that carries urine from the bladder out of the body. Bacteria, including those that are sexually transmitted, are the most common cause of urethritis… read more Although antibiotics quickly clear bacteria from the urine in the bladder, most of these drugs cannot penetrate well enough into the prostate to quickly cure an infection there. Usually antibiotics must be taken for weeks at a time. Consequently, if drug therapy is stopped prematurely, bacteria that remain in the prostate tend to reinfect the bladder.
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How Is It Investigated
If you have recurrent UTIs, then some of the ways that we investigate this are:
Enhanced Urine Testing We will take a urine sample to test for bacteria and white blood cells. We may also send your urine for specialised urine tests such as broth cultures and polymerase chain reaction to look for more unusual bacteria
Imaging It may be necessary to do ultrasounds to check on your kidneys and bladder emptying, special X-ray studies to see if there is an obstruction or stones in the urinary tract. We may also look into your bladder by passing a special scope through the opening into your bladder. This exam is called a cystoscopy.
Functional tests We may use a test called urodynamics to check how your bladder responds when it is filling up and how well coordinated your bladder and urethra are when you try to pass urine. Problems in these aspects of your bladder function may contribute to bladder symptoms and / or increase your susceptibility to UTIs.
Urinary Tract Infections In Men That Just Dont Go Away
Although painful and distressing most are short-lived. But if you keep on getting a UTI or feel like its never really gone away you could have chronic infection.
Chronic UTI often starts when a simple infection is left untreated or fails to get better with standard treatments. Read about how and why chronic UTI develops.
Needing to pee all the time, pain when you pee, passing tiny amounts of urine, bladder and urethral pain, pain in your belly, back and legs, difficulty passing urine, problems with incontinence. The symptoms of chronic UTI are similar to acute infections but they vary from person to person.
Currently theres just not enough research to understand why some people never experience a UTI, why some people have one or two infections and why some people develop chronic infections.
The symptoms of chronic UTI are, frustratingly, not exclusive to the condition they are common to a number of other lower urinary tract health conditions as well. This can often result in other avenues being explored for diagnosis first by your GP, leading to chronic UTIs being diagnosed by exclusion of other conditions, all the while allowing the UTI to develop further.
Other LUTS conditions that are investigated in men include:
- detrusor muscle weakness or overactivity
- prostate inflammation
- neurological disease
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How Biofilms Can Cause Your Uti Symptoms To Come And Go
Lets compare the science of biofilms with the symptoms a sufferer of a chronic urinary tract infection may experience, using E.coli as an example pathogen:
|Stage One||THE SCIENCE:|
|New biofilm attachments may begin to form Free-floating bacteria are flushed from bladder Without appropriate treatment, the process repeatsHOW IT FEELS: A cycle of recurrent UTI as the biofilm fluxes over time|
We should also note here that biofilms can be fungal as well as bacterial, and there may be more than one pathogen present in the bladder at any given time. In fact, biofilms can be complex and diverse communities of multiple pathogens.
|These organisms like to live in communities. Biofilms are like apartment buildings, and the longer that you’ve had this chronic infection, the more likely it is that you have more and more residents that have come to join the party. And they like to support one another, they live synergistically. It’s sort of like a ball of yarn. You have to start pulling somewhere if we’re ever going to unravel this big, knotted up mess.|
For the sake of simplicity, and because bacterial infections of the urinary tract are much more common than fungal, well stick to bacteria for our examples. But keep in mind, what causes a chronic urinary tract infection in one person is very likely different from the next person.
Fascinated? A UK research team has put together a more in depth look at how biofilms and IBCs form for you to view.
So How Big Is The Problem
Its a massive problem. Up to 1.7 million women in the UK suffer from chronic lower urinary tract symptoms. A recent study found and other research suggests a similar number of men could be affected. A growing body of international research suggests that many people suffering from long-term urinary problems may have undiagnosed bacterial infections.
Yet the National Institute for Health and Care Excellence guidelines do not recognise the existence of chronic UTI and when tests results are negative and short courses of antibiotics fail to work many specialists seem unwilling to accept that chronic urinary symptoms can be caused by bacteria.
Patients are routinely dismissed as anxious and offered counselling and psychiatric referrals. Sufferers are forced to live in agony and lack quality of life, without ever finding effective treatment or anyone to diagnose and understand their condition. Stuck in a chronic UTI loop.
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Bladder Infections In Females Vs Males
Because bacteria can more easily reach the bladder in women, women are more prone to get bladder infections. For men it is more difficult to contract a UTI, than for women for basic anatomy reasons. However that doesnt mean it cant happen. Everyone should keep good hygiene and stay hydrated to help lower the risk of UTIs.
Risk Factors For Urinary Tract Infections
And now a brief note about reproductive parts: Although people with penises do get UTIs, people with vaginas are more at risk. It all boils down to the anatomy, Minkin says.
Bacteria that cause UTIs often make their way from the back door to the front and then up the urethra to wreak havoc on the urinary system.
Because the male reproductive system has a longer urethra than the female reproductive system, the bacteria have farther to travel, which makes it more difficult for a UTI to develop.
But regardless of anatomy, once youve had one UTI, youre more likely to get another, especially if you have a vagina. Hickling DR, et al. . Management of recurrent urinary tract infections in healthy adult women.
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