The question
I am a 28-year-old female and I keep getting urinary tract infections. Should I be worried?
The answer
While recurrent urinary tract infections (UTIs) can be due to an underlying abnormality of the urinary tract or a medical condition, some may be due to reversible causes that can be prevented with some simple lifestyle changes.
UTIs are usually caused by bacteria and can involve any part of the urinary tract including the kidneys, ureters, bladder and urethra. While some people may have no symptoms, common UTI symptoms can include burning when you pee, blood in the urine, cloudy urine, frequent urination and abdominal discomfort.
In general, women experience UTIs more than men. Approximately 10 per cent of Canadian women have had one UTI at some point in the past year. Women tend to have urinary tract infections more often because the path to the bladder - the urethra - is shorter in women than in men, which makes it easier for bacteria to enter the urinary tract. The urethra is near the anus and bacteria from the anus and rectum can travel to the urethra and cause infections.
Some simple steps to take to prevent UTIs include:
1. Increasing your fluid intake can increase the frequency of urination which flushes bacteria from the bladder.
2. Emptying your bladder after sexual intercourse helps to help flush out bacteria that may have been spread upward into the urethra during sex.
3. Wiping from front to back after bowel movements helps to prevent the spread of bacteria from the anus to the urethra.
4. Urinating when you feel the urge and emptying your bladder regularly because not urinating for a long period of time may allow bacteria time to multiply.
Another option to help prevent UTIs is to drink cranberry juice or take cranberry capsules. Studies have shown that cranberry can coat the lining of the bladder wall so bacteria cannot stick against the wall and lead to infection. Try to drink pure unsweetened cranberry juice instead of a cocktail version as these are not as concentrated and often have sugar and other preservatives.
If you are experiencing UTI symptoms, increase your fluid intake and consider seeing your doctor to see if a short course of antibiotics could be used to eliminate the infection. If despite these changes, you continue to have recurrent or chronic infections - meaning more than two infections over six months or an infection that lasts for more than two weeks despite treatment - it would be worthwhile to visit your doctor to find out if something else could be causing your symptoms.
Recurrent infections could mean that the antibiotic you have been prescribed is not working or the bacteria is resistant to it. Diabetes, pregnancy, and hormonal changes that occur in postmenopausal women can predispose people to UTIs. Some conditions can mimic UTIs such as sexually transmitted infections in both males and females and inflammation or infection of the prostate gland in males. Recurrent infections could also mean that there is an abnormality in the anatomy of the urinary tract, which can be investigated by having an ultrasound or other studies done by your doctor.
UTIs can recur in people for various reasons but by targeting the preventable causes, medication can be avoided in many cases. If your symptoms persist or worsen it would be prudent to visit your doctor to discuss possible investigations, medication and other options to prevent recurrences.
Send family doctor Sheila Wijayasinghe your questions at doctor@globeandmail.com. She will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail web site. Your name will not be published if your question is chosen.
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