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Most cases of urinary tract infections, commonly referred to as cystitis, can affect any part of the body’s “waterworks”. Most urinary infections are caused by bacteria that enter the urethra from the outside. About 70 per cent of cystitis is caused by the bacterium E coli (Escherichia coliform). This germ lives in the bowel where it is generally harmless, but when E coli gets into the bladder it breeds very rapidly and within 12 – 24 hours it is likely to start causing the typical symptoms of cystitis. Other bacterium that causes urinary tract infections includes Staphylococcus saprophyticus and Proteus.

Bacterium usually enters via the urethra (an inflammation in the urethra itself is known as urethritis) then creeps up into the bladder (where it becomes cystitis). If cystitis is not treated the infection may spread further up to the kidneys causing pyelonephritis, which is potentially serious. Untreated kidney infections can, although it is uncommon, lead to chronic pyelonephritis, which may in turn lead eventually to renal failure.

One in two women suffer from urinary tract infection at some time in their lives, and one in five experience bout after bout. The reason women experience so much more urinary tract infection than men is that most infections are caused by bacteria from the bowel. For men to be affected, the germs have to travel from the anus right down to the tip of the penis to gain entry to the urethra – an average distance of 18 or 20 centimeters; in women the distance is only about 4 centimeters.

Symptoms: The main symptom is the need to rush to the toilet, urgently, every few minutes. You may feel as though your bladder is full to bursting point, yet you pass only a dribble of urine, which may be dark or cloudy, or even tinged with blood. As you pass water you may feel a burning or stinging sensation. The need to go to the toilet is so strong that it may wake you up several times in the night. You may also feel a continuous burning or dragging pain in your pelvis or lower back, which is caused by inflammation. The inside of the bladder is lined with very sensitive cells and these react strongly to the presence of invaders. In severe attacks the bladder lining actually bleeds, and this is what causes the urine to look dark orange or red. The symptoms of extensive urinary tract infection include back pain, fever, chills and shaking, and constantly feel tired and unwell.

Common triggers: The symptoms of cystitis often come on very suddenly, often for no obvious reason. Some Doctors are of the opinion that many cases of recurrent cystitis are due to genetic factors which – in various ways – make the bladder poor at ridding itself of invasion by bacteria. For example, the urine of infection-prone women tends to be more acidic than normal – and bacteria breed better in acid conditions than in alkaline ones. Other sufferers are thought to have cells in the lining of the urethra, which helps bacteria to cling on, making it easier for them to climb up to the bladder.

Prevention tactics: Drink at least six to eight glasses of water a day to flush out germs before they breed. Cut down on coffee, tea, alcohol, sodas and sugary food. Don’t “hang on” when you need to pass water; the urine in your bladder may become stagnant and turn into a breeding ground for bacteria.

Treatment: Take action at the very first signs of cystitis: Mix a teaspoon of bicarbonate of soda in two cups of water (add weak fruit juice for a better taste) and drink it; if you have high blood pressure or heart trouble talk to your doctor first. Sodium bicarbonate makes the urine much more alkaline, so bacteria are less inclined to breed and the urine will be less irritating to the lining of the bladder. Sodium citrate and potassium citrate has a similar effect. Your doctor should use a dipstick test on your urine to find out if blood is present and to confirm the presence of infection. If you suffer from recurrent attacks, your GP may suggest a low-dose antibiotic for several months.

Imitators: Vaginal infections often produce symptoms very similar to cystitis. Thrush is caused by a build-up of candida albicans – a yeast-like substance that causes irritation and a discharge. Ironically, thrush is often triggered by antibiotics – including those prescribed for cystitis. This is because they knock out the bacteria that usually keep candida in check. Trichomoniasis is a vaginal infection that causes redness and swelling of the vulva and makes urination uncomfortable. Chlamydia occasionally causes burning on urination. The organism that causes it cannot be detected in urine tests so if you have the symptoms of cystitis but a test result is negative, ask your doctor to test for chlamydia.