Wednesday, March 17, 2010

All Woman

Feeling the burn

Monday, February 08, 2010

Dear Dr Mitchell,

I have had a situation for some time now. Whenever I drink a lot of water I go to the bathroom regularly, but when I do not drink a lot of water, my urine burns when I pass it. I went to the doctor and did a urine test and the doctor told me he does not see anything wrong. He suggested that I keep drinking a lot of water. What do you suggest?

The problem that you are now experiencing seems to be due to a urinary tract infection. When the bladder is inflamed there is usually the sensation of wanting to pass urine frequently and this is usually worsened by drinking a lot of liquids. There is also the sensation of incomplete emptying so that having passed the urine, you feel the need to go again. Sometimes there is the need to rush to pass the urine urgently for fear of passing it before being able to go to the toilet and this is because the lining of the bladder is inflamed.

Burning and pain on passing the urine is due to irritation secondary to the inflammation of the lining of the bladder and urethra. The urethra is the tube that takes the urine from the bladder. This can sometimes become traumatised and inflamed by bacteria that is contracted during intercourse and cause frequent passing of the urine. This is called cystoscopy.

A urinary tract infection is usually confirmed by sending a sample of urine in a sterile container to the lab to test for bacteria. If the urine sample does not pick up any significant infection on testing, then you will need a detailed evaluation by a urologist who will use a special instrument to look into the bladder and determine if there is any underlying problem that is contributing to the frequent passage of urine.

An ultrasound of the kidney, ureters and bladder may also be required to rule out any underlying problem such as stones or abnormal growth. A blood sugar test should be done to determine if you have diabetes mellitus since this may be an early symptom of diabetes mellitus in some individuals. This is especially important if you are overweight or have a family history of diabetes mellitus.

You should practice drinking a lot of liquids at least eight glasses daily to try and flush the bladder out. This will reduce your risk of overgrowth of bacteria. This should be done even though you will experience the inconvenience of wanting to empty the bladder frequently. Consuming cranberry juice and taking cranberry tablets daily also helps to coat the bladder and reduce the chance of bacterial overgrowth. This may be costly but will certainly help to reduce recurrent bladder infection.

Consult your doctor and have a urological consultation for further evaluation.

Best wishes.

Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to allwoman@ jamaicaobserver.com; mail c/o Jamaica Observer, 40-421/2 Beechwood Ave, Kingston 5; or fax to 968-2025. See responses to your questions in All Woman. We regret we cannot provide personal responses.

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