Urinary Tract Infections and Fibromyalgia

Urinary tract disorders are another “layer of the onion” that might need to be peeled away to make you better. Of my FMS patients, 25% have chronic UTIs or interstitial cystitis. Individuals with fibromyalgia and CFS often have problems with their urinary system. They may experience chronic urinary tract infections (UTIs), interstitial cystitis, incontinence (involuntary loss of urine), and urinary retention (inability to pass urine).

Urinary Tract Infections

UTIs are more common in women who are sexually active, people with diabetes, and people with sickle-cell disease or anatomical malformations of the urinary tract. Also, women are more prone to UTIs than males, since a women’s urethra is much shorter and closer to the anus than a man’s. This is why proper hygiene is so important in females. UTI can be especially dangerous for infants and can cause permanent renal damage.

Symptoms and signs include painful, hesitant, frequent urination and high temperature lasting for more than three days. Nausea and vomiting along with pain and temperature may indicate a more complicated UTI, in which a kidney is infected.

Some urinary tract infections are asymptomatic. Others may have quite dramatic symptoms including confusion and associated falls, which are common for elderly patients with UTI who show up at the emergency room.

Diagnosis

The diagnosis of UTI is confirmed by a urine culture. A negative urine culture suggests the presence of other illness, such as chlamydia or gonorrhea.

Causes

Common organisms that cause UTIs include E. coli and S. saprophyticus. Less common organisms include P. mirabilis, K. pneumoniae, and Enterococcus spp.

Over 90% of UTIs are caused by E. coli. This bacteria is normally found in everyone’s gut and, with the exception of a few rare dangerous forms, it is a healthy part of our normal bowel bacteria. The problems begins when E. coli escapes the bowel and enters the bladder. The bladder is able to remove most infections through the process of urination, but E. coli are quite resilient and able to use projections to help them stick to the bladder wall.

Prevention of UTIs

• Drink 70 ounces of water a day.

• Avoid excess alcohol and caffeinated beverages.

• Don’t resist the urge to urinate; visit the bathroom as soon as you feel compelled.

• If you have frequent UTIs, avoid taking baths; take showers instead.

• Practice good hygiene by wiping from the front to the back to avoid contamination of the urinary tract.

• Sexually active women—and to a lesser extent, men—should urinate within 15 minutes after sexual intercourse to allow the flow of urine to expel the bacteria before specialized extensions anchor the bacteria to the walls of the urethra.

• Clean the urethral meatus (the opening of the urethra) after intercourse.

• Clean genital areas prior to and after sexual intercourse.

Conventional Medical Treatment

Most uncomplicated UTIs can be easily treated with oral antibiotics such as trimethoprim, cephalosporins, Macrodantin, or a fluoroquinolone (such as ciprofloxacin or levofloxacin).

Symptoms consistent with pyelonephritis, a serious kidney infection, may call for intravenous antibiotics.

Patients with recurrent UTIs may need further investigation such as ultrasound scans of the kidneys and bladder or intravenous urography (X-rays of the urinary system following injection of contrast material).

Often, long courses of low-dose antibiotics are prescribed to help prevent otherwise unexplained cases of recurring UTI.

Natural Treatment

Taking antibiotics will usually kill the bacteria that is causing a bladder infection, but will also kill the healthy “good bacteria” in your body. Always combat this side effect of antibiotics by taking probiotics along with them, 12 hours apart from each other.

Another option, which I prefer, is to try natural remedies before resorting to antibiotic therapy. If the symptoms don’t clear up within a couple days, then you can always start antibiotic therapy then. Natural therapies can also be used while you’re waiting for your tests results to confirm a UTI.

• Cranberry juice can end a UTI. In addition to acidifying urine, cranberries contain substances that inhibit bacteria from attaching to the bladder lining and, as such, promote the flushing out of bacteria with the urine stream. Dosage is one to two cups of pure cranberry juice (no sugar added) or 2–4 cranberry capsules (standardized to 11%–12% quinic acid) a day for 1–2 weeks. This may well be all you need to eliminate a UTI.

• D-mannose is a naturally occurring sugar similar in structure to glucose but metabolized differently. (Because the body metabolizes only small amounts of D-mannose and excretes the rest in the urine, it doesn’t interfere with blood-sugar regulation, even in diabetics.) Though D-mannose doesn’t kill bacteria, it prevents bacteria from attaching to the bladder wall. D-mannose is safe, even for long-term use, although most people will only need it for a few days. Those who have frequent recurrent bladder infections may choose to take it on a daily basis. I’ve found it to be the best option for stubborn, chronic UTIs.