#HLWDK Daily Health Tips: UTI & Scabies


Q: Good Day Dr, Please, I need your advice. I’ve been experiencing pains and an urge to wee again each time I finish urinating for the past 6 days now. Rashes all over my neck and shoulders, though we’ve been battling scabies my son brought home from boarding school since 3 months now. These rashes are itching me badly. The vaginal pains started 2 days after unprotected sex with my hubby. We’ve using condom since after my fourth baby.

 

A: Urinary Tract Infections occur anywhere in the urinary tract (Genius me, right? :D) and include infections of the kidneys, the ureters (the tubes that connect the kidneys to the bladder), the bladder (the reservoir or store house for the urine) and the urethra (the tube that transports the urine from the bladder to the outside).

So, who is more likely to have an infection and why? Women are more likely to have infections and this is because they have short urethrae (those tubes that transport the urine outside) and because the opening of this tube is very close to the opening of the anus. And so, if a woman urinates and has not quite mastered the art of cleaning from the front to the back, she could transfer bacteria from her anus to her urethra and this in turn travels up and infects the bladder. Women who also use the birth control method, diaphragm appear to also be at risk as it may cause the bladder not to empty completely when they urinate. Indeed, not urinating immediately after sexual intercourse in women may also predispose to this as the urethra may have may have become irritated, making it easier for germs to move in. People with depressed immune systems, frequent constipation and some people born with some disorders of their uro-genital system are also prone to UTIs.

In men, narrowing of the urethra which may happen in men who have had straddle injuries (eg falling astride {with legs apart} on a pole…ouch!), history of STIs or prostrate problems may make a man open to UTIs. Recurrent and chronic urinary tract infections (UTI that keeps recurring) may be due to changes in hormone (estrogen) level as one gets to menopause, problems with the urinary tract in terms of function or shape, kidney or bladder stones, bacteria getting into the urinary tract during sexual intercourse etc What symptoms does a person with UTI have? They would complain of feeling they have to urgently urinate often and then when they do get to the toilet, they can only pass out very little urine, pain or burning sensation during urination, pain in the flank (just under the ribs at the back), the urine may be cloudy or reddish or coke coloured, fever with chills and rigours etc. UTIs have to be treated because these infections could keep back tracking from the urethra to the bladder to the ureters and then to the kidneys…we don’t want that do we?! 😀

Treatment is focused on eradicating the infection…of course 😀 Usually a urine sample is taken to the lab. Part of the lab work is a culture and sensitivity test to find out the organisms causing the infection and the specific antibiotic that is active against it. Your doctor may also order other tests as he sees fit eg checking out for congenital defects etc. Apart from the preventive tips above, be sure to drink lots of water which help dilute your urine and help flush out the bacteria.

If placed on antibiotics, please take your prescription for the right period of time even if your symptoms disappear before you finish. And don’t go taking antibiotics without prescription. If you do, you could come down with a yeast infection (candidiasis), which may have symptoms similar to UTI but is a different entity.

Candidiasis is caused by an organism called Candida, a fungus (yeast). This infection can result in cheesy white (like ground melon/egusi seeds) vaginal discharge and vaginal itching. This itching can lead to irritation/pain in the vagina, which can become further infected, by bacteria. Candidiasis is very common in diabetics (the sugar in their urine makes the vagina a rich culture medium for them) and pregnant women who have altered glucose tolerance. This infection is also common in people whose immune systems are compromised and people who wear tight panties that do not allow their delicate inner selves to ‘breath’. Preferred materials for undies would be cotton and should be loose (I see my fashionistas frowning :D). It also happens in people who take a lot of antibiotics. Normally, some bacteria and fungi (yeast) co-exist peacefully 😀 in the vagina. To encourage this peaceful co-existence, the bacteria produce some acid that hold the yeast in check and prevent their over-growth. When antibiotics are abused, this leads to a situation where the yeast takes over 😀 (almost like a coup, right?). Though this infection can be passed on through sexual intercourse…especially oral-genital contact, it’s not really called an STI because women who are not sexually active can be infected with this.

Treatment is with anti-fungal vaginal tablets and/or anti-fungal cream which can be used for between 1-3 days depending on drug of choice. A single course dose of Fluconazole can also be taken orally. Any of these regimen may be extended if the infection is complicated…let your doctor be the best judge of that 😀 Prevention is targeted at causes:

  • Wear loose fitting cotton undies
  • Stay away from or limit time spent in hot tubs or saunas
  • Stick strictly with the prescription for antibiotics in terms of quantity and duration
  • Change out of wet clothes eg swim suits as soon as possible

If these measures do not help, please see your doctor.

The rashes and itching may very well be due to scabies as you noted. It is not called the 7-year itch for nothing! Scabies is contagious (spread by person to person contact but also through beddings, towels or infested upholstery) until treatment is started. It is possible to keep re-infecting oneself if all beddings and towels etc are not thoroughly washed at the time of starting treatment.

So, make sure you and everyone exposed to this has been commenced on appropriate treatment (after diagnosis by a doctor), ensure you have prevented re-infection by washing any article that may have been infested. More on scabies over the weekend…

I hope this helps.

Have a good night, everyone 😀

 

 

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