Essential facts about kidney problems
Women have a fundamental design fault - their kidneys may be protected from germs deep inside your tummy, but the urine they produce needs a way to get out. Two tubes called ureters connect your kidneys with your bladder, where urine is stored. When you pass water, urine travels out through another tube called your urethra. In men, the urethra runs all the way along the penis - in women, it's only a few inches. The exit of a woman's urethra is also much closer to your bottom than a man's. Most bladder and kidney infections are caused by germs which live in your bowel travelling in the wrong direction, up your urethra. In women, the germs don't have far to go, so infections are very common.
Kidney stones , on the other hand, affect about one in 20 women and three times as many men. Because the kidneys filter waste chemicals from the body, tiny crystals can clump together - a bit like a pearl around a piece of grit - to form a stone. Sometimes they don't cause any symptoms. But if a kidney stone passes into your ureter, it causes excruciating colicky pain called renal colic. In most cases, there is no obvious reason, but some medicines (including cancer chemotherapy and water tablets or diuretics, commonly used for high blood pressure can make you more prone.
Most women will have at least one experience of cystitis - burning urine, low tummy pain and needing to rush to the loo every five minutes. Cystitis can occasionally lead to kidney infections but is usually just a miserable nuisance. Mild cases may settle with lots of fluids to flush out the germs. Otherwise, a short (three-day) course of antibiotics will usually get work.
Quite a lot of women get repeated bouts of cystitis - most commonly in their late 20s and after the menopause. This is nothing to do with not being clean - in fact, too much scrubbing can damage the skin around your urethra, making things worse. Wiping from front to back to avoid spreading germs from your bottom being carried to the area around the entrance to your urethra does make sense, though.
The friction involved in making love can let germs in, so emptying your bladder before and after you make love may help. Other tips which may be worth trying include; drinking enough fluids to avoid dehydration, taking a daily glass of cranberry juice and avoiding tight underwear or trousers. Some women find they get cystitis after having sex. If you've noticed a link and are using spermicides or a contraceptive diaphragm speak to your GP about alternative methods.
The symptom you must never ignore
If you notice blood in your urine, always see your doctor. It's often simply due to having an infection, but your GP will want to rule out any other cause.
Most kidney infections - the medical term is pyelonephritis - happen as a complication of cystitis. Kidney infections, like cystitis, are more common in women than men, and happen more often in childhood and pregnancy. Having kidney stones or other kidney abnormalities also makes you prone to kidney infections
You'll usually become unwell within hours, with high fevers, shivering all over, pain in your loin, feeling or being sick and often symptoms of cystitis as well.
Kidney infections usually respond quickly to antibiotic treatment and plenty of fluids, with painkillers in the short term. In severe cases, you may need hospital admission - this is more likely in people who are elderly or frail; who have existing kidney problems; who are extremely unwell; or who are at high risk of dehydration.
The hidden cause of confusion
In older people, bladder or kidney infections can cause acute confusion, sometimes without any other symptoms. If your loved one becomes rapidly more confused, think waterworks!
As you get older…
Unfortunately, urine infections get more common as you get older. In women, this is because dryness of the vagina can make the surrounding skin more fragile. In men, it's often related to enlargement of the prostate gland, which stops the bladder from emptying properly.
You may be able to reduce your risk of urine infections as you get older by eating plenty of fruit and vegetables to avoid constipation; by drinking enough fluids; and by considering a topical hormone replacement pessary or cream.
With thanks to 'My Weekly' magazine where this article was originally published.