DEAR READER: Request a clean-catch urine and sensitivity test, even if one has been done in the past. Any bacteria can be cultured and tested against specific antibiotics to determine which one will be most effective in treating the infection. Then ask your physician about low-dose antibiotics for perhaps as long as six months, or single-dose medication at the start of symptoms.

In the interim, drink 100 percent cranberry juice daily. Drink plenty of water and avoid feminine hygiene sprays and scented douches. If you remain unsuccessful in controlling this unpleasant disorder, request a referral to a urologist.

To provide related information, I am sending you a copy of my Health Report “Bladder and Urinary Tract Infections.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

Some background information: I have had bronchitis, a colonoscopy, hernia repair and my right knee scoped. I got the hernia shortly after I had the colonoscopy.
Are there any preventive options I can practice, because I seem to be prone to these infections? I do not like taking antibiotics or any other medicine. I’m an active person who loves to walk and exercise moderately.

Would a urologist be able to diagnose the problem? I retrieved some information on the Internet. Is it true that certain items such as cheese, chocolate, spicy foods and dairy products are irritants?

DEAR READER: I am unsure if your physician treated you because of the classic symptoms you presented, or whether he or she requested a urine culture. That bit of information would be extremely helpful in putting the pieces together.

In any event, let’s take things a step at a time. Urinary-tract infections affect millions of people each year. Women are more prone than men, and infections typically involve the urethra and bladder. Urine is normally sterile and free of bacteria and/or viruses in a healthy person. The urethra carries urine from the bladder for passage out of the body. Infection occurs when organisms such as bacteria adhere to the opening of the urethra and multiply, resulting in infection. Most infections come from one single type of bacteria known as Escherichia coli (E. coli), which ordinarily live within the colon. There are other micro-organisms, such as chlamydia and mycoplasma, that can cause a UTI, but they tend to be limited to the urethra and reproductive system. Symptoms of a UTI include a strong urge to urinate, hematuria (blood in the urine), a burning sensation and strong odor on urination. Chlamydia and mycoplasma can be sexually transmitted; in order to eradicate either, both partners will require medical treatment.

Your physician should have ordered a clean-catch urine and sensitivity specimen that should have been sent to your local hospital, unless he or she can test on the premises. The urine will be tested for red and white blood cells and bacteria. The bacteria will be cultured and tested against specific antibiotics to determine which one will be appropriate for eradication of the infection. The drug of choice and duration of treatment will be determined by what your specimen is sensitive to.

Speak with your physician about the possibility of low-dose antibiotics taken daily for six months or longer. If you are sexually active, you might take a single antibiotic dose following intercourse. Or take an antibiotic for a day or two when symptoms first appear. On the home front, drink plenty of water each day and supplement with 100 percent cranberry juice. Take showers instead of baths. Avoid using feminine hygiene sprays and scented douches. Following urination, wipe from front to back to prevent the spread of bacteria.

To provide related information, I am sending you a copy of my Health Report “Bladder and Urinary Traction Infections.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092, or download an order blank from my Web site, www.askdrgottmd.com. Be sure to mention the title.

She periodically uses Vagifem (vaginal estrogen pills) but continues to wake up. She tried Detrol but it made her feel terrible. This has created a long-term problem that lessens her enjoyment of life. Any thoughts?

DEAR READER: Your wife’s symptoms suggest several possibilities including chronic urinary tract infection. In my opinion, she needs a urine culture to check for bacteria and, later if necessary, she should consider cystoscopy (examination of the bladder lining). You don’t mention whether your wife is under the care of a urologist. If not, she should be. Her ailment is most likely treatable once the diagnosis is discovered.

If she does, as I believe, have a chronic urinary tract infection, she needs also to have her kidneys examined. Chronic, untreated UTIs can be the result of, or lead to, kidney infection. This is treatable with long term use of antibiotics and if caught early enough, will not cause permanent damage.

DEAR READER: Yes. But I am also concerned about the possibility of a recurring infection the source of which is still unknown.

The next time you experience symptoms, you need to have various areas checked for infection. This can easily be done and should include a C and S (culture and sensitivity) of your leg, blood stream and urine. If your problem is, indeed, a reflection of a hidden infection, the source must be identified, the bacteria defined and antibiotics prescribed.

To give you related information, I am sending you a copy of my Health Report “Bladder and Urinary Tract Infections”. Other readers who would like a copy should send a self-addressed 4 ¼” X 9 ½” letter-sized stamped envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.