Summer is here - watch out, waterworks!

Summer is well and truly on the way and our thoughts are with sunshine, barbecues and holidays. But spare a thought for your poor defenceless bladder and kidneys, which can become summer casualties without a little attention.


Why the summer worry?

In hot weather you're more likely to sweat - this is one of the body's most effective ways of cooling down. If you don't drink more water to make up for the extra fluid lost, you could get dehydrated. Your body is very efficient at detecting low fluid levels in your system, and reacts by reducing the amount of urine you pass. Dehydration means urine is more concentrated and sits in your bladder for longer. This makes it easier for germs to multiply.

What else increases your chance of bladder infections?

Anything that increases the chance of germs getting into your bladder in the first place also raises your chances of getting a bladder infection. The germs that cause bladder infections travel up your urethra - the tube your urine passes down when you pass water. Friction makes it easier for germs to get up, which is why making love can increase your risk. After the menopause the lining of the vagina gets thinner and less springy. This in turn can increase friction and with it the risk of infection. If your doctor thinks this might be to blame, he or she may suggest a topical hormone replacement therapy (HRT) cream.

Does washing more often counter the risk?

We all get hot and sweaty in the summer, and the temptation may be to wash more - especially if you're worried about germs in your delicate regions after a bout of cystitis. In fact, too much vigorous washing can damage the delicate skin around your genital area. This is good news for bacteria, which thrive on damaged skin. By all means cool off in the shower, but no scrubbing! However, it may be worth getting into the habit of always wiping from front to back after you visit the toilet. The theory is that since most of the germs that cause cystitis come from your gut, this will push them away from your bladder's entrance tube.

Cranberry to the rescue?

Cranberries contain a natural chemical which may prevent germs from sticking to the lining of the bladder and causing irritation. Try a daily glass of cranberry juice if you suffer from recurrent cystitis.

To tea or not to tea?

Water, juice, tea and coffee all count towards your daily fluid intake. Unless you drink too much, there's no truth in the old wives' tale that coffee and tea dehydrate you. Caffeine only has a diuretic effect (making you pass more water) if you have more than 400 mg - that's about four cups of brewed coffee, four mugs of instant coffee or eight cups of tea. However, if you get recurrent bouts of cystitis, it may be worth trying decaffeinated tea or coffee to see if it improves your symptoms. Some women are sensitive to caffeine, which occasionally irritates the bladder lining.

Kidney stones

Kidney stones are usually made of calcium. They're three times more common in men than in women, and once you've had one you are at greater risk of developing another in the future. You may not know you've got one unless it moves down the ureter (the tube that connects each kidney to the bladder). If this happens, you can get severe pain in your loin which can move round the side of your stomach towards your groin. The pain is 'colicky' - it usually comes in waves and makes you want to roll around. Some medicines, like calcium and vitamin D supplements, antacids and aspirin can also increase your risk. But so too can being dehydrated - keeping your fluid levels up flushes waste products through the kidneys to be passed out in the urine.

What about if I have (sssh!) incontinence?

Incontinence is a remarkably common problem - official estimates put it at over one in five women over 40, but the real figure is probably much higher. The commonest type is stress incontinence - you leak urine if the pressure inside your tummy is increased by coughing, sneezing, laughing or exercising. The second commonest kind is overactive bladder, where the muscles in your bladder are super-sensitive. Lots of my patients avoid drinking as they think it will reduce the risk of accidents. In fact, if your urine is more concentrated it's more likely to irritate your bladder, which means, guess what? More accidents!

