Dear Doctor, Lately I find myself with the need to use the bathroom a lot more frequently. It’s worse in the night. I do not feel any pain when urinating but I do not understand the constant need to pass urine and it’s never really a lot. What could be the problem? Is it an infection with my bladder?

Faith

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Dear Faith,

How long have you had this problem? Is it associated with urgency of urination (finding it difficult to hold the bladder when it is full), and a sense of incomplete evacuation?

The most common cause for frequency of urination in a young woman is cystitis, that is, infection of the bladder. There may be one or more symptoms like pain in the lower abdomen, painful urination, urgency of urination, sense of incomplete evacuation of the bladder.; fever, nausea, and vomiting. Since usually the kidney function is reduced at night and the frequency of urination reduced, the urge to urinate more in the night is perceived strongly.

Women in reproductive years are more prone to urinary tract infections (UTIs) including cystitis. Short length of the tube connecting the bladder to the exterior, dampness during periods, poor menstrual hygiene, sexually transmitted diseases, trauma during child birth, are some of the reasons which make a woman more vulnerable to UTIs. It is said that using public toilets or sharing undergarments is also a risk factor for UTIs. Those with reduced immunity like uncontrolled diabetes, HIV/AIDS, are more susceptible to develop UTIs in a more severe form. Diagnosis is made by microscopic examination of the first urine passed in the morning after waking up as bacteria tends to concentrate in the bladder overnight. The first few drops of urine are discarded as this may be contaminated by microbes present in external genitals. Midstream sample is collected and examined under the microscope in the laboratory. Culture if done can provide additional information regarding the nature of infection and antibiotics which would be useful. Treatment is by drinking enough water and taking a complete course of a suitable antibiotic.

Drinking adequate quantity of water prevents UTIs and also urinary stones, which are yet another cause for frequency of urination. However, stones are often associated with pain. Diagnosis is done by ultrasound. Small stones can pass off in the urine and no treatment is needed. Bigger stones or if they are more in number are removed by surgery, which may be minor or major.

Frequency of urination may be a sign of diabetes mellitus, where due to increased level of blood sugar, there is frequency of urination. In fact, it may be the first sign giving a clue to diagnosis of diabetes, which is confirmed by blood tests. Uncontrolled blood sugar in a known diabetic also leads to this problem. Increased vulnerability to UTIs augments it. Treatment is by antibiotic, but prevention lies in good control of diabetes by means of diet control and medicines.

Dr. Rachna Pande is a specialist in internal medicine.