Hopefully you know by now that the bladder and urine is NOT sterile but houses a community of microbes, collectively known as the bladder microbiota. Until now, we have mostly spoken about bacteria and fungi in the bladder. But a recent study has shed light on another never-before-seen member of the microbiota: tiny viruses called phages.
When speaking about urinary tract infections, we usually speak about bacterial infections. Fungi (a.k.a yeasts or mold) are different organisms from bacteria and they can cause infections such as thrush in some parts of the body. Fungal infections in the vagina for example are a well-known condition. But can there also be fungal infections in the urinary tract?
Today I’d like to take a closer look at the role of hormones on bladder health. Hormones have been known for a while to play a role in lower urinary tract symptoms such as UTIs, interstitial cystitis and stress incontinence. Hormones may be the reason why women generally seem to be more prone to bladder problems than men and also why some symptoms may get worse at certain times of the month.
There is new(ish) evidence emerging that recurrent UTIs, also known as chronic cystitis, are not always caused by a reinfection with a new pathogen but rather can be a relapse of the same pathogen.
It turns out that pathogenic bacteria have the ability to invade the cells of the bladder and live there in a dormant sleep-like state.
This is called an ‘intracellular bacterial community’.
In this state, the bacteria remain undetected by standard urine testing and unaffected by antibiotic treatment. They also remain undetected by our own immune system.
Now and again they can leave the cells, causing a relapse of the urinary tract infection.
For anyone who has read my own story, you may remember that repeated courses of antibiotics for chronic UTIs kicked off my interstitial cystitis a few years ago. Can antibiotics cause interstitial cystitis and chronic UTIs? For me, they have definitely played a big role.
This question has been at the back of my mind for a while and today I would like to take a look at some of the scientific evidence to answer this question.
In last week’s post I talked about the urinary microbiota – the bacterial communities that have recently been discovered to be present in the urinary tract.
We know now that microbes that live in and on our bodies play a crucial role in health and illness. There are friendly and pathogenic microbes (bacteria, fungi etc.) plus opportunistic microbes that can become pathogenic when left unchecked.
When the delicate balance of good vs bad microbes is disturbed we become prone to an array of health conditions and infections. This is called a ‘dysbiosis’.
The human bladder and urine have long been considered to be sterile. Emerging evidence challenges this paradigm.
Recent advances in gene sequencing have made it possible to look at the human microbiome (the collective bacteria that live in and on our bodies) and more and more studies are showing an important link between the microbiome and our health.
Standard urine testing methods are limited in their ability to show the true bacterial composition of the urine and their main use is to show certain strains of bacteria that typically overgrow in urinary tract infections.