Q-I am a 41 year old man. I had a series of bladder infections about a year ago, which is unusual in men. As a result, my doctors suggested that I undergo a series of bowel examinations to look for a hole between the bladder and bowel where bacteria
My doctors have recommended that I have about a foot of my descending colon removed. They say that my descending colon is weakened due to all the scanning that I have undergone and that, if I do not have the operation, I risk a ruptured bowel, peritonitis and a colostomy. They have not told me what the risk is or how large a risk I take if I do not have the operation. They have also said that it will take three months to recover, but there will be no side effects. I find this hard to believe as the bowel has to do with water regulation as well as elimination of waste.
I would like to know if there are any alternative treatments worth pursuing and where I can go to find out more about the risks involved in this operation, whether I can discuss this with other people who have had this operation and where I can find out about any research on it.
I think the examinations showed that a section of my bowel had reduced its diameter to 10 cm, but I do not have a copy of the letter and my GP would not give me one or allow me to get a second opinion. JH, Reading........
A-As is so often the case, it sounds as though your doctors are trying to kill a flea with a sledgehammer.
It is true that you may be getting these repeated infections from a hole in your bowel. Sometimes, the colon can form tiny sinuses, or abscesses, through which bacteria and waste from the faeces can leak out. If the bowel rests against the bladder, these bacteria can also cause a little hole in the bladder and drain into it. As your doctors say, these little abscesses can come and go, so it may be difficult to find them in a test or on scans.
It is also possible that your bladder infections are completely unrelated to such a hole and that these many infections are, in fact, just one infection. A common cause of bladder infection for men and women is the bacteria Escherichia coli. However, it is estimated that, in the USA, about 40 per cent of the strains of E. coli are now resistant to trimethoprim sulphamethoxazole, the antibiotic of choice for bladder infections. So, it may be a case of the same infection repeatedly manifesting itself because the E. coli haven't been completely eliminated.
Or you could simply have an irritated bladder. Any one of a number of foods can cause irritation these include all forms of caffeine, such as coffee, tea and carbonated beverages, and any foods containing tomatoes. Artificial sweeteners are also a secret culprit. You might also wish to avoid foods high in the amino acids phenylalanine, tryptophan, tyrosine and tyramine. These would include, in particular, citrus fruits, pineapple, cranberries, avocados, figs, yogurt and chocolate, and all wines other than those which do not undergo malolactic fermentation (Goldberg B, ed, Alternative Medicine, The Definitive Guide, Tiburon, CA: Future Medical Publishing, 1999).
The point is that it may be unusual but not impossible for men to have chronic bladder infection.
According to Dr Larrian Gillespie, an American specialist in cystitis at the Women's Clinic for Interstitial Cystitis in Beverly Hills, California, chronic bladder infection usually has more to do with bacteria being trapped in a bladder and not being able to get out, usually because the bladder isn't efficiently expelling all of its contents during urination. This was aptly illustrated in one study where medical students consented to having faeces was placed in their bladders. By the second time they urinated, no bacteria remained in their bladders.