Bladder infection in children. Bladder infection is a urinary tract infection. A urinary tract infection is an inflammation of a part of the urinary tract. The urinary tract consists of:
- the bladder
- the kidneys
- the kidney basins
- the ureters
- the urethra
With bladder infection, the mucous membrane on the inside of the bladder is inflamed. One in fifty children sometimes suffers from a urinary tract infection. Girls suffer from cystitis five times as often as boys.
Symptoms cystitis in children
In children, cystitis is not always easy to recognize. The symptoms of this in young and older children can vary considerably.
Older children Adults and older children have the following characteristic symptoms of cystitis:
- pain when urinating
- urinate often
- pee little bits
- smelly, cloudy urine
- stomach ache
If the bladder infection spreads upwards in the urinary tract, kidney infection may occur. Often the following symptoms are present in renal pelvis inflammation:
- cold shivers
- pain in the side
Young children With younger children, the symptoms of cystitis are much less obvious or they do not stand out because they wear a diaper. They are often more general symptoms that stand out in a young child with cystitis.
Infants can have the following symptoms:
- bad drinking
- gray skin color
- insufficient weight gain
- smelly urine
Toddlers and preschoolers Toddlers and preschoolers can have the following symptoms:
- bad food and drink
- stomach ache
- smelly urine
How does bladder infection develop in children?
Bladder infection is caused by a bacterium. There are different types of bacteria that can cause a bladder infection. The most common bacterium is Escherichia Coli. It lives in our intestines and has a digestive function.
There should be no bacteria in the urinary tract, but via the urethra, they can end up there from the area around the anus. They can multiply in the bladder and inflame the mucous membrane. We then speak of a bladder infection. Factors that may influence the occurrence of cystitis:
- insufficient emptying of the bladder after urination
- hold up the pee too long
- the composition of the urine
- the length of the urethra
- birth defects
Insufficient emptying of the bladder or holding up the urine for too long. The longer the urine stays in the bladder, the greater the risk of bladder infection. Children who hold up their pee for too long therefore have a greater chance of developing cystitis. In conditions where the bladder muscle is not strong enough to empty the bladder, urine can remain in the bladder and cause a bladder infection. The most common cause of bladder inflammation in children is a blockage, as a result of which the bladder is not properly emptied and urine remains in the bladder for too long.
Composition of the urine The acidity of the urine and the amount of sugar in the urine influence the ease with which bacteria in the bladder can cause a bladder infection. The less acid in the urine and the more sugar in the urine, the greater the chance of a bladder infection. Children who eat a lot of sweets have more sugar in their urine and therefore sweeter urine. And the more acidic products, such as oranges, a child eats, the more acidic his urine becomes.
Length of the urethra Girls has a shorter urethra than boys so that bacteria reach the bladder more easily in girls. Girls also have bladder infections more often than boys.
Congenital defects can also be a major cause of urinary tract infections. Usually, it is about reflux or impediments from the bladder.
- Reflux In both boys and girls a bladder infection can be caused by the backflow of urine from the bladder to the ureters and the kidneys. This backflow of urine is called reflux. Reflux is caused by an incorrect outlet of the ureter into the bladder, or by too high a pressure in the bladder itself. As a result of reflux, the kidneys can be damaged and a renal pelvis infection is easier. Reflux occurs in 30 to 50% of children under three years with a urinary tract infection. Not all forms of this condition are equally serious. Light forms of this in babies and toddlers can disappear without treatment.
- Impact barriers Due to birth defects of the bladder, the drainage of urine may be impeded. Leaving urine in the bladder can be a consequence, reflux can also occur. For boys with cystitis, there is a good chance that a hindrance barrier is a cause. Often these are valves in the bladder near the exit to the urethra. It can also be a restriction in one of the ureters themselves.
Is it serious and what can you expect?
Bladder infection is not serious in itself, but it is annoying. Your child is uncomfortable.
Treatment If the doctor suspects that your child has a bladder infection, he will take the following steps:
- he examines the urine and puts it on culture. The culture can show which bacteria caused the bladder infection and which antibiotics can eradicate the bacterium
- he prescribes antibiotics for which most bacteria are sensitive because the result of the culture lasts a few days
- your child must take these antibiotics for a few days (usually seven to ten days)
- your child will receive other antibiotics if the culture shows that the bacterium that causes bladder infection in your child is not sensitive to the antibiotics. It is important that your child finishes the course of antibiotics completely
If your child regularly has bladder infections or has abnormalities in the urinary tract with reflux, it is sometimes necessary to use a low dose of antibiotics on a daily basis to prevent bladder infections. An untreated bladder infection can spread to the ureters and the kidneys. This can cause a kidney infection or blood poisoning: these are fairly serious syndromes. The kidneys can be damaged by such a condition. Timely treatment of cystitis can prevent this.
Investigation There are three situations that are a reason to find out if there is an abnormality in the urinary tract that is the cause of cystitis:
- three times cystitis in a few months in girls
- one cystitis in a girl under three years
- one time bladder infection in a boy
In one of the above situations, contact your doctor. He will refer you to the pediatrician in the hospital. The pediatrician examines your child. Investigations being done:
- an echo of the kidneys Allows you to see if there are abnormalities of the kidneys, bladder or urinary tract
- a miction cystogram This is an x-ray of the bladder during urination to see if urine flows back from the bladder to the kidneys (reflux). For this investigation, the bladder is filled with a contrast fluid via a catheter. Most children find this part of the study annoying. Your child must then pee while lying down while taking pictures. Sometimes this urination is a bit painful
When to the doctor?
Contact your doctor’s practice if you suspect your child has a bladder infection. It is then best to take urine with you. Your doctor will examine your child’s urine and, if necessary, initiate treatment.
What is the best way to collect urine?
- wash your child’s buttocks with a washcloth and clean water
- have your child pee a little on a jar and throw it away
- let your child continue to pee and put a little of this puddle in a clean jar
There are special bags for collecting urine for babies and toddlers. You can get this at the pharmacy or at your doctor’s. These bags are stuck around the urethra. Check every ten minutes for urine in the collection bag and then put it in a jar.
It is best to take the urine to your doctor within two hours of receiving it. If this fails, you can temporarily store the urine in the refrigerator. Urine must always be examined within twelve hours of collection.
What can you do about it yourself?
If your child has a bladder infection, it is important to have your child drink enough. Sometimes this is enough to make the bladder infection disappear, but antibiotic treatment is usually required.
General advice and precautions
The chance of a bladder infection is smaller with:
- a good flow of the kidneys and the bladder
- regularly emptying the bladder
- good hygiene
You can reduce the risk of cystitis by:
- let your child drink enough
- Have your child go to the toilet at least every three to four hours
- have your child pee well
- have your child wiped from front to back
- have your child wash their hands after visiting the toilet
Source: Drs. JH Schieving (author) Drs. AAHH Latiedke – van Eijck (consultant) Drs. Lock (consultant) Drs. WJ den Ouden (consultant) in dokterdokter