Recurrent UTI with 4 year old , long term anitbioitcs, anyone else? Or paeds/dr's etc

[walkinthewoods]

My 4 yr old dd has had loads of UTi's over the last few years and in May went on long term AB's. She has had 2 ultrascans that have been normal.

She has sometimes has different symptoms each time (but generally temp, tummy ache, smelly wee, urgency, pain in kidney area).

Its bizarre but every time I took a sample to the gp's it was a UTI, now she is under hosp care I have taken 4 samples in and only 1 has been a UTI. I was sure that the other times she had a UTI. I was even at the point of questioning how they test etc.

I am worrying that a UTI is undetected and it does damage.

We had a hosp appt not so long ago and I told paed that I suspected she had a uti. Her urine was dipsticked and the nurse said it was fine. Wehn I spoke to the paed i empahsised that I wanted the urine anaylsed. It came back negative. Did they just write that dipstick result down?

The paed seemed unconcerned about dd but I just don't think things are right. Not a few days later she fell ill and I took another sampleto hops which was psotive and she was put on a different course of ab's.

DD now keeps complaining of tummy pain and needs to go quickly and dribbles out. I feel like I'm losing faith. She also had a few porblems wiht urgency of going to poo and pooing in her pants. Its like she's lost the ability to sense she needs to go to the loo. I don't think she is constipated because she knocks out some healthy looking poos on a daily basis.

Help

She needs to be referred to a nephrologist or urologist, preferably with paediatric experience.

I had kidney problems when I a child, and they did a few tests. Nothing. And then my mom took me into A & E, where fortunately a paediatric nephrologist was doing something or other, and he diagosed the problem in a few hours.

Could you ask the paed to refer her?

Urine samples are very difficult to collect from a child and, more often than not, are contaminated eg if you hold the container as she pees and some of the pee splashes on your hand and then goes in the container, it'll be contaminated. I had months of trying to collect clean ones from baby with bag attached...

Another dd did have kidney problems but this was obvious from ultrasound and also a test called Mag3 where her excretory process was tracked with radioactive dye. She ended up having surgery and was under the care of a nephrolgist for 6 years

If she has had 2 clear ultrasounds it seems unlikely that she has kidney problems. However there may be other issues and you should persist with paediatrician until you are satisfied.

The digestive/ poo systems and excretory/ pee systems are 2 completely different things, even though both are toileting issues so be quite clear in your own mind what you are talking to paediatrician about so you don't come across the wrong way!

Good luck

ILMD What did you have as a child? Do you still have probs? My concern is that it will do some damage.

pofaced Even if the samples are contaminated, surely it would still show up as an infection iyswim? Or am I way off the mark?

One thing she is not good at is going to the wee regulary. I have to keep reminding her. Sometimes she can have a wee on the potty and I amazed how much her bladder can hold. Sometimes its a real battle to make her go...no wrong phrase, I sometimes bribe her! Typing all this I feel like a complex is starting!!! I don;t want to make a big issue of it but am so worried. Each time she goes to the poo I wipe her bum for her just to make sure she is clean. But I know she is at the age that she should be able to do it herself.

MIL thinks she shouldn't be going on the potty anymore but I say anything to encourage her. Seem to be losing the way/confidence? MIL says she should be out of nappies at night. I would like her to be but I've tried for over a month a while ago and it was not sucessful. Her nappy seems to be pretty full each morning. I remeber regulary wetting the bed age 4/5 and did so up to the age of 7.

Think I'm getting myself in a tizzle and i'm sure that won;t help.

My ds2 has a question mark over the functioning of one of his kidneys. We are under the care of a pediatric urologist. Is there a Childrens' Hospital near you, perhaps you could ask for a referral?

One of the first tests ds2 had was for kidney reflux. Have they investigated this for your dd, it is a very common cause of repeated kidney infection?

I think you need to ask more questions. I second poface re: urine/bowels being 2 totally different things, so maybe speak to your GP about her poo probs first.

hydronephrosis, or kidney reflux.

If she is getting constant infections, the concern should be to investigate the cause...

Just seen your last posting.

Firstly, ignore your MiL re: potty- you do not need more stress over this, nor does your dd.

As for being dry at night - she's clearly not ready (like LOADS of kids at this age) and it is not related to the infections so personally I'd ignore that too.

Could you encourage her to drink more (esp. cranberry juice) to result in more frequent peeing? I guess if peeing is sometimes painful she may want to go as little as possible (which in term makes problem worse).

No they haven't investigated reflux, how did they investigate this? Was that the test with the dye?
Yes I was thinking that the two processes are totally seprate but the reason I am worrying is because of this complex thing (IE am I causing her to be anxious about going to the loo etc) I try to be really relaxed! But it might all be sub conscious

The test we had (for the reflux) was called a micturating cytourythrogram (or something similar). Ds2 was catheterized and a dye injected into his bladder. They then used low dose Xrays to see where the dye went when he wee'd. The test allowed them to see whether urine flowed back to his kidney, whether his urethra was blocked and whether he fully emptied his bladder went he 'went'.

The ultrasound will show shape of kidney: if your Dd has had reflux, one of the kidneys will be an irregular shape. If this is the case they'll test further using either mag3 or presumable WB's more up to date test (we were in Great Ormond St 8 years ago.

TBH, if she has had recurrent utis, reflux is the most obvious cause but it seems extraordinary that this hasn't been checked: even before we had kidney issues with dd3, dd2 had been checked out just in case the virus she had was caused by a UTI (even with no evidence of UTI because of contaminated sample(s). I knew 3 or 4 babies on prophylactic antbiotics because of urinary reflux, despite none of the being ill... ie it is (was) very common

Ignore your MIL if possible and bear in mind that night-time dryness is hereditary ie if you wet the bed at 4 or 5, your DD is more likely to

But do go back to the paediatrician, explain your concerns clearly and ask them to explain why you should not be concerned

Your OP sounds very similar to what I remember as a child. I had kidney reflux, ended up on long-term abs (IIRC) but eventually outgrew it and, AFAIK, my kidneys are fine now. I had several episodes of loss of bowel control as well, but I suspect that they were a reaction to medication. Neither my mum nor I remember exactly.

I remember the fear of weeing, because the pain could be so extreme. Sometimes I would be afraid to wee even if I didn't have an active infection.

5yo dd has an over-active bladder, which means that she has problems with bladder control day and night. Periodically she rebels against being sent to the loo. Maybe if you started giving some responsibility to your dd - bottom-wiping, perhaps, or going to the loo in certain situations - she might be more willing to co-operate? For example, dd knows that she must have a wee before watching tv or using the computer, and goes without being told.

Although the paed says dd's problem is this over-active bladder, I'm sure that there is some emotional/behavioural component as well. When things were at their worst she occasionally lost bowel control, but once we had a diagnosis and did our best to back off and accept the situation, the bowel control returned.

If you weren't dry at night until 7, then it is very likely your dd won't be ready now, either. Night dryness is often inherited. Again, same siutation with me and my dcs. (Why didn't they inherit their dad's bladder? He was dry night and day at 2y.)

Depends what the underlying issue is...

For me, it was structural. I didn't need a surgeon; I needed a plumber as it was a matter of cutting the ureter and re attaching it.

Have respect for homepathy, but it certain instances, a surgeon is necessary...

Thanks everyone.
She's not bad at drinking water but I have treid the cranberry juice, not a goer. I have found that asda do a cranberry yogurt drink, which is great because she has had problems with thrush because of ab's. Poor thing! She can be really sore sometimes.

So can I just confirm, its unlikely to be reflux as 2 scans have been fine?

I suffered from UTIs for 12 years. I was on a daily dose of antibiotics, until I discovered D-Mannose. I even took it during my pregnancies when 2 courses of antibiotics did not work. It prevents and gets rid of UTIs. The powder form can be taken by kids.

I recently discovered that my prolapsed transverse colon was squashing my bladder and making it susceptible to UTIs (for 12 years!). I also had awful pressure in my lower abdomen when lying down at night. I was made worse by 2 pregnancies. My colon was compacted with hard stuff (lack of water and fiber) so I did 2 colon cleanses and I no longer get recurrent UTIs. (DO NOT DO CLEANSES WHILE PREGNANT, WAIT TIL NOT PREGNANT - can cause MISCARRIAGE.)

I had examinations and the red dye xray too - all clear. They never checked my colon, I don't think it's on the medical curriculum. But I found this book on Google giving details - it's under 'structural problems'. The book also says there is a direct link between constipation and recurrent UTIs:

books.google.co.uk/books?id=I_KZnp4EDT8C&pg=PT520&lpg=PT520&dq=ripe+for+infection+urinary+tract+infections+prolapsed+transverse+colon&source=bl&ots=iqXIbzRCgW&sig=xpzANqG03EVvgr8t_6zaMW4yY3w&hl=en&ei=9NOATqmvKpS10QXJ-rG4CQ&sa=X&oi=book_result&ct=result&resnum=2&ved=0CCoQ6AEwAQ#v=onepage&q=ripe%20for%20infection%20urinary%20tract%20infections%20prolapsed%20transverse%20colon&f=false

by the way, you don't have to buy this book, the relevant bit is available to see on google books.