Urinary Tract Infections: The Facts

You urgently need to go to the bathroom. When you go, not much happens, and it burns. Within half an hour you need to go again, just as badly, and the same thing happens, but now, it's getting worse. What's going on? You may have a urinary tract infection (UTI). If the symptoms last for more than 24 hours, you should see a doctor.

What is it?
Urine in the healthy bladder is normally free of bacteria. However, bacteria from the rectal area may enter the urinary tract through the urethra and travel the short distance to the bladder. While normally the bladder cleanses itself of bacteria, if for some reason it can't, the bacteria may cause an infection. About 80 percent to 90 percent of urinary tract infections are caused by Escherichia coli (E. coli) bacteria, which are normally present in the rectum. A urinary tract infection can be a variety of conditions, including cystitis (infection of the bladder) and urethritis (infection of the urethra). Other conditions such as vaginitis and irritable bladder (similar to irritable bowel disorder) may produce similar symptoms.

An infection of the urinary tract commonly has the following symptoms:

  • Frequent and urgent need to urinate
  • Painful urination
  • Cloudy urine
  • Lower back or abdominal pain
  • Blood in the urine
If you have these symptoms for more than 24 hours, you should see your doctor. Fever, chills, nausea and vomiting, and pain in the mid-back may indicate a kidney infection. If you have these symptoms, you should seek immediate medical treatment.

Every year, UTIs account for more than 7 million visits to physicians' offices. Women are eight times more likely to get a UTI than men. Part of the problem may be that bacteria have a much shorter distance to travel in women. The female urethra, leading from the outside of the body to the bladder, is roughly one and a half inches long. In contrast, the male urethra is roughly eight inches in length. Another contributing factor is the female urethra's location. As it is so close to the vagina and the anus, it is much easier for bacteria to enter the urethra and work its way up into the bladder.

While children may get UTIs, most sufferers are adult women. Approximately 25 percent of women are estimated to have had at least one urinary tract infection in their lifetime. Many will have several. Infections are frequently related to sexual activity. They also may occur during pregnancy because of hormone fluctuations and increased pressure on the bladder. If left untreated, the infection can harm the fetus. The occurrence of UTIs also can increase after menopause when breakdown in vaginal tissues begins to occur due to a decrease in estrogen levels.

Some factors that may contribute to urinary tract infections are:

  • Sexual activity: Sexual intercourse may facilitate the transfer of bacteria from the anal-vaginal area to the urethra and thus to the bladder. It may also irritate tissues, making them more susceptible to infection.
  • Birth control methods: If your diaphragm is not fitted properly, it may place pressure on the bladder and thus increase your chances of infection. The chemicals in spermicides may irritate vaginal tissues and make them more susceptible to infection.
  • Low water intake: If your water intake is low, you will urinate less frequently. Bacteria that enter the bladder have more time to multiply and to take hold, causing an infection.
  • Anatomical problem: A small percentage of women may have some kind of anatomical problem that would predispose them to UTIs. Your doctor will be able to determine from your medical history, a physical exam, and simple tests whether this is the cause of your infections.

Preventing UTIs
There is no proven way to prevent UTIs, but you may find some of the following suggestions helpful:

  • Drink plenty of liquids to flush bacteria out of your system.
  • Wipe from the vagina to the anus after urinating to avoid spreading bacteria.
  • Schedule frequent bathroom breaks.
  • Drink water before and after sex so that you will urinate a good volume with a steady stream afterward. This will help eliminate any bacteria that may have entered.
  • Consider checking the fit of your diaphragm or using another method of birth control. If you continue to use a diaphragm, leave it in no longer than necessary for contraception.
  • Avoid tight clothing and pantyhose. They may irritate tissues, trap heat and promote bacterial growth.
  • Wear cotton underwear. Cotton is less irritating and provides more ventilation than nylon.
The first step your doctor will take is to confirm a bacterial infection by reviewing your symptoms and testing your urine. It is important to have the infection diagnosed by a urine culture, as several other conditions, such as a vaginal infection, gonorrhea, chlamydia, irritable bladder, and bladder cancer, have similar symptoms. When pain is the predominant symptom, your doctor may consider a diagnosis of interstitial cystitis.

If a culture shows that there are bacteria in your urine, your doctor will prescribe a course of antibiotics that should take care of the problem.

Several different antibiotics are used to treat uncomplicated infections. You may be given a regimen of one to three days if this is your first infection. Taking antibiotics for seven to 10 days also is customary for recurrent infections. It is important to continue taking the medication until it is finished, even though your symptoms may be gone after a few days. Your doctor also may prescribe a urinary analgesic, such as phenazopyridine, for the pain.

There are several other steps you can take to make yourself more comfortable:
  • Drink large amounts of water. It will help flush the bacteria out of your system (about 8 ounces an hour).
  • Put one teaspoon of baking soda in one-half cup of water once or twice a day.
  • Avoid caffeine, acid foods, spices, citrus fruits, tomatoes, alcohol, and chocolate. You may find these things increase your discomfort.
  • Drink cranberry juice cocktail. A study conducted on older women published in the Journal of the American Medical Association suggests that drinking cranberry juice cocktail may reduce the amount of bacteria in your urine.
  • Try hot water bottles or heating pads. They may ease your cramps and soothe the pain.

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