Bladder Infections
Bladder Infections
11 Remedies for a Vexing Problem
You've been spending a lot of time groping your way to the bathroom. You need to go a lot. But when you get there—well, not much happens. And when it does, it burrrnnnns.
What are we talking about? A health problem that's made a special sorority out of an awful lot of American women—five out of every ten will come down with a bladder infection at some point in their lives. (Men can get them, too, but it's so rare that bladder infections, also known as urinary tract infections, are considered a female malady.)
"It's absolutely one of the most common infections physicians have to treat," says David Staskin, M.D., assistant professor of urology at Boston University School of Medicine.
"Probably 50 percent of all women have at least one bladder infection at some time during their lives, and 20 percent or more will have multiple infections—it's not uncommon for many women to have one or two a year."
What's the cause?
Bladder infections are caused by bacteria known as E. coli that take up residence in the vagina and consequently make their way to the urethra, the tube through which urine flows, says Elliot L. Cohen, M.D., assistant professor of clinical urology at Mount Sinai School of Medicine of the City University of New York. In the vagina, the bacteria are no problem. Trouble only starts when they enter the urinary tract.
"These are bacteria normally present in all women. And the women who get UTIs (medical shorthand for urinary tract intections) aren't anatomically different from the women who don't. But for reasons we don't understand, they are more susceptible to the infection," says Dr. Cohen.
Bladder infections are really infections of the urine itself, according to Dr. Staskin, and the effect on the patient is usually relatively minor. "The bacteria irritate the wall of the bladder," he says. "In most cases, it's the bladder's equivalent of a bad sunburn."
The Alternate Route
Cranberry Juice Cure Diluted? Every women who's had a urinary tract infection—and every man who's gone through it with her—had heard about the cranberry juice cure. The big question: Does it work? The answer depends on whom you talk to. Some within the medical community say yes, but most say no. Over the years, several studies have documented an effect. But controversy remains on why it may work. "I think it probably has as much to do with increasing fluid intake as anything else," says David Staskin, M.D. "I just don't think there's enough of anything special in cranberry juice to have an effect." Joseph Corriere, M.D., agrees—to a point. "It's got quinolic acid (which converts to hippuric acid in the liver) in it, and it is fortified with vitamin C. Both hippuric acid and vitamin C have been shown to impact on the infection," Dr. Corriere says. "The problem is, you'd have to drink gallons every day to get enough to have an effect." Although there's strong doubt that cranberry juice will cure your infection, there certainly is no harm in giving it a try. But remember, if it doesn't cure you, it certainly won't hurt you, either. |
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But the infections still burn and sting and generally make life uncomfortable for those who have them There is, however, good news. There's a lot you can do to make UTIs less unpleasant and to get them over with more quickly. The following doctor-tested tips tell you how.
Drink lots of fluids. This is probably the single most important tip, for two reasons: comfort and health.
"Some women get a UTI and think, 'Aha! It only burns when I go to the bathroom,' " says Dr. Cohen. "They then reason that they won't have to go if they don't drink, so they don't—which is absolutely the worst thing they can do."
The reason: The longer any amount of urine stays in the bladder, the more bacteria there are in it—E. coli doubles its population about every 20 minutes, according to Dr. Staskin. More bacteria mean more pain.
"Absolutely the best thing a woman can do to fight the burning is drink fluids to flush out the bacteria that are causing the inflammation," Dr. Cohen says.
"There's a very strong argument for drinking more fluid both to prevent UTIs and to treat them," Dr. Staskin says. "Studies have been performed where bacteria were mechanically introduced into the bladders of volunteers. But voiding just twice effectively sterilized the bladder."
Message: The more you drink, the sooner the pain will stop. And a hint: If your urine's clear, you're drinking enough. If it's colored, you're not.
Take a hot bath. "This helps relieve pain for many women," says Richard J. Macchia, M.D., professor and chairman of the Department of Urology at the State University of New York Health Science Center at Brooklyn College of Medicine. "I don't think anyone's researched the exact mechanisms involved, but a hot bath often seems to help where there's inflammation."
Take aspirin or ibuprofen. "These are anti-inflammatories, and they do help some people," Dr. Macchia says. "They reduce the inflammation in the bladder, and the less inflammation, the less burning."
Take vitamin C. "About 1,000 milligrams taken throughout the day will acidify the urine enough to interfere with bacterial growth," Dr. Macchia says. "This is a good idea if you're having problems with reinfection or have recurrence in the middle of nowhere without quick access to medical help." Caution: Some antibiotics prescribed for bladder infections don't work will in acidic urine, so tell your doctor if you're taking vitamin C. Also tell him how much you're taking. Vitamin C is not toxic, but 1,000 milligrams is considered a large dose and should have your doctor's approval.
MEDICAL ALERT
The Signs of Something Serious There are four major symptoms that should send anyone with a bladder infection (whether it's the first or the fifth, it doesn't matter) to the doctor. They are: - Blood in the urine
- Pain in the lower back or flank
- Fever
- Nausea or vomiting
"About 90 percent of all women who get a bladder infection will have the bacteria gone with the first or second antibiotic pill, but the symptoms often last for two to three days," says David Staskin, M.D. "But a very small number may develop more serious problems with the kidneys. If they experience any of the above, they should see a physician immediately." The symptoms associated with a bladder infection can also be similar to something else—like cancer (especially if there is blood in the urine)—so it's important to always seek professional medical advice. |
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Back away. Wiping from front to back helps prevent infection from recurring, the doctors say. Wiping the wrong way is one of the most common causes of infection and a good way to get repeat infections. Wiping away is pure common sense, you want to move bacteria away from, not toward, the vagina and the opening of the urethra.
Go to the bathroom before intercourse. This helps flush out bacteria that may be present in the vagina, the experts say—bacteria that otherwise might be pushed into the bladder by intercourse.
Go to the bathroom after intercourse. This is where the myth of your partner's involvement gets its start—and like most myths, there's a grain of truth to this one, according to Dr. Staskin. A man's penis can massage bacteria present in the opening of the urethra into the bladder. Voiding effectively "rinses" the bladder out.
"There's no doubt that UTIs are more common in sexually active women," Dr. Cohen says. "But that's more the result of not knowing how to protect themselves than of sexual activity itself. If bacteria have been pushed into the bladder, urinating will flush most of them out."
Reconsider the diaphragm. "Diaphragms have been documented as major contributors to those who have stubborn, repeated bladder infections," Dr. Staskin says. "Two mechanisms are probably involved: Bacteria colonize the diaphragm itself, which is then inserted deep into the vagina, and the diaphragm interferes with bladder emptying, which means that bacteria already there aren't flushed out."
If this description fits you, you might want to talk to your doctor about another method of birth control.
Use pads instead of tampons. "No one's absolutely certain why certain women seem more susceptible to reinfection, but vaginal manipulation of some sort—sex, inserting the diaphragm, putting a tampon in—always seems to precede it," says Joseph Corriere, M.D., director of the Division of Urology at the University of Texas Health Science Center at Houston.
"I advise those of my patients experiencing chronic infection at the time of menstruation to quit using tampons and replace them with pads," he says.
Practice good hygiene. Good hygiene means wearing cotton underwear that keeps you dry, avoiding tight pants that decrease ventilation, and most of all, keeping clean—but sensibly clean.
"If you don't bathe to remove bacteria in the perineal region [between vagina and rectum], obviously you run the risk of repeated infection," Dr. Staskin says. "But too much can be as bad as too little. Douching constantly can both introduce bacteria into the vagina and rinse out the normal "friendly," noninfectious vaginal bacteria, which are then replaced with infectious E. coli. Irritation of the urethra may occur, which may feel like another UTI. Strong antibacterial soaps can do the same thing—and change the vaginal flora enough to make the individual more susceptble to infection."
The point: Be clean, but don't be obsessed.
PANEL OF ADVISERS
Elliot L. Cohen, M.D., is assistant professor of clinical urology at Mount Sinai School of medicine of the City University of New York in New York City.
Joseph Corriere, M.D., is director of the Division of Urology at the University of Texas Health Science Center at Houston.
Richard J. Macchia, M.D., is professor and chairman of the Department of Urology at the State University of New York Health Science Center at Brooklyn College of Medicine.
David Staskin, M.D., is assistant professor of urology at Boston University School of Medicine in Massachusetts.
