Urinary Tract Infection

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Urinary Tract Infections

Ease the Urgent, Burning Pain

You need to go to the bathroom. Again. When you go, hardly any urine trickles out. And when it does, it burns. Within half an hour you get the urge again, so you go again--with the same results.

So it goes with a urinary tract infection (UTI). Bacteria enter the urethra, or urine tube, that enters the bladder, and set up shop. If the infection is limited to the urethra, it's called urethritis. More often than not, the infection travels farther up the tract and into the bladder, which is called cystitis (or, simply, a bladder infection). Unless treated promptly, a bladder infection can move to the kidneys, leading to a more serious condition called pyelonephritis.

Although a woman can have a UTI without knowing it, common signs and symptoms include pain and a burning sensation when urinating, urinating frequently, voiding just a few drops at a time or passing blood in the urine.

"Most women get one or two urinary tract infections at some time in their lives, and for the most part, physicians don't really know what causes them," notes Linda Brubaker, M.D., director of the Section of Urogynecology and Reconstructive Pelvic Surgery at Rush-Presbyterian- St. Luke's Medical Center in Chicago.

"In these women the cells that line the urethra are stickier, making it easier for the bacteria to adhere," explains Kimberly A. Workowski, M.D., assistant professor of medicine in the Division of Infectious Diseases at Emory University in Atlanta.

Women who use certain birth control methods, such as spermicides containing nonoxynol-9, are also at higher risk for UTIs. "This ingredient alters the bacterial balance in the vagina, allowing growth of E. coli, the bacteria that causes most UTIs," says Dr. Brubaker. Nonoxynol-9 is found in spermicidal jellies, spermicidal foams or inserts and condoms with spermicidal lubricant.

ANTIBACTERIAL STRATEGIES

If a urine culture indicates that you have a UTI, your doctor will probably prescribe antibiotics. In addition to taking the medication, here's what you can do to relieve symptoms and prevent future recurrences.

Fix yourself a baking soda cocktail. "At the first sign of symptoms, mix half a teaspoon of baking soda in an eight-ounce glass of water and drink it," says Kristene E. Whitmore, M.D., chief of urology and director of the Incontinence Center at Graduate Hospital in Philadelphia. The baking soda raises the pH (acid-base balance) of irritating, acidic urine.

Drink water, on the hour. Drink one glass of water every hour for eight hours, continues Dr. Whitmore.

"Drinking a lot of fluids will increase urine flow," explains Dr. Workowski. "This will wash out the bacteria that are attempting to adhere to the cells lining your urethra. Drinking plenty of water will also help dilute and flush out the substances that are causing the irritation. Drink enough water so that your urine is clear. Aim for at least eight or ten glasses of water a day."

"Hydration is the best thing that you can do for a UTI," adds Dr. Whitmore. "Drinking water is fashionable, it's good for you and women I treat say that it's more effective than drug treatment."

Carry a bike bottle with you. So suggests Jean Kallhoff, advanced registered nurse practitioner at the Urology Clinic at the University of Washington Medical Center in Seattle. "It's handy, it's easy to carry and it reminds women to drink water throughout the day."

Reach for cranberry juice. "According to a study in the Journal of the American Medical Association, cranberry juice can prevent bacteria from sticking to cells that line the urinary tract," says Dr. Workowski.

"Plenty of anecdotal evidence says that cranberry juice works," adds Dr. Whitmore. "I know it works for my patients."

When To See A Doctor If you have more than two urinary tract infections (or what you think are urinary tract infections) in 6 months, or more than three episodes in 12 months, see a doctor, says Kristene E. Whitmore, M.D., chief of urology and director of the Incontinence Center at Graduate Hospital in Philadelphia. "It's critical that we get the message out to women that if they have recurrent symptoms, they need to check with their doctors and ask for a urine culture," says Linda Brubaker, M.D., director of the Section of Urogynecology and Reconstructive Pelvic Surgery at Rush-Presbyterian-St. Luke's Medical Center in Chicago. "Just because you have symptoms, it does not mean that you have an infection. There's a difference between having inflammation in your urethra, which can cause sensitivity and irritation, and having a bacterial infection. I've seen women who were eating antibiotics by the pound for years, and they never had an infection to begin with. Many women think that they have a bladder infection every month, but they don't." Women doctors say that you should always consult a physician if you experience any of the following symptoms. * Blood in your urine * Chills * Nausea * Vomiting * Lower-back pain You should also see a doctor if you've been diagnosed with a urinary tract infection and the symptoms don't start clearing up within two days.

Dilute the juice. Women doctors caution that in some women with urinary tract sensitivity, cranberry juice can act as an irritant. "Some of my patients get worse when they drink a lot of cranberry juice," warns Dr. Brubaker. "That might be because of its high acid content." Dr. Whitmore suggests diluting the juice. If that doesn't help, stop drinking the juice altogether, says Dr. Brubaker.

Nix other offenders. Whether you have a simple irritation or an infected urinary tract, the last thing that you need are known bladder irritants. The most notorious bladder irritants are citrus, tomatoes, aged cheeses, chocolate, spicy foods, caffeine, alcohol and nicotine, says Dr. Whitmore.

For certain individuals, anything carbonated--especially beer or soda--may irritate your bladder and make you go more frequently or urgently, says Kallhoff.

Vitamin C supplements may also be a problem, says Dr. Brubaker.

Avoid artificial sweeteners. "Artificial sweeteners are among the worst offenders," says Dr. Whitmore. So if you have a UTI, avoid them.

Apply soothing heat. To ease the pain sometimes associated with urinary tract problems, place a heating pad on your lower abdominal area, says Dr. Workowski.

Wear skirts, loose pants and knee-highs. "If you have an infection, wearing tight undergarments and jeans forces the bacteria that normally line your vaginal area up into your urine tube," says Dr. Workowski. If you have an irritation, constrictive clothing can cause pain and discomfort, because it presses against the already inflamed urethral opening.

Toss out douches and sprays. Feminine hygiene sprays may irritate the urinary tract, say doctors.