Bladder Infection

Bladder Infection

You have to go, and you have to go now. Come to

think of it, it seems like you've had to go every 15

minutes since you woke up this morning. And each

time, it's been the same story. Not much comes out,

but it burns like crazy. What in the world is going

on?

If you have pain or burning on urination, the

frequent urge to urinate, and/or blood in your urine,

chances are you have a bladder infection (also

called cystitis, urinary tract infection, or UTI).

These symptoms may also be accompanied by

lower abdominal pain, fever and chills, and an allover

ill feeling.

Bladder infections are caused by a bacterial

invasion of the bladder and urinary tract. "The urine

in the bladder is normally sterile," explains Amanda

Clark, M.D., assistant professor of obstetrics and

gynecology at Oregon Health Sciences University

in Portland. "However, if it becomes contaminated

with bacteria, a bladder infection can develop."

If you're a woman who suffers from bladder

infections, you're not alone. "Women tend to suffer

more bladder infections than men because the

female urethra, the tube leading from the bladder to

the outside of the body, is only about one-and-ahalf

inches long--a short distance for bacteria to

travel," says Sadja Greenwood, M.D., a women's

health specialist and assistant clinical professor in

the Department of Obstetrics, Gynecology, and

Reproductive Sciences at the University of

California at San Francisco. (A man's urethra is

about eight inches long.) Frequently, the urinary

tract becomes contaminated with Escherichia coli,

bacteria that are normally present in the bowel and

anal area. In 10 to 15 percent of cases, bladder

infections are caused by another organism, such as

Chlamydia trachomatis.

Women also suffer more bladder infections

because sexual intercourse can irritate the urethra

and contribute to the transport of bacteria from the

anal area and vagina into the bladder. "We don't

really know exactly why intercourse increases the

risk of bladder infections," says Clark. "We think it

might make the bladder tissues a little more

receptive to having an infection or it may cause

more bacteria to move up the urethra."

Women who use the diaphragm for birth control

have a greater risk of bladder infections, too, says

Clark. The diaphragm presses against the neck of

the bladder, which inhibits normal urination, she

says. As urine flow decreases, pressure within the

bladder increases, and the bladder is unable to

completely empty itself. The pooled urine then acts

as a growth medium for bacteria.

Pregnant women are also more likely to suffer

from bladder infections. The changing hormones of

pregnancy and the pressure exerted by the enlarged

uterus on the bladder and ureters (the two tubes that

carry urine from the kidneys to the bladder) put

pregnant women at greater risk.

Men can also suffer from this malady. In men,

bladder infections are almost always secondary to

an infection of the prostate gland (prostatitis),

according to Theodore Lehman, M.D., a urologist

in private practice and director of The Oregon

Impotence Center in Portland. "Primary infection of

the bladder in men just doesn't happen, because the

bladder is well protected," explains Lehman. "But

the prostate sits right in front of the bladder, and

bacteria can get into it--through sexual intercourse,

trauma like bouncing on a bicycle seat, or some

kind of blockage--and it stirs up an infection in the

prostate. Then the prostate infection can 'move

upstream,' if you will, and infect the bladder."

In men, prostate infection usually feels like

"you're sitting on a brick," says Lehman. When the

infection extends to the bladder, the symptoms of

irritation, urinary frequency, and pain and burning

on urination join the achy-bottom feeling.

Bladder infections can often be treated at home

with the self-care tips that follow. However, if your

symptoms persist for more than 24 hours, if they

don't respond to home remedies, or if you suspect

that your symptoms may be due to a sexually

transmitted disease or other infection, see your

physician.

Load up on fluids.

At the first sign of bladder infection, start drinking

water and don't stop. During the first 24 hours,

Greenwood recommends drinking at least one eightounce

glass of water every hour. People who suffer

from recurrent bladder infections usually don't

drink enough liquids. So even when you don't have

an active infection, you should make a habit of

drinking eight tall glasses of water every day.

According to Lehman, drinking lots of fluid not

only dilutes the urine, giving bacteria less to feed

on, it also has a "washout" effect on bacteria. "The

more bacteria you can wash out," says Lehman,

"the less there will be to reproduce."

Clark warns, however, that people who suffer

from urinary leakage (incontinence) probably

shouldn't increase their fluids. She says it can make

the bladder infection and the incontinence worse.

Have a cranberry cocktail.

If you've never developed a taste for the sweet

tanginess of cranberry juice, now's the time.

Cranberry juice (without added sugar) may make

urine more acidic and less hospitable for bacterial

growth, says Clark. Drinking cranberry juice is also

a way to increase your fluid intake.

Go, go, go.

Lehman advises both men and women to avoid

what he calls "L.A.-freeway-driver bladder."

"Many people don't urinate when they first get the

urge because it's inconvenient or there isn't the time

or place," he says. "Take a guy who gets off work,

has a couple of cups of coffee or a couple of beers,

and gets on the freeway in rush-hour traffic. He

feels the urge to urinate, but he can't get off the

freeway. When he finally gets home and urinates,

it's difficult and it burns. By the next day, he's

calling his doctor with a prostate infection."

Holding urine allows it to concentrate in the

bladder, creating a perfect medium for bacterial

growth. In older men, holding urine can cause

congestion, inflammation, and obstruction of the

prostate and can eventually lead to a prostate

infection or sometimes a bladder infection. Not

urinating at the first urge also causes the bladder to

distend and stretch. "Essentially, the bladder is a

hollow muscle," says Lehman. "If you repeatedly

stretch it, then it won't void completely and creates

a place for bacteria to grow."

Heat it up.

For lower abdominal pain, use a heating pad or hotwater

bottle or take a hot bath, advises Greenwood.

Lehman says that heat not only relieves the

symptoms, it also brings more blood with white

blood cells and other infection-fighting blood

products to the affected area. (Pregnant women,

however, should not sit in a hot bath or hot tub for

too long, since raising the body temperature above

100 degrees Fahrenheit for long periods may cause

birth defects or miscarriage.)

Take a bath.

If you have a lot of burning, a warm "sitz" bath

(sitting in three to four inches of water) can ease the

pain.

Take a break.

Rest in bed, especially if you have a fever. You'll

conserve energy and speed healing.

Wear cotton underwear.

Cotton underwear, cotton-lined panty hose, and

loose clothing will allow the genital area to breathe

and stay dry. For men, boxer-type shorts rather than

jockey-style shorts are better if prostate and bladder

infections are a problem.

Avoid alcohol.

Alcohol is a urinary tract irritant for both men and

women and should be avoided during a bladder

infection.

What about spicy foods, tea, and coffee? Clark

says, "They really shouldn't hurt a bladder infection.

" However, the caffeine in coffee, tea, and colas

does stimulate the kidneys to produce more urine

and makes the bladder fill up faster during a time

when urination is painful. If caffeine seems to make

your symptoms worse, avoid it until the infection

goes away.

Take a pain reliever.

Bladder infections can be painful. Acetaminophen,

ibuprofen, or aspirin, especially if taken at bedtime,

can ease the pain.

Wash up, lovers.

Both partners should wash up before intercourse.

Urinate after lovemaking.

If you suffer from recurrent bladder infections,

urinate immediately before and after intercourse,

advises Clark. This can help flush out bacteria that

may have entered the urinary tract.

Switch birth-control methods.

Women who use a diaphragm and suffer from

recurrent infections should try switching to

condoms or a cervical cap. "If you have recurrent

bladder infections, see your doctor to have your

diaphragm's fit rechecked," says Clark. "You may

do better with a smaller diaphragm or a cervical cap"

Keep a bladder-infection diary.

If you suffer from recurrent bladder infections,

keep a diary to discover what patterns precede an

attack. Some people find that their infections are

related to stress, menstruation, lovemaking, or other

factors. Once you discover what precipitates your

infections, you can make changes to alter those

patterns.

Wipe from front to back.

Most women wipe from back to front, which moves

bacteria from the rectum dangerously close to the

urethra.