Urinary Tract Infections

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Urinary Tract Infections

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You have a nearly uncontrollable urge to go. But once in the bathroom, you have very little success, just lots of burning and pain. And almost as soon as you go back to what you were doing before you were so rudely interrupted, that insistent impulse is back again. Sound familiar? It could be a urinary tract infection (UTI).

UTIs are a common malady, especially as you age, accounting for about eight million doctor visits a year. They are caused when bacteria enter the urethra, or urine tube. If the bacterial infection stays in the urethra, it is called urethritis. If the infection travels farther up the urinary tract into the bladder, as it often does, it is called cystitis (or, simply, a bladder infection). Unless treated promptly, a bladder infection can move to the kidneys, leading to a serious condition called pye lonephritis.

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Try This First
Wise Ways

Women are especially prone to UTIs. In fact, one in every five women experiences a UTI during her life. The reason is partly structural. Since a woman’s urethra is shorter than a man’s, bacteria can travel up to her bladder quickly. Even though men are less susceptible in general, their odds of getting UTIs increase as they get older. In men, however, the problems usually stem from some urinary obstruction—such as a kidney stone or an enlarged prostate—or from a medical procedure involving a catheter. In fact, any abnormality of the urinary tract that obstructs the flow of urine sets the stage for an infection.

People with diabetes also have a higher risk of UTIs because of changes in their immune systems. Any disorder that suppresses the immune system raises the risk of a urinary infection. Not everyone with a UTI has symptoms. But if you do, you may have a frequent urge to urinate. Or you may experience a painful burning feeling in the area of your bladder or urethra during urination. It is not unusual to feel bad all over—tired, shaky, washed out—and to feel pain even when you are not urinating, says Dorothy M. Barbo, M.D., professor of obstetrics and gynecology and director of the Center for Women’s Health at the University of New Mexico in Albuquerque.

If you suspect that you have a UTI, you should see a doctor as soon as possible. A prescription of antibiotics will help kill the infection, says Dr. Barbo. But there are also some actions you can take yourself to help ease your discomfort and minimize the problem. The first few tips are for both men and women, but the rest apply to women.

Try This First

Flush the system. Many doctors suggest that you drink plenty of water when you are in the throes of a UTI.
Eight to 10 glasses a day of any caffeine- or alcohol-free fluid will cleanse the bladder and wash bacteria out of the urinary tract, says Phillip Barksdale, M.D., urogynecologist at Woman’s Hospital in Baton Rouge, Louisiana. “Drinking plenty of water flushes out the system, reducing the amount of irritating bacteria.” To pace yourself, have an eight-ounce glass of water every hour throughout the day, he advises. Drink enough water so that your urine is light yellow. Yellow- or amber-colored urine is a sign that you aren’t consuming enough fluid, he says. Even more fluid is needed if you are in a hot environment or exercise strenuously, says Dr. Barbo.

Other Wise Ways

Ward it off with cranberries. cranberry juice—a popular home remedy for UTIs—actually can prevent bacteria from sticking to cells that line the urinary tract. A study by Mark Monane, M.D., gerontologist and director of Merck-Medco Managed Care in Boston, found that women who downed a 10-ounce glass of cranberry juice every day for six months had fewer UTIs than those who drank other fluids. Apart from clinical research, plenty of anecdotal evidence shows that cranberry juice helps, says Dr. Barbo. “I know it works for my patients,” she says. The juice increases the acidic quality of urine, which, in turn, reduces bacteria levels.

Dr. Barbo recommends drinking four ounces of diluted cranberry juice two or three times a day. If you have diabetes, be sure to select low-calorie cranberry juice, which Dr. Barbo says is safer for diabetics. Avoid irritants. Certain foods and beverages can magnify UTI discomfort. The worst of the offenders are coffee, alcohol, spicy foods, citrus, and chocolate. Avoid them until the infection clears up, says Dr. Barksdale.

Don’t hold it. Even though it might be painful to urinate when you have a UTI, don’t resist the urge, says Dr. Barbo. In general, you should try to empty your bladder completely every three to four hours. “It’s a wise way to prevent bacterial infection and to hasten recovery if you already have one,” she says. Urinating frequently helps to eliminate bacteria before they have a chance to multiply.

Have a seat after sex. Women should urinate after they have sexual intercourse, says Dr. Barbo. During sexual intercourse, bacteria may enter the urethra. By urinating, you help wash out the invaders right away.

Soothe with heat. To relieve the pain and cramping that are sometimes associated with a UTI, try a warm sitz bath, says Dr. Barksdale. Fill your bathtub with three to four inches of warm water and sit in the water for 10 to 15 minutes. When you are out of the tub, resting with a heating pad on your lower abdominal area can also help, he says.

Wear nonrestrictive clothing. Women should avoid clothes that constrict the genital area, says Dr. Barksdale, particularly control-top pantyhose and tight jeans. Clothes with tight crotches put pressure on the inflamed urethral opening, he says, and can force bacteria back up the urine tube. Skirts, loose pants, and knee-highs are far more comfortable and therapeutic when you have a UTI, he says.

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Take off that bathing suit. Avoid wearing a wet bathing suit for long periods of time, adds Dr. Barksdale. “Bacteria love to grow in warm, moist areas,” he says. “A wet swimsuit provides an ideal environment for bacteria that cause UTI, so you are asking for trouble.”

Keep moving. Even though the discomfort of a UTI may make you want to take to your bed, doctors say it is best to stay active since mobility aids bladder function, says Dr. Barksdale. “Exercise is always beneficial for the bladder, and it helps to get your mind off your discomfort.”

Managing Your Meds
While no medications are believed to make you more prone to urinary tract infections (UTIs), you may already be on medication that can help you avoid UTIs. Estrogen replacement therapy (ERT) reduces the risk of UTIs, says Dorothy M. Barbo, M.D., professor of obstetrics and gynecology and director of the Center for Women’s Health at the University of New Mexico in Albuquerque.

The urethra is sensitive to estrogen, explains Dr. Barbo. Lack of estrogen can cause the tissues of the urethra to become dry, thinned out, and more prone to injury and infection, which puts women who are past menopause at increased risk for UTIs. Estrogen improves circulation in all of the tissues of the genital tract and makes them more resilient and less susceptible to infection. This UTI protection is an added benefit of estrogen replacement, she says.

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Clean with care. Keep infections at bay by cleaning the vaginal area with a front-to-back motion, says Dr. Barbo. Many women were taught to wipe from back to front after a bowel movement, which can spread bacteria from your anus to your urethral opening, she says. Proper wiping can prevent a significant number of UTIs, especially among women who get them recurrently.

Ditch douches and sprays. Give up feminine hygiene sprays and scented douches—both can irritate the urethra and vulva, says Dr. Barbo.

If you feel the need to douche, don’t do so any more often than once a month. “Frequent douching can introduce infectious bacteria into the vagina and rinse out the normal ‘friendly’ noninfectious vaginal bacteria,” says Dr. Barbo.