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 all-over 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-­a-half 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 eight-ounce 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 I added sugar) may make urine more I 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 rush­hour traffic. He feels the urge to urinate, but he can’t get of the freeway. When he finally gets home and urinates, it’s difficult and it bums. 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 hot-water 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, cotton­lined 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.

Use condoms. Prostate infection, which can lead to bladder infection, is more common among men with multiple sex partners. Practice safe sex, and always use condoms with partners.

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