Urinary Tract Infections

How do I know if I have a urinary tract infection?

A urinary tract infection (UTI) isn't difficult to recognize: You'll feel a pressing need to empty your bladder every few minutes, though little or no urine may come out, and you'll feel a burning sensation when you do urinate. You may also have discomfort in your lower back or just above your pubic bone or pain during sex. Like any infection, it can make you feel feverish, shaky, and drained. About 50 percent of women will get a UTI at some point in their lives; for some, the problem becomes chronic. Men rarely get them.

How did I get it?

Most likely some nasty bacteria (usually E. coli) made its way from your rectum to your urethra (which isn't far to travel on a woman's body) and then up into your bladder. This proximity may be the reason women are much more susceptible to UTIs then men are. It's common to get a UTI after having sex with a new partner or following a period of celibacy. (That's why it's been called "honeymoon cystitis.") Studies have also linked UTIs to the use of diaphragms and condoms with spermicides, which seem to make the vagina more hospitable to bacteria. You may be more likely to get UTIs as you age. Having a short urethra or a condition, such as diabetes, that weakens your immune system can also make you vulnerable.

Do I need to see a doctor?

Yes. Don't assume the infection will go away by itself, even if your symptoms clear up. Left to multiply, the bacteria may travel farther up your urinary tract and damage your kidneys. Your doctor will ask about your symptoms and check your urine for bacteria by examining a sample under a microscope. If you're having low back or abdominal pain, she or he may do a pelvic exam as well to rule out other causes. If the UTI diagnosis is confirmed, your doctor will prescribe a course of antibiotics to kill the bacteria causing your infection. Your symptoms should go away in a few days, but make sure you take all the pills prescribed to prevent a recurrence.

Can drinking cranberry juice really help?

It seems so. In a study at Harvard, 76 postmenopausal women who drank 10 ounces of cranberry juice cocktail (which is less than 30 percent actual cranberry juice) a day were less than half as likely to have bacteria in their urine after a month as those who drank a similar-tasting beverage. And researchers at Rutgers think they've discovered why: Cranberries contain substances that prevent E. coli from attaching to the lining of the urinary tract, so the flow of your urine more easily washes the bug out of the body. So a glass a day might keep you from getting an infection if you're prone to them but probably can't dispatch one that's already started. You'll need antibiotics for that.

For prevention, stick with the juice rather than dehydrated cranberry capsules; one researcher found that some brands of the pills didn't contain any of the bacteria-fighting substances. Also, if you take the blood-thinning medication warfarin, don't drink cranberry juice -- it may lead to bleeding.

What else can I do to ward off a UTI?

  • Drink a lot of water. The idea is to flush out any bacteria that may be making their way up your urethra before they can settle in and start to reproduce.
  • If you notice that coffee, spicy or acidic foods, or alcohol irritates your bladder, cut back on your intake. Such agitation may compromise your bladder's ability to fight off an infection.
  • Keep your genital area clean. Wash with plain water once a day. Soap, bubble bath, and other personal hygiene products (sprays, powders, douches) may be irritating.
  • Keep the area dry and ventilated. Synthetic fibers and tight pants can trap moisture and heat, promoting bacterial growth. Wear cotton-crotch underwear and loose-fitting clothes.
  • Practice good sexual hygiene. You and your partner should wash before and after sex. If you use a diaphragm, make sure it fits properly and use plenty of lubrication. Empty your bladder after intercourse to flush out bacteria lingering in the urethra.
  • Take care of yourself. Don't put off trips to the bathroom when you feel the urge to go, and be sure to empty your bladder completely when you urinate.
  • Avoid spermicide-coated condoms.
  • Always wipe yourself from front to back to reduce the chance of spreading bacteria from the rectal area into the vaginal area. Nurture your immune system by eating well, getting enough rest, and reducing stress in your life as much as you can.

What can I do if I keep getting them?

About 20 percent of women suffer from recurrent UTIs -- and the more you have, the more likely you are to get one again. If you've had more than three in one year, ask your doctor about taking preventive antibiotics. Your doctor can do a urine culture to see which drugs will kill your particular strain of bacteria, since some bugs are resistant to certain antibiotics.

You may have to take a low dose every day for six months, a single dose each time you have sex, or a few doses whenever symptoms appear. (If you have symptoms regularly, you might want to try the UTI detection kits now available in drugstores, which can pick up about 90 percent of UTIs when used first thing in the morning.) Your doctor may also take X-rays or do other tests to check for blockages in the urethra. If this is the case, surgery may be necessary. Researchers are also working on a vaccine that may prevent recurrent UTIs by building up your natural infection-fighting proteins.

Reference

Mayo Clinic. Urinary Tract Infection. Updated June 26, 2010. http://www.mayoclinic.com/health/urinary-tract-infection/DS00286

National Kidney and Urologic Diseases Information Clearinghouse. Urinary Tract Infections in Adults. August 2007. http://kidney.niddk.nih.gov/kudiseases/pubs/uti_ez/

Moller LA, et al. The prevalence and bothersomeness of lower urinary tract symptoms in women 40-60 years of age. Acta Obstet Gynecol Scand;79(4):298-305.

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