By far the most common problem causing bladder symptoms is a urinary tract infection (UTI).
A UTI is referred to as a bladder infection or cystitis if it affects the lower urinary tract, that is, the urethra and bladder. This occurs more frequently in women as our urethras are shorter (slightly less than 2 inches) and thus closer to the anus than in men. This makes it relatively easy for fecal bacteria to enter and migrate up the urinary tract to cause infection in the bladder.
urinary tract infection
nearly half of all women will experience at least one UTI in their lifetime
Normal sexual activity increases the likelihood of contracting a UTI, although it is NOT considered a sexually transmitted infection. In people under age fifty, UTI is far less common in men than in women and is usually associated with some other type of urological abnormality. If untreated, UTIs can become kidney infections, which are extremely painful. Any infection can result in sepsis (a serious medical condition involving a whole-body or “systemic” inflammatory response triggered by infection) and become life-threatening. However, this is not common in healthy women yet more likely if our immune system is compromised.
what causes a UTI?
The symptoms of a UTI are caused by the body’s inflammatory response to the invasion by pathogenic micro-organisms. Not all symptoms are easily recognized and some infections may be completely asymptomatic.
high risk populations
spinal cord injury
a general decrease in immunity
an increase in fecal and urinary incontinence
an increase in neurologic and cognitive dysfunction
increased exposure to infections from hospitalization or institutionalization
Escherichia coli (E. coli)
what are the symptoms of a UTI?
frequency but often very little urine comes out
discomfort with urination
any type of discomfort with urination such as pain, burning or pressure. There may be a sensation of tenderness, heaviness, or abnormal warmth just above the pubic bone
an intense need to urinate
cloudy urine (which may contain a large number of white blood cells, blood, or mucus)
difficulty starting or maintaining a urine flow
a peculiar odor and/or color to the urine
what are symptoms of pyelonephritis
pyelonephritis is an infection that involves the upper urinary tract
In addition to the above symptoms, infection that has progressed up the ureters to involve the upper urinary tract and kidneys involves fever and pain in the flank or mid-back, which may be only one-sided.
This type of infection is known as pyelonephritis, and symptoms may progress to a feeling of extreme weakness, severe nausea and vomiting, and unremitting pain. Left untreated, pyelonephritis is life threatening. Pyelonephritis during pregnancy can cause complications, including premature labor. If you suspect you may have this condition, seek treatment immediately!
Because UTI is a common infection, diagnosis is very routine. A “clean-catch” urine specimen is collected.
in your doctor’s office, a special stick is dipped into the specimen to test for levels of glucose, blood, leukocytes (white blood cells), pH, and ketones (formed when the body breaks down fat). A high number of white blood cells may suggest infection.
the sample is sent to the lab where it is cultured for bacterial growth
most common pathogens
Escherichia coli (E. coli)
If bacteria is found it is further tested with a range of possible antibiotics to determine which kills the largest number of organisms. This advises your physician which antibiotics are appropriate for treating the specific bacteria. New strains of antibiotic-resistant organisms are emerging so not every antibiotic will work even if you used it before.
As above, testing will determine which antibiotic is best for treating the specific bacteria found. Below are some of the commonly used antibiotics
trimethoprim with sulfamethoxazole (Bactrim)160/800 mg twice per day for three days
nitrofurantoin (Macrobid or Macrodantin) 100 mg twice per day for five days
fosfomycin (Monurol) given as a 3-g single dose
quinolones (Levaquin, Cipro) are no longer first line of treatment for a UTI as they have been found to cause “soft tissue” damage, such as tendon rupture
In addition to antibiotics your health care provider might suggest adding a bladder analgesic. These medications do NOT treat a UTI but help relax the bladder as the antibiotics are working. Pyridium (phenazopyridine hydrochloride) is available as a prescription as well as over-the-counter known as AZO urinary relief.
fact or fiction?
should I drink a lot of water?
Increasing liquid intake may indeed help to flush bacteria from the urinary tract and prevent infections from developing. However, excessive intake may dilute our natural immune defenses.
The better advice may be to follow these simple principles: Drink when you’re thirsty; drink enough to maintain clear, light-yellow urine, and always increase liquid intake when you have a fever.
should I drink cranberry juice?
The original theory was that by increasing the acidity of urine and creating an environment that did not favor bacterial growth, cranberry juice would help prevent UTI.
Instead, more recent studies have identified the cranberry components fructose and proanthocyanidins as having the potential to prevent bacterial adherence to epithelial cells in the urinary tract and bladder, thus decreasing the chances of developing an infection. This factor may be especially important in the case of E. coli, the most common urinary pathogen. Instead of juice that contains sugar, these compounds can be found in extract supplements.
how important is it to wipe front to back?
Hygiene is sometimes overlooked as a major strategy in the prevention of UTI. We’ve all heard the old adage about wiping from front to back, and it is still great advice. It is especially important if you suffer occasionally or frequently from loose stools. Regular, frequent showering is important, always using the front-to-back cleansing strategy. However do NOT douche (vaginal cleansing). This isn’t necessary, and it has the potential to disrupt normal, healthy vaginal bacterial flora which helps balance the urogenital tract.
Is it harmful to hold my pee for a long time?
Another possible cause of bladder infection is irregular voiding, or holding urine for too long, which allows any bacteria present to adhere to the bladder lining and begin to multiply, rather than being flushed out at regular intervals. It is important to drink water regularly and to void regularly; this is how our bodies are designed to function properly.
a vegetarian diet may lower risk of UTI
UTIs are usually caused by gut bacteria, which enter the urinary tract through the urethra and affect the kidneys and bladder. Previous research has shown that meat is a major reservoir for E. coli strains known to cause UTIs, but it is unknown whether avoiding meat reduces the risk of UTIs.
A recent study found that the overall risk of UTIs was 16 percent lower in vegetarians than in non-vegetarians.
The reduced UTI risk associated with a vegetarian diet was greater in men than women, although overall UTI risk for men was 79 percent lower than for women, regardless of diet.
The authors suggest that by not eating common sources of E. coli, such as poultry and pork, vegetarians may avoid ingesting E. coli that may cause UTIs. They also propose that the higher fiber diet of many vegetarians may prevent the growth of E. coli in the gut and decrease UTI risk by making the intestine more acidic.
a diet high in fermented foods helps promote good bacteria
Prevention: Probiotic Foods
Probiotics offer beneficial bacteria. What are probiotic foods?
Yogurt – Milk, fermented by good bacteria
Kefir – Fermented probiotic milk drink
Sauerkraut – Finely shredd cabbage, fermented by lactic acid bacteria
Tempeh – Fermented soybean product
Kimchi – Fermented, spicy Korean side dish
Miso – Japaneses seasoning
Kombucha – Fermented green or black tea drink
Pickles – Pickled cucumbers, soaked in a water and salt solution
Traditional Buttermilk – Fermented dairy drink
Natto – Fermented soy bean product
Some types of cheeses – Gouda, mozzarella, cheddar and cottage cheese