The disease goes by different names — bladder
infection, cystitis, urinary tract infection or
UTI — but the symptoms are always the same and
they're always agonizing. Suddenly you feel an urgent need to
urinate. When you try to do so, however, you can produce
very little, and a dreadful burning sensation rewards your
efforts. The urge returns every few minutes, too —
sometimes accompanied by lower abdominal pain, a low-grade
fever, chills or blood in the urine.
Although it's certainly not fatal, cystitis is a very
uncomfortable condition and it strikes an amazingly large
segment of the population. In fact, many authorities agree
that it's women's most common bacterial infection
and their second most common illness overall,
occurring more frequently than any disease except colds!
The bacteria usually responsible for UTI are
Escherichia coli (commonly known as
E. coli ) — organisms necessary to
proper digestion — which lives in the intestines and bowel. In
order to cause UTI, though, the bacteria must find their
way into the urethra and then up to the bladder where
they feed on urine, multiply and cause infection. As you'd
imagine, then, bladder aliments are of primary concern to
women, because of some basic anatomical differences between
the sexes: Women's urethral and anal openings
are closer together than are men's, and their urethras are
also considerably shorter.
How to Prevent a Urinary Tract Infection
Because most UTI are caused by E. coli
micro-organisms that have crept from the anal area into the
vagina and urethra, proper hygiene is the best way to
prevent flare-ups. Here are four basic rules a woman should
follow if she wishes to avoid a painful bout of cystitis.
 After eliminating, be careful to wipe from front to
back (away from the urethra), to prevent the passage of
bacteria into the bladder.
 Keep the vaginal and anal areas clean, preferably with
a mild, non-perfumed soap.
 Drink plenty of fluids to dilute the urine (so it will
provide less nourishment for E. coli) and keep the
system flushed. We recommend eight tall glasses of water a
 Urinate frequently, at least once every two or three
hours. This will expel bacteria and eliminate the urine
they feed on.
Contributing Factors to Bladder Infections
As any woman who has suffered UTI will confirm, cystitis is
more than just a minor infection: It can become an
unwelcome part of one's life. If you get recurrent
UTI — as 10 to 15 percent of all women do — you should
probably take steps to determine what factors might be
contributing to the situation. Possible causes include (but
aren't limited to) the following:
- Stress. Job or family problems, school
pressures, decreased resistance due to another illness and premenstrual tension have all been known to
contribute to the onset of cystitis. A personal stress
management program (many people use meditation, yoga, or
regular exercise) may help.
- Lovemaking. UTIs have long been associated with sex.
(In fact, it's still occasionally referred to by the now
rather archaic term "honeymoon cystitis.") If you suspect
this is the cause of frequent flare-ups, discuss the
problem with your partner. You may want to change
styles of lovemaking or methods of birth control.
(Urinating both before and after intercourse is also a good
- Underwear. Choose cotton undergarments, because that
natural fabric is less irritating than are synthetic
fibers. Cotton also allows the vaginal/anal area to
"breathe" and doesn't tend to trap bacteria-attracting
heat and moisture.
- Menstrual products. Blood is an excellent culture
medium for bacteria, so avoid its buildup by changing
tampons or sanitary napkins frequently. Also, beware of
deodorant tampons (which can cause allergic reactions) and
super-absorbent types (which expand in the vagina and can
irritate the neighboring urethra).
- Estrogen. As the level of estrogen in a woman's
blood rises, so does her susceptibility to cystitis because this hormone makes the urinary tract more
hospitable to bacteria. Therefore, pregnant women (whose
bodies release estrogen naturally) and those who use oral
contraceptives (the pills raise estrogen levels
artificially) are especially susceptible to UTI. If you
take birth control pills and have recurrent bladder
infections, you might consider switching to lower-estrogen
pills or — as mentioned before — even
choosing an entirely different contraceptive method.
- Perfumed Products. Scented toilet paper and soap,
feminine deodorant sprays and even bubble baths can
contribute to cystitis. In fact, the FDA recently ordered
bubble-bath manufacturers to print a cautionary label on
their products warning of possible "irritation to the skin
and urinary tract."
- Laundry products. Bleaches, detergents and fabric
softeners can leave residues that may cause irritation and/or allergic reactions.
- Food and drink. Alcohol, spicy foods, coffee, tea,
and other foods that contain caffeine — even
chocolate! — can act as irritants to the urinary tract.
First Aid For Bladder Infections
The onset of a bladder infection is fairly easy to
recognize, as it'll be heralded by the symptoms mentioned
at the beginning of this article. If you feel UTI coming
on, there are several things you can do that might nip it
in the bud — or at least reduce your discomfort until
you can get to a doctor.
Drink lots of water immediately, and keep on
drinking it. Some women get relief by drinking cranberry juice, because
the acidic beverage makes urine less hospitable to
infection-causing E. coli. Others, however, find that
the juice increases the burning sensation accompanying
urination and prefer to stick to water.
Urinate as frequently as possible.
Try a tea of German (not Roman) chamomile, bearberry and
flaxseed. These herbs — which have been used for
centuries to treat UTI — ease the pain by relaxing the
urinary tract. (Bearberry dyes urine green, so don't be
Take Pyridium. This prescription drug is a urinary
analgesic (pain killer) that will dye your urine bright
orange and take the edge off that searing pain. However, it
shouldn't be used by pregnant women or anyone with kidney
problems. If you can't get to a doctor for a prescription,
you might want to try one of the (almost equally effective)
over-the-counter urinary analgesics. They're most
often sold under the names Baridium or Azo-Standard.
A heating pad on the lower abdomen or a hot bath often
Professional Care For a UTI
Of course, sometimes first aid won't work, and a visit to
the doctor's office or emergency room is necessary.
Professional treatment of a bladder infection involves
three steps: determining that there are bacteria in the
urine, testing their sensitivity (that is, discovering
what will kill them) and then attacking with an
appropriate medication. The typical prescription for UTI is
a sulfa drug, either Gantrisin or Azo-Gantrisin. Stubborn
infections are sometimes treated with Macrodantin, a more
Some women are allergic to sulfa drugs and black females
may develop serious anemic reactions to such medications,
so be sure to discuss those possibilities with your doctor — he or she may want to prescribe ampicillin instead.
Any of the drugs used to treat cystitis will relieve the
pain quickly, but it's important to take the entire course
of medication you receive, in order to completely destroy
the bacterial strain. Remember, too, that antibiotics will
kill not only the invaders in your bladder, but also other
beneficial micro-organisms in your intestines. For that
reason, it's a good idea to eat lots of yogurt (which
replenishes the supply) while taking sulfa medication.
Unfortunately, many women receive unsympathetic — or
even hostile — reactions when asking their physicians
for advice on how to treat urinary complaints, because some
medical "experts" assume incorrectly that all UTI is
sex-related while others consider the patient's
problem psychogenic. This is complicated by the fact that,
in many cases, bacterial counts in the woman's urine
specimen aren't high enough to be considered — by some
standards — symptomatic of a bladder infection.
Then again, recent studies have indicated that recurrent
UTI is often caused not by E. coli, but
by Chlamydia, a micro-organism that doesn't even
grow in urine cultures (and therefore can't be detected by
standard UTI tests). Physicians who are unaware of the
Chlamydia-cystitis link — and surprisingly,
quite a few are — may believe the negative test instead
of the woman and give her tranquilizers for her "imagined"
symptoms. Therefore, if you know you have a
bladder infection, don't accept a prescription for Valium.
Instead, inquire whether your urine specimen contained
white blood cells (which, of course, would indicate an
infection) and suggest that Chlamydia might be the
cause. The proper medication for such cases would be
tetracycline or erythromycin.
An Anatomical Problem
If you experience recurring UTI despite your best
preventive efforts, you may have an anatomical
problem in your urinary tract. This could be either an
unusual stricture (or narrowing) of the urethra,
or — more commonly — a condition called
"vesico-ureteral reflux," in which the valves between the
bladder and ureters don't close completely after the
bladder contracts to release urine. As a result,
bacteria-contaminated urine returns to the ureters, and
drops back either into the bladder to cause another UTI
or — worse yet — into the kidneys to cause a kidney
infection. [EDITOR'S NOTE: Regular cystitis
symptoms — when accompanied by high
fever — usually indicate kidney injection. If
you develop this potentially serious condition, see a
doctor right away.] Physicians use a special x-ray — called an intravenous pyelogram, or
IVP — to investigate structural problems in the urinary
tract. If such irregularities are discovered, they can
often be corrected surgically.