The Dreaded Urinary Tract Infection


SEX AND AGE can increase the risk of a urinary tract infection (UTI), although it’s most common in young to middle-aged women. Waiting too long to go to the bathroom can also up the risk.

The most common bacteria involved in urinary tract infections, E.coli, lives in the intestine of healthy people but causes problems when it moves out of the intestine and into some component of the urinary tract (bladder, kidneys, ureter, urethra).

The most common, cystitis, is E.coli infection of the bladder, known to cause pain while peeing, described as anything from a burning sensation to feeling like you’re peeing razor blades.  Other symptoms include the intense urge to pee, needing to pee more often and peeing little when you go.  Also urine that looks cloudy, is reddish or smells bad; and pain below the rib cage.

Despite extreme discomfort, bladder infections are considered mild and respond well to antibiotic treatment. On the other hand, infection in the kidneys, responsible for filtering out body waste and creating urine, can have serious health consequences.

Bacteria most often migrates from the intestines during or after sex (when tiny bits of feces can enter the urinary tract).  Once its presence is detected in a urine sample, a culture is done to determine which bacteria are causing the infection to pinpoint which medications are most effective.

Alternatively, an over-the-counter (OTC) dipstick test comes with strips that can be dipped in urine, like a pregnancy test, and turn a different color depending on the results, although a positive outcome requires visiting the doctor for a culture.  Furthermore, the reliability of these tests can be affected by medications and other factors.

“Azo, however, is very reliable. “Never leave home without it,” one user recommends.  OTC Azo is the pain reliever phenazopyridine, which deals with symptoms of pain, burning, increased urination and the increased urge to urinate but doesn’t treat the infection. Azo is known for turning urine dark orange or red, along with causing permanent stains on clothes, discoloring soft contact lenses and altering results from urine tests.

Those who are susceptible to recurring UTIs should drink a lot of water to help dilute the urine and flush out any bacteria in the urinary tract.  One woman believes her infection arose after a conference where she didn’t drink enough water and held her pee too long.

Empty your bladder at least every four hours during the day, advises Johns Hopkins gynecologist Tola Fahsokun.  And very important: Wipe from front to back.  Many suggest urinating as soon as possible after intercourse to help wash bacteria from the urethral opening.  Take showers instead of baths and use birth control other than diaphragms or spermicides.

Fahsokun also recommends loose clothing and cotton underwear.  If possible, wear nothing at all a few hours a day. Tight and/or synthetic materials can trap heat and moisture, creating more opportunity for bacteria to multiply around the area.

As for cranberry juice, the medical jury is still out.  Many sufferers think it’s still worth trying, and some recommend cranberry pills.  Used as a treatment in Europe, cranberry pills and herbal teas helped DC-area resident L.S. recover, albeit after days of “misery.” But when she used the remedy again several years later and it didn’t work, she was sorry she’d spent any time trying. “I do not recommend delaying getting medical attention,” she says now.

With aging, decreased vaginal estrogen causes changes in the cellular lining of the vagina, allowing bad bacteria to move too close to the urethra with access to the bladder. For chronic UTIs that occur with menopause, vaginal estrogen therapy can help.

Less than a week of antibiotics resolves most UTIs, but those susceptible to chronic infection are often prescribed low-dose antibiotics for anywhere from a week to up to two years, or are advised to take ahead of time at the first hint of infection.

—Mary Carpenter

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