Frequency, urgency, hesitancy, small voids and painful urination are the typical symptoms of urinary tract infections. Costly in terms of time and money, UTIs result in an estimated 7 million office visits, 1 million emergency department visits and over 100,000 hospitalizations annually, with an associated annual cost of $1.6 billion, according to the National Institute of Health.
WHAT CAUSES UTIS?
Our kidneys filter one-third of the blood pumped with each beat of our hearts. They kick out contaminants and regulate our electrolytes and fluid balance. A normal breakdown product of our proteins (muscles and enzymes) is a small molecule named urea, which the kidneys filter into the urine, causing its distinctive smell. The urine produced by the kidneys goes down tubes (ureters) and sits in the bladder until we urinate.
Normally, urine is sterile — that is, free of bacteria. Although it can become infected from above, such as when the body is septic, bacteria more commonly access the bladder from below. Women have a very short tube from the bladder to the outside, the urethra, and with age, this tube becomes flabby — allowing bacteria to enter it more easily. It’s also susceptible to leaking in bacteria when irritated, such as with sexual intercourse or bubble baths. Other physical activities, such as horseback or motorcycle riding, do not seem to be causes.
HOW ARE UTIS TREATED?
Fortunately, bladder infections are easily treated. Because the urine sits in the bladder’s smooth-walled container, as little as a single pill or three days of antibiotics cures over 90 percent of infections. About a third of bladder infections will heal without any treatment or with holistic care, such as increased fluid intake. However, if the infection works its way up to the kidneys, more serious symptoms of fever and vomiting result, and a more vigorous and extensive intervention of antibiotics and IV fluids may be necessary.
WHAT CAUSES RECURRENT INFECTIONS?
Anomalies of the bladder, like polyps or stones, can cause recurrent infections. Uncommonly, a kidney stone can obstruct the output from a kidney and cause infection, in which case the kidney may die — putting the patient at serious health risk. Usually, though, once an infection is treated, the patient has no significant aftereffects.
Some women suffer frequent urinary infections. For them, a workup that includes a cystoscope (a device used to examine the bladder) and ultrasound is warranted to ascertain if there’s a structural cause, such as a polyp or stone. Treatment with a single, low-dose antibiotic daily has been found markedly effective at preventing these recurrent infections, while some patients prefer to keep a supply of full-strength antibiotics on hand if symptoms start.
Urine infections are common, with one in three women requiring treatment by age 24. Fortunately, most can be easily cured. Common recommendations of emptying the bladder after coitus, limiting spermicide use and drinking cranberry juice have not been found effective, but they seem harmless and may help certain individuals.
