How to Bladder Infection (Cystitis) Treatment

How to Bladder Infection (Cystitis) Treatment

It's the most uncomfortable kind of infection there is. Sometimes it comes on suddenly with such force that you wonder if you'll make it to the lavatory in time. Then it burns when you urinate, and even when you're done that full bladder feeling is still there, only there's nothing left to come out. You pace around with a fidgety feeling like a four-year-old. Still, the ache continues, moving up into the abdomen and back. Next time you urinate you may even see a little blood. It's enough to scare you to death.

A rare disease? Hardly. Millions — mostly women — fall victim to bladder infections (cystitis) each year, and for 80 percent of them it won't be the last time, either. In fact, so common is this ailment that it's sometimes referred to a 'cold in the bladder.' But don't let that fool you. It's not at all as simple as a runny nose. Urinary-tract infections (UT Is) can affect the urethra (the tube which vents urine from the bladder) or kidneys as well as the bladder. They're caused by any number of treacherous bacteria, but most often by Escherichia coli, a normal inhabitant of the bowel and harmless when it remains in its own territory. But let those bugs wander into the normally sterile area of the urinary tract, and you could wind up with a full-blown case of UTI.

For women, the bacteria don't have to wander very far. One look at the female anatomy shows you why. A woman's urethra is only 1 ½ inches long just a short walk for the bacteria to reach the bladder.

Besides that, the urethra and the rectum (the original source of the E. coli) are close together.

No wonder women outnumber men by more than ten to one in cases of UTI. On top of that, some women have the bad habit of wiping from back to front, making a short trip even shorter for the bugs. Add underwear in fabrics that don't breathe (nylon and other synthetics), tights and tight jeans, and you've got the warm, dark, moist environment that E. coli thrive in.

Which they do with the test in women of all ages. According to Calvin M. Kunin chairman of the department of medicine at Ohio State University School of Medicine, all women are susceptible to UT Is, but the prevalence increases about 1 percent per decade of life in adult women and may be as high as 10 percent in elderly women.

'Honeymoon cystitis'

Still, there are certain stages in a woman's life when flare-ups seem almost predictable. Like just after her first few experiences of sexual intercourse. Cystitis, the most common type of urinary tract infection, is so common at this time that it's been dubbed 'honeymoon cystitis'.

The theory is that any bacteria in the neighborhood of the urethra have a good chance of being pushed up into the bladder during intercourse. Once the honeymoon is over, though, cystitis may still be a lingering reminder of those more active nights. In fact, women with a history of UTI are more prone to it during pregnancy, especially during the last trimester. That's when the space inside is at a premium and the bladder gets wedged between the uterus and the pubic bone so that it may not be able to empty itself completely. Any bacteria remaining from previous infections dive into the pool of leftover urine and start multiplying.

What's worse, says Dr. Kunin, is that there appears to be some change in the urinary tract during the last part of pregnancy that makes it easier for these bladder bacteria to spread upward and invade the kidneys.

Still, giving up sex isn't the answer, according to Leo Galland, the assistant clinical professor of medicine at the University of Connecticut. Along with sociologist Kiku Otto, Dr. Linda Granowetter, and nurse-social worker Kitty Doebele, Dr. Galland conducted a study that compared 84 women with a history of recurrent UTI with a group who were free of this problem. Their purpose was to determine if there were any notable differences in the sexual, hygiene and urinating habits of women with recurring UTI and those who had never been affected.

Contrary to popular belief, sex was not the culprit it was originally thought to be. 'The sexual habits of the patients and controls were strikingly similar, ' says Dr. Galland. 'Not only were both groups sexually active, but they contained about the same percentage of women having frequent intercourse (three to seven times a week). Discomfort associated with sexual encounters was also distributed evenly. '

Other factors

There was one factor related to sexual behavior that was significant, however, and that had to do with postponing urination after intercourse. The majority of the controls (68 percent) frequently voided within ten minutes of sexual intercourse while only 8 percent of the patients did.

However, the most striking difference between patients and controls was the high frequency of 'holding it in' among the patient group.

Voluntary retention of urine for more than an hour after experiencing the urge to 'go' was present in 61 percent of the patients but in only 11 percent of the controls. And more than two-thirds of the patients reported waiting three hours or longer before urinating. [Journal of the American Medical Association, 8 June 1979].

Not surprisingly, while the urine is accumulating in the bladder, so are the germs. But there's more to it than that. Jack Lapides of the University of Michigan Medical Center has spent 20 years investigating the causes of urinary tract infections. He speculates that ignoring nature's call damages the wall of the bladder, making it more susceptible to infection.

The distended or full bladder causes a decreased blood flow through its veins. The anti-bacterial agents naturally found in the bloodstream are also decreased, and the body can't defend itself against incoming germs. 'In the female patient,' says Dr. Lapides, 'it is primarily poor voiding patterns that cause overdistention of the bladder, thus accounting for most urinary-tract infections. '

Considering the consequences, it's hard to imagine anyone consciously choosing to ignore the urge for even one hour, but apparently, women do consistently hold it in, and for lots longer than that. In one group of 250 women that Dr. Lapides studied, 66 percent were infrequent voiders, going only once in five to ten hours!

And it wasn't for lack of facilities, either. Dr. Galland's patients most frequently cited embarrassment in social situations and unwillingness to use public toilets as their reasons for putting off what comes naturally. Others just didn't want to take time out of their activities, whether at home or at work. And those reasons were not unique to this particular study, either. Dr. Lapides's group listed the very same reasons as Dr. Galland's patients, adding that sometimes there were too few toilets at their place of work or in various shopping areas, or that they were afraid of contracting a venereal disease in a public toilet. Some unfortunate women ignored the inevitable as long as possible because neck-to-thigh foundation garments were such a hassle to remove.

A regimen that works

The fact is, no excuse is good enough when your health is involved. Especially when prevention of UT Is can be as easy as going to the toilet — frequently, of course.

Dr. Galland's experiment proved that point. After the initial study, the patients were then given a basic preventive regimen to follow. It included regular urination (about every two hours), voiding ten minutes after intercourse, drinking eight glasses of fluid a day and wiping front to back after urinating.

After six months, the patients showed a re-infection rate of only 15 percent — more than encouraging when you consider that cystitis usually occurs in about 80 percent of sufferers.

It's no wonder that both Dr. Galland and Dr. Lapides stress the importance of frequent urination as the first step in a preventive program. If you're prone to recurrent urinary-tract infection (and even if you're not), it makes good sense to follow the regimen that they suggest.

And take some hints from the patients they interviewed, too. That means making time for normal functioning, no matter how involved you are with activities. Wear clothes that don't stifle your ability to urinate frequently. And while you're at it, make sure that undergarments are cotton (for better air circulation), and change them every day. Keep your bottom clean and dry, and avoid chemical irritants such as scented powders, perfumed sprays or bubble baths.

If, in spite of these precautions, you feel the symptoms of UTI coming on immediately start to drink plenty of water. Eight glasses a day is recommended, and that's usually enough to flush out your urinary tract of invading bacteria. Besides, the more dilute the urine, the less painful voiding will be.

'An alternative to water,' says Dr. Galland, 'is cranberry juice. But don't substitute any other fruit juices for the eight glasses of water. Cranberry juice is unique and good because it contains hippuric acid that inhibits the growth of bacteria. '

Others heartily agree. Wisconsin doctor D. V. Moen reported success with cranberry juice almost 20 years ago. In the Wisconsin Medical Journal, he recommended two (6 oz) glasses daily for continued relief of urinary symptoms

(See also URINARY PROBLEMS).

Meanwhile, in your effort to purge the germs from your urinary tract, don't forget old reliable vitamin C. 'Its presence in the urine may actually promote good health in the bladder and kidneys,' says Dr. Alan Gaby of Baltimore Maryland. 'Vitamin C can kill some bacteria, including E. coli, the most common cause of urinary-tract infections. That killing power is especially strong at the uniquely high vitamin C levels that are possible in the concentrated fluid of urine. Doctors have used vitamin C for years to prevent urinary-tract infections in people likely to develop them. It's generally assumed that the vitamin works by producing an acid urine that inhibits the growth of bacteria. In fact, vitamin C does a poor job of acidifying the urine. The effectiveness of the vitamin is more likely related to a direct bactericidal [bacteria-killing] action. '

While battling an infection, it's best to stay away from coffee, tea alcohol, and spicy foods, since they may irritate your already sensitive urinary tract.

It is possible to cure a urinary tract infection without ever having to resort to antibiotics. Still, if the self-help remedies you try don't relieve symptoms within 24 hours, it's time to see a doctor. An infection in the bladder should not be ignored since there's always the risk of kidney involvement.