Urinary Tract Infection

A Urinary tract infection goes by many names: UTI, bladder infection, cystitis. No matter what you call it, it can make you feel miserable.

When you have a urinary tract infection, you're constantly running to the bathroom because of a persistent urge to void. Then when you go, you don't produce much urine, but you experience intense pain and burning nonetheless. Your urine may appear pinkish, a sign of blood. And you may develop a fever, along with pain in your lower abdomen.

Urinary tract infections are usually caused by the intestinal bacteria Escherichia coli. These bugs are necessary for digestion, but if they find their way into your bladder and grow there, you get a UTI.

How do E. coli travel from point A to point B? They get incorporated into your stool, and when you move your bowels, some of the bacteria remain around your anus. From there, they get transported to your urethra, usually by careless wiping or vigorous or careless sex. Then they work their way into your bladder.

Depending on the study, E. coli are responsible for 50 to 90 percent of UTIs. But several other intestinal microorganisms, including staphylococcus, can cause UTIs, too.

Both men and women get UTIs, but women are at much greater risk. A woman's urethral and anal openings are closer together than a man's, so bacteria can easily migrate from one opening to the other. Also, a woman's urethra is considerably shorter than a man's, so bacteria don't have to travel far to infect the bladder.

Anything that puts pressure on the bladder increases the likelihood of a UTI, which is why many women get the infections during pregnancy. In addition, women may become more prone to UTIs after menopause, as the urethra and bladder become more fragile. About half of all women develop at least one UTI during their lifetimes, and millions suffer maddeningly frequent recurrent infections.

The good news is that most UTIs respond well to home treatment. Only the most persistent infections require medical intervention. Here's what the experts say can help.

Nutrition

Restore balance with yogurt. The bacteria that cause UTIs may get out of hand because you don't have enough beneficial (probiotic) bacteria to keep them in balance. One way to increase the population is to eat yogurt containing live cultures of Lactobacillus acidophilus and other beneficial bacteria, says Anne Simons, M.D. Look for the words "live cultures" on yogurt labels.

Supplements

Buy bacteria in capsules. If you're not fond of yogurt, you can buy L. acidophilus and other beneficial bacteria in supplement form. Most of these products require refrigeration. One that doesn't is PB8, says Christiane Northrup, M.D., founder ofthe Women to Women health center in Yarmouth, Maine, and past president of the American Holistic Medical Association.

Fight infection with C. Vitamin C can help prevent UTIs, Dr. Northrup says. She recommends taking 1,000 to 2,000 milligrams a day. And if you tend to get UTIs after sex, you can take an additional 1,000 milligrams before intercourse and 1,000 milligrams after.

Herbal Medicine

Consider the cranberry cure. Cranberries have an age-old reputation as a treatment for urinary problems. While the berries definitely seem to help, scientists have had a hard time figuring out why. The latest theory is that cranberries prevent and treat UTIs not by killing bacteria but by stopping them from attaching to the bladder wall.

If you suffer from recurrent UTIs, Dr. Northrup recommends drinking 8 ounces of cranberry juice a day as a preventive. But be aware that commercial cranberry juice is actually "cranberry juice cocktail" -a little juice with lots of added sugar. If you don't want all that sugar, Dr. Northrup suggests taking a concentrated cranberry extract in pill form. CranActin is a popular brand. Follow the label directions for proper dosage.

Bear up better with bearberry. Bearberry is the common name of the medicinal herb uva-ursi. "Uva-ursi contains a urinary antiseptic called arbutin," says Joseph Pizzorno Jr., N.D. Arbutin is particularly effective against the E. coli bacteria that usually cause UTIs.

According to Dr. Pizzorno, uva-ursi seems to produce the best results when taken as a tea. Add 2 teaspoons of the herb to 1 cup of boiled water and steep for 10 minutes. Strain. Drink three cupfuls of the tea per day.

Dr. Northrup says that uva-ursi also works well when taken as a tincture. She recommends one dropperful of tincture in water three times a day.

Keep your eye on echinacea. Also known as coneflower, echinacea stimulates the immune system. "There's a great deal of research showing that the herb's immune­boosting effects help the body fight bacterial infections such as UTIs," says James A. Duke, Ph.D. He recommends taking a teaspoon of tincture three times a day, mixed into water or juice.

Feel golden with goldenseal. "Goldenseal is one of the most effective herbal antibiotics," Dr. Pizzorno says. "It's particularly effective against E. coli and other bacteria that cause UTIs." He recommends taking 1 to 1 1/2 teaspoons of tincture three times a day. If you're a woman and your UTIs seem to come on after sex, Dr. Pizzorno suggests rinsing your labia and urethral opening with a solution of 2 teaspoons of goldenseal and 1 cup of water after intercourse.

Minimize discomfort with marsh­mallow. Naturopath Jill Stansbury, N.D., chairperson of the botanical medicine department at the National College of Naturopathic Medicine in Portland, Oregon, suggests drinking marshmallow tea at the first sign of a UTI. Marshmallow contains a soothing fiber called mucilage that relieves pain, reduces inflammation, and promotes healing of the bladder-often quite quickly. To make marshmallow tea, gently boil 1 teaspoon of chopped marshmallow root in 1 cup of water for 10 to 15 minutes. Strain out the plant material and allow the tea to cool. Drink up to three cupfuls a day.

Home Remedies

Prevent infections with yogurt suppositories. Dr. Northrup suggests dipping a stiff tampon, such as the O.B. brand, in live­culture yogurt and inserting it in your vagina for a few hours. In one study, 27 women with recurrent UTIs who used L. acidophilus vaginal suppositories reported significantly fewer infections.

Drink lots of agua. At the first twinge of infection, Dr. Pizzorno says, start drinking lots of water-up to 10 glasses (8-ounce size) a day. You may be able to flush the bacteria out of your bladder before they become established enough to cause a full-blown infection.

Eliminate irritants. Some substances can irritate your urinary tract. The list includes spicy foods, caffeinated beverages, alcohol, and nicotine in cigarettes. If you're prone to UTIs and you consume any of these substances, abstain for a while and see whether you notice any change in the frequency and severity of your infections.

Go when you gotta. Studies of women with recurrent UTIs show that they tend to hold their urine for extended periods, Dr. Simons says. If you feel the urge to urinate, go. In fact, even if you don't feel the urge, go every hour or two anyway.

Wipe from front to back. When you go to the bathroom, always wipe away from your urethra. Wiping in the other direction, from back to front, moves bacteria from your anus to within striking distance of your urethra.

Be sanitary. During menstruation, change tampons or sanitary napkins often, Dr. Simons says. Blood is an excellent medium for bacterial growth.

Dress in cotton. Wear underpants made from cotton, which is less irritating than synthetic materials. Avoid leotards and other tight-fitting garments, which may help move bacteria toward the urethra.

Make love gently. Many women develop UTIs after making love unusually enthusiastically or frequently. Back when premarital sex was less common than it is today, so many new brides developed UTIs that the condition was dubbed honeymoon cystitis. "If you're prone to UTIs, make love gently and consider using a commercial lubricant," Dr. Simons says. "Vigorous sex can irritate your urethra and increase the risk of moving anal bacteria into it."

Keep it clean. Another reason why honeymoon cystitis was so common was that many newlyweds were uninformed about sexual hygiene. "Nothing that touches a woman's anal area should come in contact with her vagina," says Sacramento, California, sex and marital therapist Louanne Cole-Weston, Ph.D. "Keep track of where fingers and any sex toys have been."

Head for the bathroom afterward. "Be sure to empty your bladder after intercourse," Dr. Simons says. "Urinating helps flush out any bacteria before they have a chance to cause infection."

Consider the contraception connection. Compared with women who use other forms of birth control, those who use diaphragms are more susceptible to UTIs. For a long time, doctors believed that the diaphragm rim was to blame. When the rim presses against the urethra, it causes irritation, which increases the risk of infection. Now research suggests that the spermicide used with diaphragms plays a role in UTIs, too.

Don't stop using birth control, advises Andrew T. Weil, M.D., director of the program in integrative medicine at the University of Arizona College of Medicine in Tucson. But if you use a diaphragm, you may want to consider other contraceptive options.

Other Good Choices

Relaxation Therapies

For relief, relax. "Stress and tension aggravate the discomfort of a UTI and impair your immune system's ability to fight the infection," says Martin 1. Rossman, M.D. "Deep relaxation shouldn't be considered a primary treatment, but it's a useful, immuneboosting adjunct." He recommends regular practice of any relaxation technique that appeals to you: deep breathing, meditation, visualization, massage, yoga, or tai chi.

Homeopathy

Ask a homeopath for help. Homeopaths recommend an array of medicines for UTIs, depending on a person's individual symptoms. Among the medicines commonly prescribed are Apis, Berberis, Cantharis, Mercurius, Nux vomica, Pulsatilla, Sarsaparilla, and Staphysagria, says homeopath Dana Ullman. To find out which of these medicines might work best for you, consult a homeopath.

Chinese Medicine

Turn down Heat. Practitioners of Chinese medicine attribute UTIs to the stagnation of qi in the Bladder. "The stagnation creates Heat, which obstructs qi and makes the urinary tract vulnerable to external attack;" says Efrem Korngold, O.M.D., L.Ac.

To treat UTIs, Dr. Korngold prescribes several herbal formulas. One formula, called Qian Lie Xian Wan, contains a combination of licorice root, astragalus root, peony root, and other herbs. Another formula, Yao Zhi Gui Ling Gao, is made from a mixture of licorice, rehmannia root, Ionic era flowers, and other herbs and animal parts.

Make your point against pain. You may get some relief from your UTI symptoms with acupressure, says Michael Reed Gach, founder and director of the Acupressure Institute. He suggests applying steady, penetrating finger pressure for 3 minutes to each of the following points.

• Spleen 6, located four finger-widths above your inner anklebone on the back inner border of your shinbone
• Liver 8, located on your inner leg at the end of your knee crease

If your symptoms don't improve, consider consulting an acupuncturist. Sometimes professional needle stimulation helps when finger pressure doesn't.

Ayurvedic Medicine

Put out your fire. Ayurvedic physicians view UTI as a condition of excess Pitta, or fire, says David Frawley, O.M.D. To treat a UTI, he recommends an anti-Pitta approach: lots of cranberry juice, pomegranate juice, and coconut milk; no spices, alcohol, or members of the nightshade family (especially tomatoes but also potatoes and eggplant, among others).

He also prescribes Ayurvedic herbs, especially sandalwood, which he calls a natural urinary antiseptic. Other helpful herbs include coriander, marshmallow, fennel, lemon­grass, gotu kola, punarnava, and shilajit.

Naturopathy

Douse discomfort with water. Heat helps relieve the discomfort of a UTI, Dr. Simons says. She suggests taking tolerably hot baths or applying a heating pad to your lower abdomen.

Or try alternating hot and cold baths, advises Tori Hudson, N.D., professor of gynecology at the National College of Naturopathic Medicine in Portland, Oregon. First, sit in a tolerably hot bath for up to 5 minutes, then sit in a basin of cold water for 30 seconds. Repeat this sequence three times, finishing with the cold water. Alternating hot and cold compresses on your pelvic area produces similar beneftts, she adds.

Medical Measures

If you see your doctor about your UTI, you'll probably be asked to produce a urine sample. If the sample contains bacteria, you'll be given an antibiotic. Be sure to take the entire prescription, even if your symptoms subside sooner, Dr. Simons says. Otherwise, some of the bacteria may linger in your urinary tract, leading to another infection that's harder to treat.

If you tend to develop vaginal yeast infections after taking antibiotics, Dr. Simons suggests asking your physician to prescribe a yeast medication-just in case.

If you're prone to recurrent UTIs, Dr. Simons recommends keeping some phenazopyridine (Pyridium) on hand. It's a urinary pain reliever that helps minimize the burning sensation that accompanies a UTI. Phenazopyridine is available by prescription only. Ask your doctor for enough to see you through several UTIs, Dr. Simons says. Just don't use it for more than 24 hours without consulting your physician to see if you need antibiotics. Also, be aware that phenazopyridine turns your urine bright orange.

Red Flags

Some mainstream M.D.'s prescribe sulfa antibiotics to treat UTIs. If you're Mrican­American, you don't want to take these drugs until you've been tested for a hereditary deficiency of an enzyme called G6PD. About 10 percent of Mrican-Americans have this deficiency and should not take sulfa drugs. If you are G6PD-deftcient, your doctor can prescribe other antibiotics.

Left untreated, a UTI can move from your bladder into your kidneys, causing infection there (acute pyelonephritis). Usually, the first symptom is pain on one or both sides of your midback, where your kidneys are located. As the infection progresses, other symptoms may develop, including fever, chills, nausea and vomiting, and difficult and painful urination. If you experience any of these, see your doctor right away. A kidney infection is a potentially serious condition. It usually responds to treatment with antibiotics but often requires hospitalization.