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All About Urinary Tract Infections (UTIs)

Urinary tract infections (UTIs) are the second most common infection among women, behind colds and flu. And for many women, they're as painful as they are prevalent. For some women, it's worse than having a cavity filled, says Kristine E. Whitmore, MD, clinical associate professor of urology at Medical College of Pennsylvania-Hahnemann in Philadelphia. Unfortunately, the pain isn't the worst part -- if you're pregnant, UTIs are potentially dangerous to you and your baby. Here's the scoop on what causes them, what they feel like, and how to prevent them.

If you've ever had a UTI, you're all too familiar with the symptoms. You need to go to the bathroom every 30 minutes to an hour. Often nothing comes out. And when you do go, it hurts or burns. You may even have back pain or bloody urine.

So what causes all of this? Ninety percent of the time, it's Escherichia coli (E. coli), a bacterium found around the anal area, that becomes trapped in the bladder. One of the easiest routes is via toilet paper; if you wipe back to front, the germ can make its way up your urethra, the tube that connects the bladder to the outside world. Female biology makes it even easier -- women have a short urethra (it's 4 centimeters long, while the average man's is 12) -- so it takes the bacteria little time to get to the bladder.

There are a number of other ways to get infected. Not drinking enough fluids results in infrequent urination, and urinating is an effective way of clearing germs from the bladder and urethra. And diabetics or people with urinary tract abnormalities are more at risk. But chances are, if you've had a UTI, you got it from sex. Bacteria from the colon and vagina can get into the urethra during foreplay and intercourse, Dr. Whitmore says. Vigorous sex can cause the bladder to become inflamed, so bacteria stick to its lining. The end result of all that sex -- pregnancy and childbirth -- can leave you more susceptible to UTIs, too. The enlarged uterus and increase in the hormone progesterone prevent the bladder from emptying completely, explains Kevin Ault, MD, assistant professor of obstetrics and gynecology at the University of Iowa. As a result, there's a pool of urine left in the bladder, in which bacteria can flourish. And the more time you spend pushing the baby out, the longer the baby's head presses against the bladder, brushing it and making it hospitable to bacteria.

It's wise to visit your doctor the moment the first symptom strikes. If left untreated, a UTI could develop into a kidney infection, whether you're pregnant or not. Kidney infections can lead to a blood infection, which is potentially life threatening, cautions Dr. Whitmore. For an accurate diagnosis, you need to have a urine culture, which will determine the presence of bacteria.

If you have a UTI, your doctor will prescribe safe antibiotics to cure the infection. If the meantime, drink plenty of water to help flush out the bacteria. To get rid of UTI pain, you may want to pick up some pyridium pills, such as Uristat, at the drugstore. Of course, if you're pregnant, talk to your doctor before taking any medications, over-the-counter or otherwise.

Recurrent UTIs -- more than two in six months -- warrant a consultation with a urologist and a thorough urological workup, Dr. Whitmore says. An ultrasound of the kidney and telescopic examination of the bladder can determine whether the UTI is being caused by another medical problem, such as a kidney stone. If bacteria are the reason for your recurrent UTIs, your doctor can write you a renewable antibiotic prescription that you can fill at the first sign of infection.

Ten percent of expectant moms will get a UTI at some point during pregnancy. However, these infections sometimes go untreated because women don't recognize the symptoms, or there are none; 2 to 7 percent of UTIs among pregnant women are asymptomatic. And therein lies a serious problem: If an expectant mother doesn't know she has a UTI, she won't seek treatment. If left untreated, about 30 to 40 percent of asymptomatic UTIs develop into a kidney infection in the third trimester, putting a woman at risk for preterm labor and a low birth weight baby.

There's no need to panic; most ob-gyns test a woman's urine on her first prenatal visit, to screen for asymptomatic bacteria and to determine whether she has any risk factors that indicate she'll need regular urine cultures for asymptomatic UTIs, such as diabetes.

You can prevent feeling the burn time and time again. Here are seven things you can do:

1. Practice good hygiene. When cleaning the anal area, always wipe from front to back.

2. Avoid dehydration. Drink eight glasses of water a day to flush bacteria out of your system.

3. Empty your bladder frequently. Holding it gives bacteria time to grow.

4. Watch your diet. Caffeine, alcohol, cheese, and chocolate are a few of the substances that can irritate the bladder.

5. Drink cranberry juice or take a cranberry pill. Cranberries can prevent E. coli from adhering to the bladder.

6. Urinate before and after sex. This will help eliminate genital bacteria.

7. Talk to your doctor about your birth control method. Diaphragm users are more likely to get UTIs because the rim can cause trauma to the urethra.

Chances are, these methods will help prevent this small and easily remedied part of womanhood.

The information on this Web site is designed for educational purposes only. It is not intended to be a substitute for informed medical advice or care. You should not use this information to diagnose or treat any health problems or illnesses without consulting your pediatrician or family doctor. Please consult a doctor with any questions or concerns you might have regarding your or your child's condition.