By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

A WOMAN CAN TAKE ACTIONS TO PREVENT URINARY TRACT INFECTIONS

Question: I recently had my first bladder infection. My friends tell me that all women get bladder infections, and it’s normal to have them. They were surprised that this was my first at age 37. Are they right? Is this normal? Will I keep getting them?

Answer: Infections in the bladder and urinary system are more frequent in women than in men, but your friends are guilty of a bit of over generalization. The fact is that only about 20 percent of women ever get even one urinary tract infection (UTI) in their entire lifetime.

The urinary system is made up of three organs -- your two kidneys and your bladder -- and connective tubes. The tubes that connect the kidneys with the bladder are called the ureters. The larger diameter tube that connects the bladder with the outside is called the urethra. Sometimes the kidneys and the ureters are called the upper urinary tract, and the bladder and the urethra are called the lower urinary tract.

The urinary system is built to prevent backflow of urine up into the kidneys. This is one reason that kidney infections are much less common than bladder infections. Kidney infections when they do occur, though, are much more serious. In the rest of today’s column, I’ll concentrate on UTIs of the lower urinary tract.

In the normal course of events, the bladder and urethra are kept free of bacteria because they are flushed out frequently through urination, and urine itself is sterile. Urinary tract infections, then, are not normal in either women or men. However, due to the location and the shorter length of a woman’s urethra, it is easier for her to get bacteria into the urethra. From here bacteria can spread into the bladder and multiply there. This causes an infection in the bladder, called cystitis.

UTIs can occur in people of any age, even infants. In women, the likelihood of getting a UTI increases with age. They are also more common during pregnancy and in diabetics.

UTIs are routinely treated with antibiotics and usually resolve quickly. If a person develops recurrent or chronic UTIs, then his or her doctor may prescribe a low dose antibiotic for an extended period of time. People who have chronic infections may need to have special testing to look for abnormalities of the urinary system.

There are several things that a woman can do to help decrease the risk of getting a UTI. One is to drink lots of water and urinate frequently. Many women put off urinating as the bathrooms have waiting lines or they are limited in the number of bathroom breaks they can take during the day. Those women often cut back on water to keep from needing to use the bathroom. This behavior pattern can make UTIs more likely.

Some women seem to get UTIs from taking tub baths. They should take showers instead. Baths can also contribute to frequent UTIs in young girls.

Another preventive tip is for women to remember to wipe from “front to back” after going to the bathroom. This helps to prevent spreading germs from the rectal area to the urethra. And, always urinate before and after having intercourse to flush any bacteria from the urethra.

Finally, drink cranberry juice. This old folk remedy really does help prevent UTIs in some women by making the urine more acidic.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.