What is a bladder infection?

A bladder infection, also called cystitis, is a type of urinary tract infection. The inner lining of the bladder becomes inflamed (red and swollen). The infection is usually caused by bacteria, although it can also be caused by a virus.

How does it occur?

The urinary tract is normally sterile (contains no bacteria). A bladder infection occurs when bacteria enter the urinary tract (the urethra) and travel up to the bladder.

Females are more prone to bladder infections than males because the urethra in females is short. The short urethra makes it easier for bacteria to travel up the urethra and into the bladder from the anus or vagina during normal activities such as wiping or sexual intercourse.

Bladder infections frequently occur in young women who have just become sexually active. This is sometimes called honeymoon cystitis.

The diagnosis of a bladder infection in males is usually followed by further studies, since cystitis occurs rarely in men.

If the flow of urine is blocked or the bladder cannot empty completely, there is an increased likelihood of a bladder infection. For example, a stone or tumor in men or women or prostate enlargement in men might block the flow of urine.

During pregnancy hormonal changes cause the muscles of the urinary tract to relax, resulting in retention of urine in the ureters (the tubes that carry urine from the kidney to the bladder) and in the bladder. This urine retention makes pregnant women more susceptible to urinary tract infections.

What are the symptoms?

The symptoms of a bladder infection include:

• a frequent and urgent need to urinate

• a burning or stinging sensation during urination

• a gnawing pain or discomfort in the lower abdomen just above the pubic bone

• a need to urinate more often in the night

• cloudy urine that smells bad

• possibly blood in the urine

• leaking of urine

• fever and occasionally chills.

How is it diagnosed?

Your doctor will examine you and may ask you to provide a specimen. The urine sample will be analyzed in the lab to see if there are bacteria in the urine and to determine which antibiotics will kill these bacteria.

Blood tests may be ordered.

How is it treated?

Bladder infection is a common problem that is usually easily treated. Your doctor will prescribe an antibiotic to kill bacteria and prevent the spread of infection to your kidneys. The doctor may prescribe an antibiotic without asking you to have a urine culture, before the results of the urine culture are known, or may use the results of the culture to prescribe an antibiotic.

Your doctor may also prescribe Pyridium, a drug to help reduce the pain and spasm of the bladder during the first couple of days. Pyridium will turn your urine orange. The orange dye can stain your clothing, so you may want to wear a panty liner.

You may need to return to the doctor's office after you have taken all of your medication to give another sample of your urine. The urine will be analyzed by the lab to see if it still contains bacteria. Further tests may be done if you have recurrent infections.

How long will the effects last?

Prompt treatment of a bladder infection with antibiotics usually controls the infection and relieves the symptoms in 24 to 48 hours. However, if the infection spreads to the kidneys before treatment begins, damage to the kidneys may occur.

How can I take care of myself?

• Take all of the antibiotic medication that your doctor prescribes, even when you feel better. Do not take medication left over from previous prescriptions.

• Drink six to eight glasses of fluids each day to cleanse the bladder and the rest of the urinary tract.

• Take warm sitz baths, which may help to relieve some of the discomfort.

• If directed, return to your doctor for a follow-up urine test within 1 week after you finish your antibiotic medication.

• Follow your health care provider's recommendation for regular urine testing to check for recurrence.

If you have a fever:

• Rest in bed if your temperature is over 100 degrees F (38 degrees C). After your temperature has fallen below 100 degrees F (38 degrees C), you can resume your normal activities.

• Ask your doctor if you can take aspirin or acetaminophen to control your fever. Anyone under the age of 21 with a fever should not take aspirin because of an increased risk of Reye's syndrome.

• Keep a record of your daily temperature.

Call your doctor if your symptoms persist more than 5 days after you started taking the antibiotic.

What can be done to help prevent bladder infection?

Women can take the following steps to help prevent a bladder infection from recurring:

• Urinate regularly during the day and empty your bladder completely each time.

• Keep the vaginal area clean and wipe from front to back after a bowel movement. Be sure to wash the genital area each time you bathe or shower. However, use soap only on the outside of your vagina, because the chemicals in soap may cause additional irritation.

• Urinate before and after intercourse. Never combine anal and vaginal intercourse.

• Wear cotton underwear, which allows better air circulation than nylon. Wear pantyhose that have a cotton crotch.

• Avoid tight clothes in the genital area, such as control-top pantyhose and tight jeans. Do not wear a wet bathing suit for long periods of time.

• During pregnancy, tell your doctor if you have a history of urinary tract problems. Your doctor may order a urine culture before you have symptoms of urinary tract infection.

If you have a history of recurrent urinary tract problems, your doctor may prescribe small doses of antibiotics to be taken continually to prevent cystitis from recurring.