Infection and pain in the bladder: symptoms and treatment

Bladder infections have a way of getting your attention. You make countless trips to the bathroom, and still you feel like you have to go again. And once you’re in there, instead of mindlessly going about your business, you feel burning or pain every time you pee.When you get a bladder infection, it leads to cystitis, which is when your bladder swells and gets irritated. That’s what causes the symptoms. A bladder the most common type of urinary tract infection (UTI)

Women get bladder infections much more than men do. Usually, the infections are more annoying than they are serious, and antibiotics are the treatment. But they can travel up the ureters to the kidneys and cause more severe problems, so it’s important to treat them right away.

Get medical help at once if it hurts to pee and you also have any of these symptoms:
• Vomiting
• Fever
• Chills
• Bloody urine
• Belly or back pain

This may mean potentially life-threatening kidney disease, a prostate infection, a bladder or kidney tumor, or a urinary tract stone.Bladder infections are often more annoying than they are serious. But they can travel up to your kidneys, where they can cause more severe problems.So it’s important to treat bladder infections right away. Doctors usually use antibiotics to kill the bacteria causing the infection.

Causes

The main culprits are bacteria, usually E. coli. These bacteria live on your skin and in your intestines and most of the time, they’re not a problem. Everyone has them. But if they get into the urethra, they can end up in the bladder and cause an infection.

In women

Bladder infections are more common in women than men for several reasons.

• A woman’s urethra is shorter than a man’s, and it’s close to the vagina and anus, where bacteria live. Having sex, wiping from back to front after you go to the bathroom, putting in a tampon, and using a diaphragm for birth control are all ways bacteria can get in.

• During pregnancy, the baby can press on your bladder, which prevents it from emptying completely and gives bacteria a place to thrive.

• After menopause, women have less of the hormone estrogen. That causes the lining of the urethra to get thinner and may change the balance of bacteria in the vagina, making infections more likely.

In men

When men get them, a prostate infection usually is the cause. But any blockage like from a bladder stone or enlarged prostate can prevent the bladder from totally emptying and cause infection.

Symptoms

The most common sign of cystitis (the medical term for a bladder infection) is a burning feelingwhen you pee. Some people might call it a “scalding” sensation.

Other symptoms you might have include:

• Need to pee more often.
• Peeing only in small amounts at a time
• Cloudy or bloody urine
• Urine that smells worse than it should
• pain in your lower belly
• Fever (a sign that the infection might have spread to your kidneys)

In older people, prolonged tiredness (fatigue) or mental confusion might be signs of a more serious urinary tract infection.If you help take care of a child, you may want to watch for accidental daytime wetting that wasn’t happing before. Other signs include a drop in appetite and vomiting.

Test and diagnosis

Your doctor can do some simple tests to find out if you have one, and they’re usually easy to treat. If you get bladder infections often, your doctor may want to do more some advanced tests to find the cause.

Basic Tests

Your doctor will first do a physical exam and talk to you about your symptoms. That may be enough to find out whether you have one.If not, you’ll get a urine analysis. This is a test that checks for bacteria, blood, or pus in a sample of your pee. Your doctor may also run a urine culture to find out which bacteria are causing your infection.

Advanced Tests

To find the cause of a bladder infection, your doctor can use:

• Cystoscopy. Your doctor inserts a cystoscope  a thin tube with a camera  into your urethra to look for problems or to get a tissue sample for more testing (biopsy).

• Imaging. An ultrasound, CT scan, and MRI can show tumors, kidney stones, and other issues.

• Intravenous urogram (IVU). This is an X-ray that uses contrast dye to take images of the kidneys, ureters, and bladder.

• Voiding cystourethrography. Your doctor puts a dye into your bladder to see if any urine flows backward from the bladder toward the kidneys.

• Retrograde urethrography. This test uses contrast dye to find problems in the urethra.

Treatment

Antibiotics

A mild bladder infection may go away on its own within a few days. If it doesn’t, it’s usually treated with antibiotics. You usually start to feel better in a day or so, but be sure take all the medicine as directed.Women with a basic infection usually take antibiotics for 3 to 7 days, though some doctors may give you an antibiotic you can take just once. For stronger infections, or if you get them often, you may take antibiotics for 7 to 10 days. And, if you have another health condition, such as diabetes, you may get a stronger antibiotic to take over a longer time.For women past menopause, your doctor may also suggest a vaginal cream with estrogen, if it’s safe for you.For men who have a bladder infection caused by a prostate infection, you may be on antibiotics for several weeks.Your doctor may also give you medicine to help with symptoms such as pain or the constant urge to pee.

Analgesics as needed

A variety of drugs can relieve symptoms, especially the frequent, insistent urge to urinate and painful urination. Phenazopyridine may help reduce the pain by soothing the inflamed tissues and can be taken for a couple of days, until antibiotics control the infection.

Sometimes surgery

Surgery may be necessary to relieve any physical obstruction to the flow of urine or to correct a structural abnormality that makes infection more likely, such as a drooping uterus or bladder. Until surgery can occur, draining urine from an obstructed area through a catheter helps control the infection. Usually, an antibiotic is given before surgery to reduce the risk of the infection spreading throughout the body.

Self-Care

Here are some things you can do at home to get relief:
• Avoid having sex.
• Drink lots of water, but avoid caffeine, and spicy foods. They can all make your symptoms worse.
• Take a pain reliever.
• Try a 15- to 20-minute soak in a warm bath.
• Use a heating pad on your lower belly.

PREVENTING

In women who experience three or more bladder infections in a year, these measures may help:

• Increasing the intake of fluids
• Urinating often
• Urinating within a short time after sexual intercourse
• Avoiding the use of spermicides (used with a diaphragm and/or condom for birth control)
• Taking antibiotics continually in low doses
• For postmenopausal women who have atrophic vaginitis or atrophic urethritis, applying estrogen cream to the vulva or inserting estrogen suppositories into the vagina