DEAR DR. DONOHUE: Please explain urinary tract infections. Why do they recur? My doctor prescribes antibiotics, but shortly after I’ve completed taking them, I have another infection. What do you suggest as treatment? A pharmacist told me that I needed one or two days in the hospital to flush out my kidneys. — S.A.
ANSWER: Urinary tract infections fall into one of two types. Upper tract infections indicate that the kidneys are involved. These are serious and less-common infections. Lower urinary tract infections are bladder infections, and they are very common. That’s the kind of infection I believe you have.
Women are prone to develop bladder infections for a number of reasons. One, the tube (urethra) that empties their bladder is much shorter than in males, so bacteria can gain access to the bladder more easily. Secondly, the opening of the female urethra is in a place with a large population of bacteria. And thirdly, sexual relations massage bacteria into the female urethra and bladder.
A bladder infection — cystitis — provokes frequent trips to the bathroom, an urgent need to quickly empty the bladder or suffer an accident, and pain, usually described as burning, during urination.
Women with repeated bladder infections need to be evaluated to see if the infection is a relapse (an infection with the same bacterium) or a new infection (infection with a different bacterium). The approach to treatment hinges on that information.
If a woman has another infection with the same bacterium, the doctor can put her on the same antibiotic for a longer period of time and can continue to treat long after symptoms have gone. The continued treatment is with a reduced antibiotic dose.
Another way to prevent a recurrence is to give the woman a prescription for an antibiotic that she takes after intercourse. Home remedies can be helpful. Drinking 8 ounces of cranberry juice daily benefits prevention of the most common cause of these infections. The kidney flush suggestion is not a good one.
The booklet on urinary tract infections delves deeper into these common maladies. To obtain a copy, write: Dr. Donohue — No. 1204W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 with the recipient’s printed name and address. Allow four weeks for delivery.
DEAR DR. DONOHUE: have a small lump on the back of my left wrist. It’s soft and doesn’t hurt even when I push on it. It’s been there for at least two months. I don’t remember injuring it. Lumps freak me out. My brother had bone cancer. When I see things sprouting on me, I think of cancer. Could it be? — F.L.
ANSWER: It’s not likely to be bone cancer. A more likely bet is a ganglion. That’s a kind of cyst filled with thick, gelatinous material. It communicates with the wrist joint or with one of the wrist tendons. If it doesn’t hurt or interfere with wrist motion, you can ignore it. It if does, a doctor can remove it without much fuss. Many ganglion patients want their doctor to drain it. Drainage is possible, but the recurrence rate is very high.
Readers may write Dr. Donohue or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. ©2011 North America Synd.