Everything you need to know about bladder infection

By Goretti Cowley 

Reviewed by Suzanne Falck, MD, FACP

Causes | Symptoms | Treatment | Home | remedies

A bladder infection is a
bacterial infection of the bladder. It is also sometimes known as a urinary
tract infection because the urinary tract includes the bladder, urethra,
ureters, and kidneys.
Bladder infections are much
more common in women than in men. It is estimated that more than 50 percent of
women will experience a bladder infection at least once in their lifetime. Most
are uncomplicated infections typically caused by the Escherichia coli (E. coli)
The term
“uncomplicated” is used to describe infections that occur in healthy
women as opposed to “complicated” bladder infections that happen to
people with other conditions, such as catheters, urinary stents, diabetes,
pregnancy, or other causes.
Although an uncomplicated
bladder infection is often easily treated with a short course of antibiotics,
it can be considerably uncomfortable for the person who has it.

Bladder infections often occur
when bacteria get into the urethra, the tube that carries urine out of the
body, and then move into the bladder.
Once in the bladder, the
bacteria can stick to the lining of the bladder, causing it to become inflamed,
a condition known as cystitis. The bacteria can also move from the bladder into
the kidneys, resulting in a kidney infection.
There are a number of factors
that can increase the risk of getting a bladder infection, including:

  • frequent sexual intercourse
  • having sexual intercourse with
    a new partner
  • using a diaphragm and a
    spermicide for birth control
  • not urinating immediately
    after sexual intercourse
  • having diabetes
  • having a bladder or kidney
    infection within the past 12 months
  • changes in the urinary system

The symptoms of a bladder
infection can include:

  • pain or burning when urinating
  • urgent and frequent need to
    urinate, often passing small quantities of urine
  • discomfort in the lower
  • offensive-smelling urine
  • cloudy urine
  • blood in the urine
People with kidney infections
have similar symptoms, but they may also have:

  • fever
  • back pain or pain in the side
    or groin
  • nausea or vomiting
A doctor can usually diagnose
a bladder infection after discussing the symptoms a person is experiencing and
doing a urinalysis. This is a urine test that looks for the presence of white
blood cells in the urine, and signs of inflammation, which indicates an
If a kidney infection is
suspected, the doctor may recommend a urine culture. A urine culture is a
laboratory test used to identify the different bacteria that may be present in
a urine sample.
Urine cultures are often
recommended if the person:

  • experiences symptoms that are
    not typical of a bladder infection
  • gets frequent bladder
  • has “resistant”
    bladder infections that do not improve with antibiotics
  • does not begin to feel better
    within 24-48 hours after starting antibiotics
  • is pregnant

People with uncomplicated
bladder infections are usually treated with a short course of antibiotics.
Treatment options vary, but the following are the most common prescriptions for
uncomplicated cystitis:

  • trimethoprim-sulfamethoxazole
    (Bactrim) – 160-800 milligrams (mg) twice daily for 3 days
  • nitrofurantoin monohydrate –
    100 mg twice daily for 5 – 7 days
  • fosfomycin trometamol – 3
    grams (g) in a single dose
A 3-day course of treatment
has been found to be as efficient as a 7-day course of treatment and people
experienced fewer side effects. Side effects usually stem from the overgrowth
of yeast, which can cause a rash and yeast vaginitis. The 3-day course is also
more cost efficient than the 7-day regime.
A single-dose treatment is
also available, but it generally results in lower cure rates and more frequent
Most people find that their
symptoms begin to improve the day after beginning the treatment. Even if
someone feels better, it is important that they take the full course of
antibiotics in order to completely eliminate the infection. If they do not
finish the whole dose, the infection may return, and it can be harder to treat
the second time around.
If symptoms persist for more
than 2 or 3 days after starting treatment, people should contact their doctor.
People with more complicated
bladder infections will usually need to take antibiotics for 7-14 days.
Complicated infections include those that occur during pregnancy, or in people
who have diabetes or a mild kidney infection. It is also recommended that men
with acute urinary infections take antibiotics for 7-14 days as well.
Less commonly,
fluoroquinolones and beta-lactam antibiotics are used to treat more invasive
infections. These antibiotics are effective, but they are not recommended for
initial treatment because of concerns about bacterial resistance.
Home remedies

Given the worrying problem of antibiotic-resistant
bacteria, doctors try to encourage women who experience regular bladder
infections to use prevention strategies when possible. These strategies may

  • Changing their method of birth
    control: Bladder infections appear to be more common in women who use
    spermicides and a diaphragm.
  • Staying hydrated and urinating
    directly after sexual intercourse: This may help to wash out any bacteria that
    enter the bladder.
  • Topically applying estradiol
    cream if postmenopausal: Postmenopausal women may benefit from using vaginal
    estrogen to reduce risk of infection. Estradiol cream is available to purchase
  • Using a preventive antibiotic:
    This may be recommended if someone repeatedly develops bladder infections and
    has not responded to other preventive measures.
People can also help prevent
bladder infections by including unsweetened cranberry juice, D-mannose, apple
cider vinegar, ascorbic acid (vitamin C), and probiotics into their diets. Of
these remedies, cranberry products and D-mannose appear to be the most popular.
Cranberry juice

Drinking unsweetened cranberry
juice or taking cranberry supplements is often promoted as one way to help
prevent frequent bladder infections. Compounds known as proanthocyanidins found
in cranberries are thought to prevent bacteria from sticking to the walls of
the urethra and bladder, reducing the risk of infection.
The recommended dose is 3
glasses of unsweetened cranberry juice daily, or 2 tablets daily, until the
infection subsides.
Cranberry juice is available
for purchase online.

D-mannose is a naturally
occurring sugar found in certain fruits, such as cranberries and blueberries. A
new study suggests that D-mannose is just as effective as antibiotics in
preventing recurrent urinary tract infections in women.
The sugar attaches to any E.
coli bacteria present and prevents them from sticking to the walls of the
urinary tract or bladder. The bacteria are then flushed out on urination.
D-mannose is available in
powder or capsule form. The recommended dose is 500 mg taken every 2 hours for
5 days. People who experience recurrent bladder infections could take a lower
daily dose of D-mannose as a preventive measure.

Uncomplicated bladder
infections are mainly treated with a short course of antibiotics. This
treatment is highly effective, inexpensive, and most people tolerate it well.
Typically, symptoms start to improve after 48 hours and are often resolved
within 72 hours.
For people whose infection has
spread to the kidneys, antibiotics are usually administered for 10-14 days.
After this time, most infections get better without any further complications.
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Kayode Ojo
Kayode Emmanuel Ojo is the Co-Founder and Managing Director at SHEFFA Limited. He is presently studying Computer Science at the National Open University, Victoria Island, Lagos.