What to do for painless bladder infections
DEAR DR. DONOHUE: Please write something about bladder infections. Can you have a bladder infection with no symptoms? — A.
ANSWER: The signs and symptoms of bladder infections are the same for men and women. The irritated, infected bladder demands frequent, urgent trips to the bathroom so it can be emptied. People have a burning sensation when passing urine. Pain is felt in the bladder area. Sometimes blood appears in the urine.
Men have far fewer bladder infections than women. Women have a shorter urethra than men. The urethra is the tube that empties the bladder of urine. Bacteria can ascend the female urethra without trouble. It’s harder for them to climb the male urethra. Women’s urethras open in an area that has a large bacterial population. The act of sexual relations frequently massages those bacteria into the female urethra. And men’s prostate glands secrete substances that have antibacterial properties.
The presence of bacteria in the urine without any signs of bladder infection is called asymptomatic bacteriuria. Doctors treat pregnant women with asymptomatic bacteriuria to prevent symptoms from arising, as they often do during pregnancy. Infected urine, even without symptoms, can lower the birth weight of babies who were in the uterus during that period.
Otherwise, asymptomatic bacteriuria in women or men, at any age, does not usually require treatment. In women, bacteria in the bladder are often transiently there. They disappear many times on their own. Treatment can lead to the development of resistant bacteria and can produce side effects. Furthermore, it is costly. The guidance from most experts, therefore, is not to treat asymptomatic bacteriuria.
Exceptions exist. Diabetics might benefit from treatment.
The topic of urinary tract infections and their treatment are covered in the booklet on that topic. Readers can order a copy by writing: Dr. Donohue — No. 1204, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: Some time ago, a person wrote to tell you the success she’d had with symptoms of irritable bowel syndrome after her doctor prescribed a drug off-label. Will you tell me the name of that medicine? I have suffered from IBS for years. — L.O.
ANSWER: The medicine is rifaximin, brand name Xifaxan, a medicine marketed for the treatment of one kind of traveler’s diarrhea. It’s somewhat costly and has a list of side effects. Have you tried other remedies? Capsules of peppermint oil, found in health-food stores and some drugstores, have helped many IBS patients. Levsin (hyoscyamine) and Bentyl (dicyclomine), both prescription drugs, calm the hyperactive digestive tract of IBS. A few people respond to probiotics, biologic remedies that contain harmless bacteria like bifidobacterium (Align) or lactobacillus (Culturelle). Neither requires a prescription. Irritable bowel syndrome consists of abdominal pain, often crampy, with bloating and either diarrhea, constipation or diarrhea alternating with constipation. It is one of the most common digestive-tract illnesses seen by doctors.
DEAR DR. DONOHUE: I am a healthy 65-year-old woman. The only medicine I take is Zocor for cholesterol. Recently I read that a person can have complications from having an MRI brain scan. I have had two. One was six years ago after an accident, and the other was a year ago because of dizziness. No problem was found. What can I expect in the future as a complication of having these scans? — J.K.
ANSWER: An MRI is a safe procedure. No radiation is involved. Magnets and radio waves combine to take pictures of inner body structures like the brain. Millions of people have had MRI scans. I know of no serious complications from them. People with metallic objects implanted, like pacemakers, can’t have an MRI because of the magnets used. Manufacturers are producing new pacemakers that are tolerant of the MRI scanner. I don’t believe you’ll ever suffer any complications from having your scans.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

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