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 massages 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. 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: My husband and I are in our late 30s and have been heavy drinkers for many years. Now we have it under control. What damage have we done to ourselves? My liver enzymes were tested and are normal. — Anon.

ANSWER: Twelve ounces of beer (a standard beer container), 5 ounces of wine and 1.5 ounces (a jigger, a shot) of 80 proof whiskey, gin or vodka have 12 grams of alcohol and are considered one drink. A man who drinks 60 to 70 grams of alcohol a day (five to six drinks) and a woman who drinks 20 to 40 grams (two to three drinks) for 10 years run a great risk of incurring liver damage. That doesn’t happen to everyone. Some people smoke all their lives and suffer no lung damage. The chances are not in people’s favor to go unscathed either from smoking or heavy drinking. Your tests showed no liver damage. You can be grateful. You and your husband would make a wise choice to abstain from alcohol.

DEAR DR. DONOHUE: My barber, Vinnie, said my eyebrows were receding and that is an indication of thyroid problems. I write to see what your take is on this. I would like to establish fact from fiction. — P.D.

ANSWER: Vinnie is somewhat near the truth by saying hair loss is a possible consequence of both an underactive and overactive thyroid gland. However, the loss is usually on the scalp, when and if it does occur. Loss only of eyebrow hair isn’t a symptom of thyroid disease. And hair loss from the scalp is not the only sign that things are wrong with the thyroid. Other signs must be present, too.

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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