The first clue might be an annoying need to visit the bathroom way too often. That's followed by a burning sensation while urinating and sometimes pain in the pelvic area.
Urinary tract infections most often affect women, but men aren't immune, especially in later life when enlargement of the prostate gland can increase the likelihood.
But lately there's good news for sufferers. Treatment of urinary tract infections -- which can involve the bladder, kidneys or the urine-transporting tubes -- has become easier in recent years, thanks, in part, to new antibiotics and shorter courses of medication.
Urinary tract infections, or UTIs, are nearly always bacterial. Women are more prone than men, due partly to anatomy. A woman's urethra -- the tube through which urine is excreted from the bladder -- is shorter, making infection more likely. Infection can occur after intercourse, when bacteria normally found in the genital area can be pushed up into the urinary tract.
UTIs are so common, some experts say, that most women can count on having at least one at some point in their lives. Published figures estimate 10 percent of women have had UTIs, says Dr. Eila Skinner, assistant professor of urology at the University of Southern California, but she suspects the percentage is actually much higher. "And of those women who get one, 20 percent will have recurring infections," she adds.
Use of a diaphragm or IUD for contraception can be associated with UTIs, experts say. At the first sign of infection, many women self-treat by drinking plenty of fluids, including cranberry juice, hoping to flush out the bad bugs. It probably can't hurt in most cases, experts say.
But anyone who's had a type of kidney stone composed of calcium oxalate -- the most common kind -- should avoid the cranberry juice remedy because the juice contains oxalic acid, says Dr. Barton Wachs, urologist and a clinical instructor at Harbor/UCLA Medical Center in Los Angeles. But others, including a spokeswoman for a cranberry juice manufacturer, counter that there's not enough oxalic acid to do harm.
Self-care helps about half of women, Dr. Skinner says. If symptoms don't improve in two or three days, see a doctor, she advises. Seek medical help, too, if the urine contains blood.
Men or children with suspected UTIs should always see a physician because their infections are likely to be associated with potentially serious underlying problems.
A physician may order a culture of the urine, which can pinpoint bacteria involved and determine whether kidney stones have formed.
Oral antibiotics are the usual treatment. Commonly prescribed are such medicines as ampicillin or nitrofurantoin. Quinolones, a newer choice, have become a common treatment, but they are being overused, says Dr. Philip Hanno, chairman of the department of urology at Temple University School of Medicine in Philadelphia. Quinolones -- such as ciprofloxacin (Cipro) -- should be reserved for "complicated cases," he believes.
"But they're a lifesaver on a Friday afternoon when you can't get a culture (analyzed)," Wachs counters.
Not too many years ago, standard antibiotic treatment for UTIs took seven to 10 days, Hanno says. Now, patients are placed on "shorter and shorter" courses, with two-day regimens common.
Sometimes the medicine is even taken in a single dose, thus increasing patient compliance.
"Within 24 hours after starting an antibiotic you should feel better," Wachs says.
Following antibiotic treatment, however, women are more prone to yeast infections, Wachs says. So he recommends an over-the-counter anti-fungal remedy (such as Monistat 7 or Gyne-Lotrimin) or a prescription anti-fungal medicine.
If a woman has repeated UTIs, a physician might recommend daily use of antibiotics for three to six months to build resistance. Or, some women are given an emergency supply of antibiotics to use when they notice symptoms or to take before and after intercourse.
Women who get more than four UTIs in a year should see a urologist, Wachs says.