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Urinary Tract Infections

Urinary tract infections, or UTIs, are a common problem for men and women of all ages, although they are more common among certain people than others.
 
It’s important to recognize the symptoms of a UTI and seek help quickly, as severe infections can cause kidney damage and compromise other organ systems.

 

Although some mild UTIs can be treated with over-the-counter remedies, most will require antibiotics and other medical intervention. By learning to recognize the symptoms of a urinary tract infection, you can seek the appropriate treatment necessary to return your body to health.

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What is a Urinary Tract Infection?

Your urinary tract is the system that carries liquid waste out of the body in the form of urine. It consists of the kidneys, which filter toxins out of the liquid you drink; the bladder, which stores urine; the urethra, which allows urine to pass out of the body; and the tubes that connect all of these parts. A urinary tract infection occurs when any of these parts become infected.

 

Depending on the part of the body affected by the infection, the specific term for the urinary tract infection will change. Bladder infections are called cystitis, and the relatively more rare urethra infections are urethritis. Kidney infections are called pyelonephritis.

 

The most common UTIs are bladder infections, which occur when the bladder becomes obstructed or exposed to bacteria. Bladder infections are usually fairly mild, but the symptoms can be very uncomfortable. If left untreated, however, the infection can spread to the kidneys. A kidney infection is much more serious and can permanently damage your kidneys. If you develop symptoms consistent with a kidney infection, it’s important to seek aggressive medical care quickly to prevent permanent injury to your vital organs.

What a Urinary Tract Infection is Not

Because the urinary tract is situated near sexual organs, it can often be grouped together with these bodily systems. However, it’s important to distinguish between infections of the urethra and the vagina or penis. Urinary tract infections are not the same as infections of sexual organs, although they can sometimes be caused by the same pathogens as discussed below.

 

Additionally, certain diseases and disorders of the urinary tract may mimic the symptoms of a UTI, but they are not treated in the same way and do not have the same underlying causes. For example, an enlarged prostate may cause straining and burning with urination, and certain types of kidney disease may mimic the symptoms of pyelonephritis. These conditions have different root causes than UTIs, however, and require different treatment.

 

This is one reason why it’s important to have a doctor check for bacteria in a patient’s urine whenever the patient presents with UTI symptoms. The symptoms may be caused by a different underlying concern, or that underlying medical condition may cause the UTI as a secondary infection. Until the root cause is discovered and treated, chronic urinary tract infections may occur.

What causes a Urinary Tract Infection?

Most urinary tract infections are bacterial in nature. When fecal bacteria from the anus makes its way into the urethra, the bacteria can multiply and travel upward to the bladder and kidneys. This condition is even more common in people whose urine flow is obstructed by kidney stones or an enlarged prostate. This is because urine becomes trapped in the bladder or surrounding systems. The resulting buildup of urine creates the sort of warm, damp environment that bacteria thrive in, and the decrease in urination prevents the urethra from flushing out pathogens as it normally might.

 

There are several ways that fecal bacteria can get into the urinary tract:

  • Poor bathroom hygiene

  • Diarrhea

  • Sex acts involving the anus

  • Catheter use

  • Swimming in unsanitary water

 

Even when none of these situations are common, bacterial migration can still occur. Women are more prone to urinary tract infections than men due to their short urethras. Women are also in particular risk of contracting a UTI because of the proximity of their vagina, anus and urethra enabling bacterial migration between these locations. For some women, chronic or recurring UTIs become common.

 

While most urinary tract infections are caused by the bacteria E. coli, it’s important to know that not every UTI is caused by fecal bacteria. Other types of bacteria can cause bladder and kidney infections, and certain fungi may be responsible for infections as well. Viral infections of the urinary tract are not common.

UTIs and STDs

Some sexually transmitted diseases mimic the effects of urinary tract infections. Additionally, certain STDs can cause urinary tract infections if the bacteria spreads to the urethra rather than or in addition to the sex organs. For example, chlamydia can cause urinary tract infections, and its symptoms may be difficult to distinguish from other types of UTIs.

 

Because the risk of UTIs increases in people who are sexually active, patients may not recognize the early signs of an STD or may mistake it for a urinary tract infection. If you experience any of the signs or symptoms of a UTI as explained below, it’s a good idea to have your urine tested to confirm the exact cause of the symptoms. If your symptoms are caused by an STD rather than a more straightforward UTI, your treatment may differ.

Risk Factors for Urinary Infections

In a healthy person, the urinary tract is kept healthy through a routine flush of sterile urine. This helps keep the urethra clear and prevents bacteria from entering the bladder. In order for a urinary tract infection to occur, pathogens must enter the urethra and stay inside the body long enough to multiply. Although anyone can get a urinary tract infection, there are several factors that may make them more likely to occur:

  • Digestive upsets that cause chronic diarrhea

  • Exposure to unsanitary water, such as in a pond or river

  • Blockages in the urinary tract, such as kidney stones, that inhibit urination

  • Frequent sexual activity, especially unprotected sex or sex involving the anus

  • Forcing urine to stay in a full bladder, for example during a long car ride

  • Suppressed or compromised immune systems, especially in the elderly

 

One of the most common causes of urinary tract infections is the prolonged retention of urine in the bladder. Because urine is sterile, it serves an important role in flushing out the urinary tract. Urination acts to clear the urinary tract and wash away bacteria that are attempting to make their way up the urethra. Preventing the passage of urine, such as by suppressing the urge to urinate when the patient has a full bladder, can prevent this flushing from taking place.

 

Additionally, a full bladder can create an environment where bacteria can dwell and thrive. If kept inside the bladder for too long, the sterile urine may begin to harbor bacteria. This in turn will cause the infection to multiply and spread. Because of the dangers of suppressing urination, it’s important for people to relieve themselves frequently. This may require frequent bathroom breaks at work or during car trips. People who are bed-ridden are at particularly high risk of developing UTIs, so careful attention to bed pans or catheters is vital for these patients.

 

Because of their sexual habits, age or lifestyles, certain people may be more prone to urinary tract infections than others:

  • People who live or work in conditions where E. coli bacteria multiply

  • Individuals who have unprotected anal sex

  • The elderly and infirm, especially those confined to bed rest or who use catheters

  • People who have compromised immune systems due to illness or medication use

  • People who are restricted from normal bathroom use on a routine basis

 

All people can reduce their risk of UTIs by practicing good hygiene and ensuring adequate water intake. Some people also believe that certain fresh foods such as cranberries, blueberries and pineapples can play a role in preventing urinary tract infections and promoting overall urinary tract health.

UTIs and the Elderly

People who are elderly or infirm are at particular risk of developing urinary tract infections. The elderly often have suppressed immune systems, which can cause infections to spread quickly. Additionally, many elderly people have mobility issues that may reduce their ability to relieve themselves frequently. Catheters that become dirty or are misused can cause urinary tract infections as well.

 

Finally, the elderly need to pay particular attention to the health of their urinary tract as the initial minor symptoms do not always present themselves in people over the age of 65. By the time the patient begins experiencing symptoms, the infection may have become quite severe.

Urinary Tract Infections and Sex

UTIs following sexual intercourse are so common that they have earned their own nickname, “honeymoon cystitis.” These bladder infections occur in women when bacteria is introduced to the vagina during sexual intercourse; they can also happen in men when bacteria travels up the urethra after the penis comes in contact with bacteria. Here are some ways to prevent UTIs caused by sex:

  • Observe personal hygiene and grooming before sexual contact

  • Avoid cross-contamination; do not have vaginal sex after anal penetration without changing condoms or washing the penis first

  • Avoid anal sex without condom use

  • Urinate after sex to help flush the urethra

 

It may also be a good idea to avoid sexual contact with your partner while he or she has an active urinary tract infection. Otherwise, you run the risk of passing the infection back and forth between you, which will cause it to become resistant to antibiotics. This may be one reason that some people suffer from chronic UTIs.

Signs and Symptoms of a Urinary Tract Infection

Urinary tract infections may go unnoticed at first, especially if the initial symptoms are mild. Symptoms generally worsen and magnify as the infection spreads. One of the first symptoms is often a frequent urge to urinate coupled with small amounts of urine or the feeling of being “unfinished” after urinating. This may lead to straining. An itching or burning sensation during urination is common as well. Other symptoms, like blood in the urine, may be more obvious and suggest a more serious infection.

 

Most urinary tract infection symptoms are consistent between genders, but some symptoms are more prevalent in one gender than the other. Urinary tract infections are more common in adult females than males. Other diagnosis, such as a low grade infection of the prostate and sexually transmitted infections should be carefully considered.

In Women

  • Frequent urges to urinate, with only small amounts of urine

  • Cloudy or dark urine

  • Blood in urine

  • Foul-smelling urine

  • Burning sensation while urinating

  • Pain in the pelvis or lower abdomen

  • Pain in the back just below the ribs

 

In Men

  • Frequent urges to urinate, with only small amounts of urine

  • Cloudy or dark urine

  • Blood in urine

  • Urine with a strong, foul odor

  • Burning sensation while urinating

  • Penis pain or discharge

  • Pain in the back just below the ribs

 

For either sex, back pain below the ribs is associated with kidney infections and should be taken seriously. If you experience kidney pain coupled with a fever, weakness, chills or nausea, seek medical attention immediately to prevent complications.

 

Diagnosis of Urinary Tract Infection

Because viral infections of the bladder and kidneys are relatively rare, most UTIs require antibiotics. Leaving a UTI untreated can cause the symptoms to worsen and may result in permanent kidney damage or a weakened bladder; failure to treat a UTI may make future UTIs more common and serious.

 

If your doctor discovers that your infection has spread to your kidneys, the treatment may be much more involved. Depending on the severity of the infection, hospitalization may be required to fully treat the kidney infection.

 

Treatment for Urinary Tract Infection

Urinary tract infections are treated with antibiotics, which kill the bacteria responsible for the infection. Some of the most common antibiotics prescribed by doctors to treat UTIs include Amoxicillin, Bactrim or Ciprofloxacin. If a patient has developed a resistance to one type of medication, the doctor will prescribe a different antibiotic. If you have a history of urinary tract infections, be sure to mention this to the doctor as it may precipitate a change in what drugs are prescribed.

 

In addition to antibiotics, the doctor may recommend that the patient take the over-the-counter drug phenazopyridine, commonly sold as AZO or Uristat. This drug will not cure the UTI, but it does help to treat its symptoms and relieve discomfort. The primary purpose of phenazopyridine is relief from the itching or burning sensation that often accompanies a UTI; it may also help relieve the frequency and urgency of urination. Be aware that this drug can cause bodily fluids like urine and tears to turn bright orange, so don’t be alarmed if this occurs.

 

If the UTI is severe and has spread to the kidneys, the patient may require hospitalization. Antibiotics will be delivered intravenously, and additional treatment may be required as well to ensure kidney health and prevent the infection from entering the bloodstream.

 

Urinary Tract Infections and Yeast Infections

The symptoms of a urinary tract infection are easy to distinguish from a yeast infection, but they do affect similar systems and can often occur together. Antibiotics can sometimes cause the natural, healthy bacteria in your body to die, which weakens your defenses against other microbes. The result is often a yeast infection.

 

Yeast infections cause an itching or burning sensation in the vaginal or penile tissue. This may be coupled with discharge or a foul smell. When coupled with the symptoms of a urinary tract infection, a yeast infection can be unbearable.

 

Home Remedies and UTI Prevention

Although most UTIs require antibiotics, there are a few home remedies that can be used to relieve the symptoms of the infection. Nevertheless, certain home remedies can prove helpful, especially if they are used in conjunction with antibiotics. Mild infections may also resolve themselves if the patient utilizes these tactics early on:

  • Stay hydrated with plenty of water to flush out the urinary tract

  • Drink pure, undiluted cranberry juice to increase the acidity of your urine and make the bladder more hostile to bacteria

  • Eat blueberries and pineapple for their anti-inflammatory properties

  • Take vitamin C to boost your immune system and increase urine acidity

  • Urinate frequently and do not suppress the urge to urinate

 

The best home remedy for urinary tract infections is proper prevention. By maintaining good personal hygiene, especially before and after sex, you can greatly reduce your chance of contracting a UTI. Drinking enough liquid and urinating as often as necessary will also prevent most bacteria from entering the urethra. Additionally, all of the above treatments can be used safely at all times to help promote urinary tract health and reduce the likelihood of infection.

 

It’s important to recognize that certain over-the-counter remedies for urinary tract infections can cause problems if used incorrectly. For example, the drug AZO reduces the symptoms of UTIs, such as burning during urination or increased urgency. It does not, however, treat the underlying cause of the infection. By suppressing the symptoms, the patient may believe that the infection has cleared up on its own and resist seeking further treatment. This can be very dangerous as it will allow the infection to spread. Although these over-the-counter drugs can be extremely helpful in conjunction with antibiotics, they should not be considered a complete treatment for urinary tract infections.

When should I call a Doctor for a Urinary Tract Infection?

Sometimes, the body’s natural immune system fights off the infection quickly without medical intervention. Most urinary tract infections, however, will not resolve themselves, and they can become severe quickly. If symptoms persist for more than a few days, it’s a good idea to speak with a doctor and begin taking antibiotics. There are some over-the-counter test strips that can help identify the presence of bacteria in the urine if you wish to check for an infection before pursuing medical care.

 

If your primary symptom is frequent urination accompanied by burning, you may wish to try an over-the-counter remedy for a few days. Beware, however, that drugs like AZO can suppress the symptoms of a UTI without treating its cause, which may actually worsen the infection. Always use caution when using any home remedies without antibiotics.

 

If you develop lower back pain or pelvic pain in conjunction with a fever or nausea, be sure to get medical assistance right away. These are signs of a severe infection that has spread to the kidneys. Left untreated, this infection may cause kidney damage and ultimately lead to kidney failure. It could also release the bacteria into your bloodstream, leading to a life-threatening infection.

When to Pursue Professional Medical Care?

Certain groups of people should always consult with their doctors immediately upon developing UTI symptoms:

  • The elderly and infirm

  • People with suppressed immune systems

  • Pregnant women

  • Individuals with kidney disease

 

Urinary tract infections can be linked to a number of complications in pregnant women, including premature birth and difficulties during delivery. Additionally, pregnant women are at a higher risk of contracting UTIs due to hormonal changes and a shift in the PH balance of the urine. Because back pain, frequent urination and urgency are common in pregnant women, these patients may not immediately recognize the symptoms of a UTI. If urination is ever accompanied by itching or burning, or if blood is found in the urine, the pregnant woman should seek medical attention immediately. Kidney infections are more common than bladder infections in pregnant women.

 

The elderly are at particularly high risk of severe urinary tract infections, and they should seek medical care immediately after symptoms are discovered. Many people over the age of 65 fail to exhibit any symptoms at all until the infection becomes severe. Additionally, the poor immune systems of many elderly people make infections particularly dangerous and likely to spread.

 

All individuals with suppressed immune systems should seek medical assistance after UTI symptoms are discovered. The body of an immunocompromised patient is not equipped to ward off an infection on its own, and the infection can spread and worsen much more quickly than it might in a person with a healthy immune system. Additionally, an active UTI will further weaken an already-stressed immune system, which makes secondary infections more likely.

 

Urinary tract infections are a common occurrence in adults, especially those who are sexually active, but they do not need to become chronic. Careful maintenance of health and monitoring of symptoms will prevent the infections from multiplying and returning.

 

By recognizing the signs and symptoms of a urinary tract infection, you can pursue the treatment required to relieve your symptoms and return your body to health. If you’re experiencing any symptoms of a UTI, it’s important to address them quickly to relieve your discomfort and prevent further complications or risks from developing.

This page offers general health information to facilitate discussion with your telehealth provider. You must not rely on the information on our website as an alternative to medical advice from your doctor or other professional healthcare provider.

If this is a medical emergency, please call 911. For mental health emergencies, call 988.

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