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Urinary Tract Infections - UTI Information

Posted on July 15 2019

A urinary tract infection, or UTI, is an infection in any part of your urinary system including: your kidneys, ureters, bladder, and urethra. Most infections involve the lower urinary tract - the bladder and the urethra. Women are at a greater risk of developing a UTI than men. 

Infection that is limited to your bladder can be painful and frustrating. However, serious consequences can occur if a UTI spreads to your kidneys. Doctors typically treat UTI's with antibiotics, but you can take steps to reduce your chances of developing a UTI in the first place. 

Symptoms of a UTI

Urinary tract infections don't always cause signs and symptoms, but when they do, they may include:

  • A strong, persistent urge to urinate
  • A burning sensation when urinating
  • Passing frequent, small amounts of urine
  • Urine that appears cloudy
  • Urine that appears red, bright pink, or cola colored - a sign of blood in the urine
  • Strong smelling urine
  • Pelvic pain, in women - especially in the center of the pelvis and around the area of the pubic bone. 

UTI's may be overlooked or mistaken for other conditions in older adults. 

Types of UTI's

Each type of UTI may result in more specific signs and symptoms, depending on which part of your urinary tract is infected. 

Kidneys (acute pyelonephritis): signs and symptoms include: upper back and side (flank) pain, high fever, shaking and chills, nausea, and vomiting. 

Bladder (cystitis): signs and symptoms include: pelvic pressure, lower abdomen discomfort, frequent and painful urination, and blood in urine. 

Urethra (urethritis): signs and symptoms include: burning with urination and discharge. 

You should always contact your doctor if you have any signs and symptoms of a UTI.

Causes of UTI's

Urinary tract infections typically occur when bacteria enters the urinary tract through the urethra and begin to multiply in the bladder. Although the urinary system is designed to keep out such microscopic invaders, these defenses sometimes fail. When that happens, bacteria may take hold and grow into a full-blown infection in the urinary tract.

The most common UTIs occur mainly in women and affect the bladder and urethra.

Infection of the bladder (cystitis): This type of UTI is usually caused by E. coli, a type of bacteria commonly found in the gastrointestinal (GI) tract. However, sometimes other bacteria are possible. Sexual intercourse may lead to cystitis, but you don't have to be sexually active to develop it. All women are at risk of cystitis because of their anatomy - specifically, the short distance from the urethra to the anus, and the urethral opening to the bladder.

Infection of the urethra (urethritis): This type of UTI can occur when GI bacteria spreads from the anus to the urethra. Also, sexually transmitted infections can cause urethritis. 

Risk Factors

UTIs are common in women and many women experience more than 1 infection during their lifetimes. Risk factors specific to women for UTIs include:

Female anatomy: A woman has a shorter urethra than a man does, which shortens the distance that bacteria must travel to reach the bladder.

Sexual activity: Sexually active women tend to have more UTIs than women who aren't sexually active. Having a new sexual partner also increases the risk.

Certain types of birth control: Women who use diaphragms for birth control may be at a higher risk, as well as women who use spermicidal agents.

Menopause: After menopause, a decline in circulating estrogen causes changes in the urinary tract that make you more vulnerable to infection.

Urinary tract abnormalities: Babies born with urinary tract abnormalities that don't allow urine to leave the body normally or cause urine to back up in the urethra have an increased risk of UTIs.

Blockages in the urinary tract: Kidney stones or an enlarged prostate can trap urine in the bladder and increase the risk of UTIs.

A suppressed immune system: Diabetes and other diseases that impair the immune system - the body's defense against germs - can increase the risk of UTIs.  

Catheter use: People who can't urinate on their own and use a tube, or catheter, to urinate have an increased risk of UTIs. This may include people who are hospitalized, people with neurological problems that make it difficult to control their ability to urinate and people who are paralyzed. 

A recent urinary procedure: Urinary surgery or an exam of your urinary tract that involves medical instruments can both increase your risk of developing a UTI. 

Complications

When treated promptly and properly, lower urinary tract infections rarely lead to complications, but left untreated, a UTI can have serious consequences. 

Complications of a UTI may include: 

  • Recurrent infections, especially in women who experience 2 or more UTIs in a 6 month period or 4 or more within a year. 
  • Permanent kidney damage from an acute or chronic kidney infection due to an untreated UTI.
  • Increased risk in pregnant women of delivering low birth weight or premature infants. 
  • Urethral narrowing in men from recurrent urethritis, previously seen with gonococcal urethritis. 
  • Sepsis, a potentially life threatening complication of an infection, especially if the infection works its way up your urinary tract to your kidneys. 

You can also take steps to prevent and reduce your risk of UTIs: 

Drink plenty of liquids, especially water: Drinking water helps dilute your urine and ensures that you'll urinate more frequently - allowing bacteria to be flushed from your urinary tract before an infection can begin. 

Drink cranberry juice: Although studies are not conclusive that cranberry juice prevents UTIs, it is likely not harmful. However, don't drink cranberry juice if you're taking blood thinning medication, such as warfarin.  

Wipe from front to back: Doing so after urinating and after a bowel movement helps prevent bacteria in the anal region from spreading to the vagina and urethra. 

Empty your bladder soon after intercourse: Also, drink a full glass of water to help flush bacteria. 

Avoid potentially irritating feminine products: Using deodorant sprays or other feminine products in the genital area can irritate the urethra. 

Change your birth control method. 

Avoid drinks that may irritate your bladder: Avoid coffee, alcohol, and soft drinks containing citrus juices or caffeine until your infection has cleared. They can irritate your bladder and aggravate your frequent or urgent need to urinate. 

Use a heating pad: Apply a warm, but not hot, heating pad to your abdomen to minimize bladder pressure or discomfort. 

Diagnosis & Treatment

Tests & procedures used to diagnose UTIs infections include: 

Analyzing a urine sample: Your doctor may ask for a urine sample for lab analysis to look for white blood cells, red blood cells or bacteria. 

Growing urinary tract bacteria in a lab: Lab analysis of the urine is sometimes followed by a urine culture. This test tells your doctor what bacteria are causing your infection and which medications will be most effective. 

Creating images of your urinary tract: If you are having frequent infections that your doctor thinks may be caused by an abnormality in your urinary tract, you may have an ultrasound, a CT scan, or MRI. Your doctor may also use contrast dye to highlight structures in your urinary tract. 

Using a scope to see inside your bladder: If you have recurrent UTIs, your doctor may perform a cystoscopy, using a long, thin tube with a lens to see inside your urethra and bladder. The cystoscope is inserted in your urethra and passed through to your bladder. 

Antibiotics usually are the first line treatment for UTIs. Which drugs are prescribed and for how long depend on your health condition and the type of bacteria found in your urine. 

The group of antibiotic medicines known as fluoroquinolones aren't commonly recommended for simple UTIs, as the risks of these medicines outweigh the benefits for treating uncomplicated UTIs. In some cases, such as a complicated UTI or kidney infection, your doctor might prescribe a fluoroquinolone medicine if no other treatment options exist. 

Often, symptoms clear up within a few days of treatment, but you may need to continue antibiotics for a week or more. Take the entire course of antibiotics as prescribed. 

For an uncomplicated UTI that occurs when you're otherwise healthy, your doctor may recommend a shorter course of treatment, such as taking an antibiotic for 1 to 3 days, but whether this short course of treatment is enough to treat your infection depends on your symptoms and medical history. 

Your doctor may also prescribe a pain medication that numbs your bladder and urethra to relieve burning while urinating, but pain is usually relieved soon after starting an antibiotic. 

If you have frequent UTIs, your doctor may make certain treatment recommendations, such as:

  • Low dose antibiotics, initially for 6 months, but sometimes longer
  • Self diagnosis & treatment, if you stay in touch with your doctor
  • A single dose of antibiotic after sexual activity if your infections are related to that
  • Vaginal estrogen therapy if you're postmenopausal

For a severe UTI, you may need treatment with IV antibiotics in a hospital. 

Please consult with your doctor or other qualified healthcare professional before starting or stopping any medication, taking any supplement, or beginning a health care regimen. 

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