Roughly half of all women will have a UTI at some point. Here’s how to spot UTI symptoms, info on your treatment options, and how to prevent a UTI from striking in the first place.
What is a UTI?
A UTI is an infection of all or part of the urinary tract. Most infections begin in the lower urinary tract, which includes the urethra (the tube that allows urine to exit the body) and bladder (where urine is stored). Sometimes these infections travel upward through the ureters (the tubes that ferry urine from each kidney to the bladder) to the kidneys (where urine is produced).
Common symptoms include pelvic pain, burning with urination, and urgent or frequent need to urinate. Women, men, and children of all ages can get a UTI. But women are at much greater risk. It’s estimated that roughly half of all women will have a UTI sometime during their lives. Some 150 million UTIs occur worldwide each year.
Types of UTIs
There are three main types of UTIs defined by the part of the urinary tract that becomes infected.
- An infection of the urethra only is called urethritis. It causes the urethra to come inflamed.
- The most common type of UTI is a bladder infection, also known as cystitis. It’s what people usually mean when they say they have a UTI.
- Kidney infections are a more serious type of UTI. The medical term is pyelonephritis.
“UTIs are common, so a lot of women are aware of them,” says Bilal Kaaki, MD, a specialist in female pelvic medicine and reconstructive surgery at UnityPoint Health in Cedar Falls and Waterloo, Iowa. But, he adds, “not everyone knows that a UTI can turn into a kidney infection.”
What causes a UTI?
Normally, your body’s own immune system defends against possible infection. One way it does that is through the continual flow of urine. This helps to prevent bacteria from adhering to the walls of the urinary tract. But sometimes germs sneak through anyway.
It all begins when bacteria, usually E. coli, enter the urethra, stick to the bladder wall, and begin to multiply. The next thing you know, you’ve got a bladder infection (cystitis). And sometimes bacteria from the bladder invade the upper urinary tract, infecting one or both kidneys.
UTI risk factors
Some people are more likely than others to develop a UTI. Risk factors include:
- Being female. Women have much shorter urethras than men, and the opening of the urethra is much closer to the anus. Due to these anatomical differences, bacteria can easily enter a woman’s urinary tract.
- Being sexually active. Sex pushes bacteria into the urethra.
- Being older. After menopause, estrogen levels drop. That affects levels of healthy, infection-fighting bacteria, called lactobacillus.
- Using diaphragms or spermicide-coated condoms.
- Having trouble emptying your bladder. Incomplete evacuation of urine can promote bacterial growth.
- Having a kidney stone. (In men, an enlarged prostate can be a risk factor.)
- Having diabetes or a weak immune system.
- Having a prior UTI.
- Using a catheter or having undergone a recent surgery or medical procedure involving the urinary tract.
What are the symptoms of a UTI?
It’s possible to have a UTI without outward signs of infection. But most people have one or more symptoms.
A classic symptom that women describe is painful urination, says Emily Cunningham, MD, associate professor of obstetrics and gynecology at the University of Kentucky in Lexington.
“It’s this ache—it feels like they have to pee even though they don’t have to pee—and when they do go to the bathroom, the last drop gives the ache.”
Common bladder infection symptoms
- Urge to urinate, even when the bladder is empty or you have only a few drops of urine to pass.
- Frequent urination.
- Aching, pressure, or pain in the lower abdomen or pubic area.
- Painful urination.
- Cloudy or bloody urine.
- Strong- or foul-smelling urine.
Signs your infection has spread to the kidneys
Bladder infections that spread to the kidneys can cause additional symptoms. These include:
- Fever.
- Flank (side-of-abdomen) or low-back pain.
- Nausea or vomiting.
- Chills or sweats.
- Confusion or mental changes.
You should consult a doctor any time you have symptoms of a UTI.
“It doesn’t mean you immediately need to run to an emergency room,” Dr. Cunningham says, but UTIs are so uncomfortable that “most people seek treatment very quickly.”
Of course, if you are running a temperature (or have other concerning symptoms), get evaluated—pronto. Fever suggests your bladder infection is turning into a kidney infection, she explains.
How is a UTI diagnosed?
If you visit your doctor with urinary symptoms, be prepared to pee in a cup. A urine test, called a urinalysis, can reveal whether signs of infection are present. Sometimes a urine culture is ordered to identify the type of bacteria causing your infection, and that can help your doctor choose the best treatment.
“You’re not just treating based on a guess,” Dr. Kaaki explains.
That said, if you’re a young, sexually active woman, sometimes a phone call to your doctor to report UTI symptoms may be all that’s necessary.
“That’s enough to just treat them empirically,” he adds. “Just give them a three-day course of antibiotics. You don’t even need to test them because it’s very common.”
If you get frequent UTIs or have an infection that won’t respond to treatment, your doctor may want to take a closer look at your urinary tract. That may involve some kind of imaging, like x-rays, ultrasound, or CT scan. Another common diagnostic test, called a cystoscopy, may be done. You doctor will insert a lighted scope through your urethra to peer inside your bladder.
How do you treat a UTI?
Antibiotics are the go-to medicines for resolving urinary tract infections. Which drug your doctor prescribes and how long you need to take it may depend on your test results, severity of symptoms, and other factors. If you’re a woman with a simple bladder infection, a three-day course of antibiotics may do the trick. (Men usually require a longer course of treatment.)
For complicated UTIs or kidney infections, doctors may prescribe more powerful antibiotics called fluoroquinolones, a category that includes medicines like ciprofloxacin (Cipro). These drugs ought to be used sparingly to prevent antibiotic resistance.
Your doctor may also recommend phenazopyridine to relieve urinary symptoms. These drugs, available by prescription or over-the-counter, should be taken along with an antibiotic.“You don’t want to just treat the pain; you want to treat the problem,” Dr. Cunningham says.
Your doctor may also recommend boosting fluid intake. Drinking lots of liquids, especially water, may help to flush out infection-causing germs. It also dilutes your urine so it’s less painful to pee.
Can you get better without antibiotics? Perhaps. Like any infection in the body, UTIs occasionally resolve on their own, Dr. Kaaki said. You could try pushing fluids for 24 to 48 hours, he says. But if symptoms don’t resolve, it might be worth trying an antibiotic.
Common antibiotics prescribed for UTIs
- Nitrofurantoin, such as Macrobid and others.
- A trimethoprim/sulfamethoxazole combination. Options include drugs like Bactrim and Septra.
- Fosfomycin (Monurol).
Other remedies
- Take prescription or over-the-counter phenazopyridine (available as Pyridium, Azo-Standard, and others). This bladder relaxer eases urinary pain, burning, frequency, and urgency.
- Drink plenty of water and other liquids.
- Apply a heating pad to ease abdominal pain.
Are there any possible UTI complications?
Most UTIs can be successfully treated without complications. But without proper and timely treatment, a simple bladder infection can spiral out of control. Germs from the bladder can make their way up the ureters and invade the kidneys. And that can set you up for serious health consequences.
Possible UTI complications
- Recurring UTI infections.
- Kidney infection.
- In pregnancy, low-birth-weight, premature, or stillborn infants.
- Sepsis, a potentially life-threatening condition that can lead to tissue damage, organ failure, and even death.
How to prevent a UTI
There are steps you can take to ward off future urinary tract infections.
Lifestyle measures
- Drink plenty of fluids, especially water. This dilutes urine and flushes out bacteria.
- Urinate when you feel the need. Holding it in promotes bacterial growth.
- Wipe from front to back after using the bathroom. You don’t want bacteria entering the urethra.
- Urinate after sexual intercourse to help flush out bacteria that may have entered the urethra during sex.
- Take showers, not baths, and wash your vulva using warm water.
- Avoid using powders, sprays, and douches.
- Stop using spermicide. If you use birth control method that are treated with spermicides, such as a diaphragm or condoms, consider switching to another type of contraception. Spermicides kill off good bacteria.
Medications
- If you get recurrent UTIs, ask your doctor about prescribing a low-dose antibiotic that you will take either after intercourse or daily for a period of months.
- If you are an older women who experiences frequent UTIs, consider vaginal estrogen cream. There’s good evidence that it decreases the risk of recurrent infections in postmenopausal women, Dr. Kaaki says. (This is not an option for women with a history of breast cancer.)
Nutritional supplements
- Consider using oral or vaginal probiotics. A small randomized trial found that a regimen of lactobacillus suppositories reduced UTIs in women with a history of recurrent infections.
- Drink cranberry juice or take cranberry pills. While the evidence is mixed, cranberry prevents bacteria from sticking to the cells of the urinary tract. Don’t consume cranberry if you take the blood-thinner warfarin (Coumadin) because it may raise your risk of bleeding.
Source: https://www.prevention.com/health/health-conditions/a22734350/urinary-tract-infection-symptoms-treatments/