What Are Urinary Tract Infections (UTIs)?

In every portion of your digestive system, your kidneys, ureters, bladder, and urethra, a urinary tract infection (UTI) is an infection. The lower urinary tract, the bladder, and the urethra are involved in most infections.

Women are more at risk of developing a UTI than men are. It can be painful and irritating to have infections confined to your bladder.

However, if a UTI spreads to your kidneys, severe consequences will occur. Usually, physicians treat urinary tract infections with antibiotics. But in the first place, you should take steps to lower the chances of having a UTI.

Symptoms of Urinary Tract Infections (UTIs)

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

• A heavy, chronic urge to urinate
• When urinating, a burning feeling
• Frequent, small quantities of urine pass by
• Urine looks cloudy 
• Black, light pink, or cola-colored urine, a result of blood in the urine
• Strong-smelling urine
• In women, particularly in the center of the pelvis and around the pubic bone region, pelvic pain

UTIs can be overlooked or mistaken for other medical conditions in older adults.

Types of urinary tract infection

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

Kidneys (acute pyelonephritis)

• Nausea
• Vomiting
• Upper back and side (flank) pain
• High fever
• Shaking and chills

Bladder (cystitis)

• Frequent, painful urination
• Blood in urine
• Pelvic pressure
• Lower abdomen discomfort

Urethra (urethritis)

• Discharge
• Burning sensation during urination

Causes of Urinary Tract Infections (UTIs)

Urinary tract infections normally occur when bacteria enter the urinary tract through the urethra and start multiplying throughout the bladder.

While the urinary system is intended to keep such microscopic invaders out, sometimes these defenses fail. Bacteria may take hold and develop into a full-blown infection in the urinary tract when that happens.

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

• Bladder infection (cystitis): Escherichia coli (E. coli), a form of bacteria generally found in the gastrointestinal (GI) tract, is normally caused by this type of UTI. Other bacteria are, however, also responsible.  Sexual intercourse can result in cystitis, but you don’t have to be sexually active to develop it. Because of their anatomy, specifically the short distance from the urethra to the anus and the urethral opening to the bladder, both women are at risk of cystitis.
• Urethral infection (urethritis): As GI bacteria propagate from the anus to the urethra, this type of UTI may occur. Often, since the female urethra is near to the vagina, urethritis can be caused by sexually transmitted infections, such as herpes, gonorrhea, chlamydia, and mycoplasma.

Risk factors

Urinary tract infections are more common in women than men, and many women experience more than one infection during a lifetime.

Reasons why women experience UTIs more include:

• Female anatomy: A woman possesses a shorter urethra than a man does, which makes the distance that bacteria must travel to reach the bladder shorter.
• Sexual activity: Sexually active women tend to experience UTIs more than women who are not sexually active. Having a new sexual partner also heightens your risk of getting UTIs.
• Certain types of birth control:  Women who birth control, such as diaphragms, may be an increased risk, as well as women who make use of spermicidal agents.
• Menopause: After menopause, a reduction in circulating estrogen causes changes in the urinary tract, making you more vulnerable to infection.

Other risk factors for UTIs include:

• Urinary tract abnormalities: There is an increased risk of UTIs for babies born with urinary tract defects that don’t allow urine to exit the body normally or cause urine to back up in the urethra.
• Blockages in the urinary tract:  The urine in the bladder may trap kidney stones or enlarged prostate and increase the risk of UTIs.
• A suppressed immune system: The risk of UTIs can be increased by diabetes and other diseases that weaken the immune system, the body’s defense against germs.
• Catheter use: There is a heightened chance of UTIs in people who can’t urinate on their own and use a tube (catheter) to urinate. This could include hospitalized persons, individuals with neurological disorders that make it difficult to control their ability to urinate, and paralyzed individuals.
• A recent urinary procedure: Your risk of contracting a urinary tract infection may both be increased through urinary surgery or an examination of your urinary tract involving medical instruments.

Complications

Lower urinary tract infections never lead to complications when treated quickly and properly. But, left untreated, an infection of the urinary tract may have severe consequences.

UTI risks can include:

• Recurrent infections, especially in women experiencing two or more UTIs within a six-month span or four or more within a year.
• Permanent kidney damage due to an untreated UTI arising from an acute or chronic kidney infection (pyelonephritis).
• Increased risk of delivering low birth weight or premature babies to pregnant mothers.
• Urethral narrowing (stricture) in men, previously seen with gonococcal urethritis, due to recurrent urethritis.
• Sepsis, an infection that is potentially life-threatening, especially if the infection works its way up from your urinary tract to your kidneys.

Prevention

You can take these steps to reduce your risk of urinary tract infections:

• Drink plenty of liquids, water in particular. Drinking water helps dilute your urine and makes sure you urinate more regularly, allowing bacteria to be flushed out of your urinary tract before an infection can start.
• Drink juice with cranberries. While studies do not indicate that UTIs are prevented by cranberry juice, it is probably not harmful.
• Front to back wipe. Doing so during urination and after a bowel movement helps avoid the spread of bacteria to the vagina and urethra in the anal region.
• Soon after sex, drain your bladder. Drink a full glass of water to help flush out bacteria, too.
• Do not use potentially irritating feminine products. The urethra may be irritated by using deodorant sprays or other feminine items, such as showers and powders, in the genital region.
• Adjust the form of birth control. Bacterial growth can all be assisted by diaphragms or unlubricated or spermicide-treated condoms.

Diagnosis

Tests and procedures that can be used to diagnose urinary tract infections include:

• Analyzing a urine sample: To look for red blood cells, white blood cells, or bacteria, your doctor can ask for a urine sample for lab analysis:You may be advised to first clean your genital region with an antiseptic pad and to collect the urine midstream to prevent possible contamination of the sample.
• Testing for urinary tract bacteria in a lab: A urine culture is often accompanied by laboratory examination of the urine. This test tells your doctor what your infection is caused by bacteria and which antibiotics would be most successful.
• Creating images of your urinary tract: You might have an ultrasound, a computerized tomography (CT) scan, or magnetic resonance imaging if you have repeated infections that your doctor feels could be caused by an abnormality in your urinary tract (MRI). To highlight structures in your urinary tract, your doctor can also use a contrast dye.
• Using a scope to see inside your bladder: If you have recurrent UTIs, your doctor can perform a cystoscopy to see the inside of your urethra and bladder using a long, thin lens tube (cystoscope). The urethra is inserted into the cystoscope and travels through the urethra to the bladder.

Treatment

The first-line treatment for urinary tract infections is typically antibiotics. What medications are administered and how long depends on the type of bacteria present in your urine and your health condition.

Simple infection

Drugs commonly recommended for simple UTIs include:

• Trimethoprim/sulfamethoxazole (Bactrim, Septra, others)
• Fosfomycin (Monurol)
• Nitrofurantoin (Macrodantin, Macrobid)
• Cephalexin (Keflex)
• Ceftriaxone

For simple UTIs, the category of antibiotic drugs known as fluoroquinolones, such as ciprofloxacin (Cipro), levofloxacin, and others, is not commonly recommended, as the risks of these drugs typically outweigh the advantages of treating uncomplicated UTIs. In certain cases, such as a complicated UTI or kidney infection, fluoroquinolone medication can be recommended by your doctor if there are no other treatment choices.

Sometimes, within a few days of treatment, symptoms clear up. But for a week or more, you might need to continue using antibiotics. Take the whole antibiotic course as recommended.

Your doctor may prescribe a shorter course of treatment, such as taking an antibiotic for one to three days, for an uncomplicated UTI that occurs when you’re otherwise healthy. But it depends on your individual symptoms and medical history if this brief course of treatment is enough to cure your infection.

A pain reliever (analgesic) can also be administered by your doctor to numb your bladder and urethra to alleviate burning when you are urinating, but the pain is typically relieved shortly after beginning an antibiotic.

Frequent infections

Your doctor can make certain treatment recommendations if you have frequent UTIs, such as:

• Low-doses of antibiotics, initially for six months but occasionally longer.
• Self-diagnosis and counseling while you remain in contact with your doctor
• If your infections are linked to sexual activity, a single dose of an antibiotic after sexual intercourse
• When you are postmenopausal, vaginal estrogen treatment.

Severe infection

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

Lifestyle and home remedies

Infections of the urinary tract can be painful, but before antibiotics cure the infection, you can take measures to relieve the discomfort. Only follow these tips:

•  Drink a lot of water. Water helps dilute and wash out bacteria from the urine.
• Avoid drinks that could make your bladder irritated. Until the infection has healed, avoid coffee, alcohol, and soft drinks containing fruit juices or caffeine. They will make your bladder irritated and help to make your regular or urgent urge to urinate worse.
• Using a pad for heating. To relieve bladder pressure or pain, apply a wet, but not boiling, heating pad to your abdomen. 

Alternative medicine

To avoid UTIs, many individuals drink cranberry juice. There is some evidence that cranberry products could have infection-fighting properties, in either juice or tablet form.

The capacity of cranberry juice to prevent UTIs continues to be studied by researchers, but the findings are not definitive. There’s no harm in it if you like drinking cranberry juice and thinking it helps you avoid UTIs. Some persons report an upset stomach or diarrhea.

If you are taking blood-thinning drugs, such as warfarin, don’t drink cranberry juice, however.

When to see a doctor?

Consult with your doctor immediately if you have signs and symptoms of a UTI or suspect your symptoms resemble UTIs symptoms.

Preparing for your appointment

Many urinary tract infections can be treated by the family doctor, nurse practitioner, or other health care provider. You may be referred to a doctor who specializes in urinary disorders (urologist) or kidney disorders (nephrologist) for an examination if you have repeated recurrences or a chronic kidney infection.

What you can do

To prepare for your appointment:

• Ask if you should do anything in advance, such as taking a sample of urine.
• Keep your symptoms in mind, even if you’re not sure they’re UTI related.
• Create a list of all the drugs you are taking, vitamins, or other supplements.
• Write down questions for your doctor to ask him.

For a UTI, basic questions to ask your doctor include:

• What’s the most probable cause of my symptoms and signs?
• Are there any other triggers that are possible?
• In order to validate the diagnosis, do I need any tests?
• What variables do you assume may have led to my UTI?
• What approach to treatment do you recommend?
• What are you going to prescribe next if the first treatment doesn’t work?
• Am I at risk of this disorder causing complications?
• What is the chance of this issue reoccurring?
• To will my chance of recurrence, what steps can I take?
• Can I see a specialist?

Don’t hesitate to ask other questions as they occur to you during your appointment.

What to expect from your doctor?

Your doctor will likely ask you several questions, including:

• When did you discover the symptoms first?
• Have you been treated in the past for an infection of the bladder or kidney?
• How serious is your pain?
• How much do you urinate?
• Will urinating alleviate your symptoms?
• Do you have pain in your lower back?
• Have you developed a fever?
• Have you found blood or vaginal discharge in your urine?
• Are you engaged sexually?
• Are you using contraception? And what kind?
• May you be pregnant?
• Any other medical problems you being treated for?
• Have you used a catheter at any time?

References;

• Urinary tract infection (UTI) : Mayo Clinic
• Urinary Tract Infection Specialist – Torrance: Urologist