Urinary Tract Infection

What is a Urinary Tract Infection (UTI)?

Urinary tract infection (UTI) is a broad term that could meaninfection anywhere in the urinary tract. The urinary tract includes your two kidneys that form urine, the ureters that carry urine to the bladder for storage, the bladder itself, and the urethra that carries urine from the bladder to outside. In men, a UTI may also affect the prostate gland because it’s very close to the urethra. While reading about UTIs, you will often come across the medical terms for infection in each of these parts. They are:

 

  • Cystitis: Bladder infection
  • Pyelonephritis: Kidney infection
  • Urethritis: Urethral infection
  • Prostatitis: Prostate infection

What causes a UTI?

A UTI occurs when germs enter the urinary tract through the urethra. The commonest culprits are bacteria living in your own gut that make their way out through the anus, and up through the urethra. In women, the vagina provides them a good place to rest and thrive en route, and sexual intercourse literally pushes them into the urethra. The female urethra is a short tiny tube, and in no time the bacteria are in the urinary bladder. For these reasons, UTIs are very common in women. Almost 1 in 5 women get a UTI in their lifetime. If you are a man, you are much less likely to get a UTI, but it can occur in some special circumstances.

Read More on UTI in Men

 

Symptoms of a UTI

Most people with a UTI experience one or more of these symptoms related to urination:

 

  • Pain or burning during urination
  • Frequent urination
  • Urgent need to pass urine
  • Need to go often, but little urine comes out
  • Feeling of incomplete voiding
  • Urge to urinate even after the stream stops

Other symptoms that may be present are:

  • Pain or pressure just above the pubic bone
  • Pain in lower back or abdomen
  • Pain in flanks
  • General feeling of illness
  • Foul smelling, dark, or blood tinged urine
  • Fever with chills, flank pain, nausea and vomiting, particularly if the kidneys get involved.

At times a UTI may not cause any symptoms, and get diagnosed during a routine urine test. The elderly often tend to have few or no symptoms.

How serious is a UTI?

Most UTIs are not serious. The body has some smart mechanisms to stop bacteria that enter the urethra from moving all the way up to the kidneys. As such, most UTIs are limited to the bladder (cystitis) or urethra (urethritis). They usually resolve within a week of starting antibiotics. However, bacteria are fast becoming resistant to commonly used medicines, making more and more cases difficult to treat. Untreated or incompletely treated UTI can move up to the kidneys. Kidney infection is a very serious condition for which you may need to be hospitalized and receive several weeks of treatment.

Diagnosis of a UTI

A UTI can be diagnosed by tests done on your urine sample. No more investigations are needed in most cases.

 

  • Urine dipstick test: It’s a special strip for testing the presence of white blood cells (WBCs) and bacteria in urine. If it comes positive for WBCs and you are experiencing typical UTI symptoms, a UTI is highly likely. If the test for bacteria is also positive, the diagnosis is nearly confirmed. But a negative test for bacteria does not rule out a UTI.  
  • Urinalysis: This is a more detailed test done on a urine sample. People with a UTI will typically test positive for pus cells (WBCs) and bacteria in urine. Some people may also test positive for protein in urine and blood in urine.
  • Urine culture and sensitivity: It is done to find out the organism causing the infection and the drug to which it will respond best. If no organism shows up on a standard culture, special tests to diagnose less common organisms causing UTIs may be ordered.
  • Imaging studies: Ultrasound, X-ray, CT scans etc. are typically not needed in a UTI work-up except in men with a complicated UTI or in some women with recurrent episodes. These tests can show underlying abnormalities that predispose you to a UTI.
  • Home Tests for UTI: UTI home test strips (AZO Test Strips for e.g.) may be used to do an initial check for UTI at home. The strips test for WBCs (leukocyte esterase), bacteria (nitrite) or both. Get in touch with your doctor if the leukocyte estersae test is positive irrespective of the nitrite results. Also contact your doctor if your home test is negative but your symptoms persist for more than a couple of days. Home tests can miss a UTI in some cases. Symptoms similar to a UTI may be caused by more serious diseases.

Treatment of a UTI

  • Antibiotics: Your doctor will recommend an appropriate antibiotic to cure the infection.  Your symptoms may abate in a day or two, but completing the prescribed course is a must to clear the infection. Patients with kidney infections may need to get hospitalized and receive require several weeks of antibiotic treatment.
  • Urinary analgesics: Over-the-counter medicines containing phenazopyridine (Pyridium, Urised etc) may be prescribed to relieve pain caused by a UTI. These drugs however do not cure the infection.
  • Self-care: Drinking plenty of water helps cleanse the urinary tract of bacteria. It is best to avoid coffee, alcohol, and spicy foods during treatment. A heating pad may help to relieve the pain.

Home Remedies for UTIs

Many popular home remedies help improve UTI symptoms when used along with proper medical treatment, but no home remedy can be trusted to cure a UTI all by itself. Here are a few things known to help:

 

  • Cranberries/blueberries: They have compounds that may discourage bacteria from clinging to your urinary tract. They are a rich sources of antioxidants and in general good for health. Sweetened juice however doesn’t work and there’s a doubt that it may make things worse.
  • Vitamin C: It makes the urine more acidic, which retards bacterial growth.
  • Pineapple: It contains an anti-inflammatory compound that may soothe symptoms.
  • Yogurt, Echinacea, baking soda, oregon grape root, and aromatherapy have helped some people but their mechanism is not yet known.

Can I have sex while I have a UTI?

The common UTI causing bacteria do not often pass from person to person during sex but some research shows that they might. Sexually-transmitted organisms may be behind a suspected UTI and can definitely spread to your partner. All in all, it appears safer to avoid intercourse or at least use condoms till you complete your course of treatment.

 

Can a UTI heal itself?

Theoretically, Yes. A mild UTI may be outdone by your own  immunity. But should you wait it out and see if the symptoms go away on their own? Absolutely not. The symptoms may reduce or even go, but the infection can linger only to show up again in a much more serious form, for e.g. a kidney infection.

 

What Can I do to Prevent UTIs?

UTIs have a strong tendency to recur. Here’s what you can do to discourage UTIs. Not that doing any of these can absolutely stop a UTI, but there is good reason to believe that they help:

 

  • Drink enough water so that you pass urine more often. Frequent urination flushes out bacteria from your urinary tract.
  • Don’t hold urine. Use the restroom at the first urge.
  • Cleanse the genital area before and after sex. If possible urinate after sex to flush out bacteria.
  • Move your toilet paper from front to back and not from back to front. This reduces the chance of spreading of bacteria in the anal region to the vagina and urethra.
  • Avoid using a diaphragm for birth-control. It presses on your urethra and impeded complete emptying of bladder.
  • Avoid scented female hygiene products and long soaks in the bathtub. Urethral irritation promotes infection.
  • There is chance of increased UTI risk with the use of condoms containing spermicidal foam.
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