Urinary Tract Infection

What is a Urinary Tract Infection?

A urinary tract infection (UTI) is an infection in any part of your urinary system your kidneys, ureters, bladder and urethra. Most infections involve the lower urinary tract the bladder and the urethra.

Urinary tract infections are more common in women than in men, and they can be painful and annoying. However, serious consequences can occur if a UTI spreads to your kidneys.

The urinary system is designed to keep out bacteria. However, sometimes defenses fail, allowing bacteria to take hold and multiply into a full-blown infection.

Types of Urinary Tract Infections

Urinary tract infections are often classified by where they occur:

• Cystitis (Bladder infection): This type of UTI is usually caused by Escherichia coli (E. coli), a type of bacteria commonly found in the gastrointestinal (GI) tract. However, sometimes other bacteria are responsible. Sexual intercourse may lead to cystitis, but you don't have to be sexually active to develop it.
• Urethritis (Urethra infection): This type of UTI can occur when GI bacteria spread from the anus to the urethra. Also, because the female urethra is close to the vagina, sexually transmitted infections, such as herpes, gonorrhea, chlamydia and mycoplasma, can cause urethritis.
• Pyelonephritis (Kidney infection): This more serious infection requires immediate medical attention. It occurs when bacteria travel up the urinary tract to infect the kidneys.

Symptoms

Upper Urinary Tract Infection (Kidney Infection) Symptoms:

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

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

Risk Factors

Urinary tract infections are common in women, and many women experience more than one 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 do women who aren't sexually active.
• Certain types of birth control: Women who use diaphragms for birth control may be at 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.

Other risk factors for UTIs include:

• 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 (catheter) to urinate have an increased risk of UTIs.

Diagnosis

Tests and procedures used to diagnose urinary tract infections include:

• Urine sample analysis: Your doctor may ask for a urine sample for lab analysis to look for white blood cells, red blood cells or bacteria.
• Urine culture: A lab analysis of your 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 your doctor suspects that an abnormality in your urinary tract causes frequent infections, you may undergo an ultrasound, a computerized tomography (CT) scan or magnetic resonance imaging (MRI).
• 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 (cystoscope) to see inside your urethra and bladder.

Treatment

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 one to three days. But whether this short course of treatment is enough to treat your infection depends on your particular symptoms and medical history.

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

Prevention

Complications

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

Complications of a UTI may include:

• Recurrent infections: Recurrent UTIs happen mainly in women and can be managed with preventive antibiotic therapy.
• Permanent kidney damage: From an acute or chronic kidney infection (pyelonephritis) due to an untreated UTI.
• Pregnancy complications: A UTI during pregnancy can increase the risk of delivering a low birth weight or premature infant.
• Urethral narrowing: In men, recurrent urethritis can cause a stricture (narrowing) of the urethra.
• Sepsis: A life-threatening complication of an infection, especially if the infection works its way up to your kidneys.

UTIs in Children

UTIs can occur in children, even in infants. They are more common in girls, but uncircumcised boys also have a higher risk during the first year of life. In babies and young children, signs of a UTI may include:

• Fever
• Irritability
• Poor feeding
• Vomiting
• Failure to thrive

When children are toilet trained, signs may include:

• A strong, persistent urge to urinate
• Accidents by a child who has been toilet trained
• Unusual urine odor
• Cloudy or colored urine

Children should receive medical attention promptly to prevent kidney damage.

Home Remedies

While antibiotics are necessary to treat a UTI, some home remedies may help ease symptoms and support the treatment:

• Drink plenty of water: Drinking extra fluids can help flush out bacteria from your urinary tract.
• Urinate frequently: Holding urine allows bacteria to multiply, so emptying your bladder often can help prevent and UTIs.
• Apply heat: Applying a heating pad to your abdomen can help minimize bladder pressure or discomfort.
• Avoid irritating foods: Steer clear of caffeine, alcohol, spicy foods, nicotine, and acidic foods while you have symptoms.
• Consider supplements: Vitamin C supplements may increase the acidity of your urine, making it harder for bacteria to grow.
• Practice good hygiene: Shower instead of sitting in a bathtub, which can increase the risk of introducing bacteria into the urinary tract.

Remember, while these home remedies may help with symptoms, they are not an alternative to medical treatment, which is necessary to eliminate the infection and prevent complications.