Urinary Tract Infection (UTI) Symptoms, Diagnosis & Treatment

banner-topUrinary tract infection (UTI) is the second most prevalent infection that affects millions of people worldwide. It is especially common in women. One in every five women will experience symptoms of urinary tract infections at least once in their lifetime. It affects men and children, but on a lesser scale. While the infection is easily treatable, it can quickly escalate into serious problems if not treated early. Therefore in this article we will show you how to recognize if you might have a UTI so you can seek treatment early. We will also explain the causes of the infection and how you can treat and lessen your chances of contracting the infection. Let us begin with the symptoms of a UTI.

Symptoms

UTIs can occur in the lower or upper part of the urinary tract. UTIs can be symptomatic (with symptoms) or asymptomatic (without symptoms). Symptoms of an upper UTI differ from that of a lower UTI, although they may have some in common.

The most common symptoms of a lower UTI include:

  • Discolored, cloudy or hazy urine
  • Urine has an unpleasant smell
  • Feeling the need to urinate more frequently
  • Difficulty with holding in urine (incontinence)
  • Painful sensation and discomfort when urinating
  • Blood in the urine
  • Back pain
  • Bloating

Symptoms associated with an upper UTI include the following:

  • A frequent urge to urinate
  • High fever
  • Nausea
  • Vomiting
  • Pain in the back or groin area
  • Persistent lower UTI symptoms (if symptoms last for more than a week)

As soon as you notice any of these symptoms, please seek medical attention immediately. Sometimes a UTI shares the same symptoms with other infections like herpes or vaginitis, but you are better off getting checked earlier for quick diagnosis so you can receive timely and appropriate treatment.

Facts

Your urinary tract is made up of organs that produce and gets rid of urine. It includes:

  • The Kidneys: makes urine from waste products in the body,
  • Ureters: connects the kidneys to the bladder,
  • Bladder: stores urine,
  • Urethra: transports urine from the bladder to the hole where it exits the body.
Male-Urinary-Tract

Male Urinary Tract

Female-Urinary-Tract

Female Urinary Tract

 

Infection occurs when pathogens enter the urinary tract through the urethra or in rare cases, through the blood stream. A UTI can happen in the upper part of the urinary tract, which consists of the kidneys and ureters, or the lower part (bladders and urethra). Upper UTIs are considered more serious than lower UTIs, because of potential damage to the kidney that could occur. Cystitis is the infection and inflammation of the bladder and is the most common form of lower UTI. Upper UTI, or kidney infection is known as pyelonephritis.

What is UTI?

The term urinary tract infection (UTI) refers to the presence of bacteria in the urinary tract. It is one of the most common bacterial infections that affect human beings, especially women. On average, 40% of healthy women will get symptoms of a UTI at least once in their lifetime. It is more rare in men and even less frequent in children.

Causes

In general, the E Coli bacteria cause 90% of UTIs. The remaining 10% consists of other bacteria and in odd cases, viruses and fungi. UTIs can be classified as complicated and uncomplicated, depending on the cause.

Uncomplicated UTI occurs in a healthy person with a normal urinary tract. A normal, healthy human being has E Coli present in the intestine, where it is usually harmless. However, it can spread and enter your urethra through the vaginal opening in several ways e.g. after sexual intercourse or when you wipe from back to front after urinating. Once it enters the urethra, it causes an infection. But this type of UTI is less severe.

On the other hand, complicated UTIs are more severe and occur when the person has a condition that makes him/her more susceptible to infection and reduces treatment effectiveness. It is most common in men. The conditions can include:

  • An abnormal urinary tract e.g. presence of kidney stones, kidney disease, etc.
  • Chemotherapy (weakened immunity)
  • Immunosuppressants
  • HIV/AIDs (poor immune system)
  • A catheter to drain urine increases likelihood of infection.

Risk Factors

There are several factors that determine your risk of getting a UTI. Some of them are:

  1. Gender: Women are more likely to develop urinary tract infection than men for several reasons. First of all, the urethra is in close proximity to the anus, making it very easy for bacteria to pass into the urinary tract. Additionally, women have a shorter urethra than men. This means it’s easier for bacteria to pass from the urethra into the bladder.
  2. Sexual Behavior: About 80% of UTIs in young women happen within 24 hours of sexual intercourse. Sex can irritate the urethra and increase susceptibility to infection. Some contraceptives also add to this risk e.g. using spermicide-coated condoms can cause irritation.
  3. Age: In women, the risk of contracting a UTI is highest after menopause. Estrogen in the body reduces significantly, leading to the thinning of the walls of the urinary tract, and its ability to fight against bacteria is lowered. Men become more prone to UTIs after they turn 50, because they usually develop an enlarged prostrate as they grow older. This places pressure on the bladder and prevents it from emptying fully, increasing the chances of becoming infected. UTIs are most common in boys than girls for the first few months of birth. However, after the age of 2, the risk increases significantly for girls, with only 2% of boys at risk of a UTI, compared to 8% of girls, throughout childhood.
  4. Antibiotic Use: Using antibiotics can change the concentration of protective bacteria in the vagina and lead to the multiplication of E Coli, which increases the risk of a UTI.

Is There A Link Between Urinary Tract Infection And Pregnancy?

Pregnant women are very vulnerable to urinary tract infections. This is due in part to hormonal changes the body. Additionally, the urinary tract is altered because the baby affects the position of organs in the body. They are especially susceptible to UTI as pregnancy progresses because of the enlarged uterus. The uterus is positioned on top of the bladder and as it gets bigger, it can block total removal of urine from the bladder, increasing the probability of infection. If it goes untreated, it can develop into a kidney infection and endanger the baby by causing premature labor and birth. So if you are pregnant, it is imperative that you get checked regularly for a UTI. Remember just because you don’t have symptom doesn’t mean you’re not infected.

How Is A Urinary Tract Infection Diagnosed?

As mentioned above, UTIs can be symptomatic or asymptomatic. Symptomatic infections can be diagnosed based on the symptoms alone. So usually when you complain to your doctor, he will start treatment for a UTI immediately. However, because UTIs can sometimes possess the same symptoms as other infections, it might become necessary to carry out a urine test. The doctor will collect a urine sample and send it off to get tested at a laboratory to confirm the diagnosis and recognize the bacteria responsible so proper treatment can be administered.

Ultrasounds or x-rays can also be used to scan the body for abnormalities, like an enlarged prostrate or thinning urethra walls, that might be contribute to infection.

Asymptomatic infection is undetectable because there are no symptoms. With the exception of pregnant women, it usually doesn’t need to be treated.

Treatment

Treatment of a UTI depends on the type of infection and the pathogen responsible. Since most UTIs are caused by bacteria, antibiotics are the most effective way of treatment. Lower UTIs and mild upper UTIs can usually be treated at home using antibiotics. Anything more serious needs to be treated in the hospital, especially if you are pregnant, have diabetes, kidney disease, cancer etc. In most cases once treatment starts, the infection should be gone within a few days. If it keeps recurring, you might have to take antibiotics daily.

If, for some reason, you cannot or do not want to take antibiotics, Methenamine Hippurate might be prescribed. While not as effective as antibiotics, it does help to fight infection.

In the case of someone with an abnormality like kidney stones, it is necessary to treat the underlying condition first to be able to stop UTI from recurring. If the symptoms don’t go after a few weeks of treatment or you have recurring infection, your doctor might refer you to an urologist, a specialist that deals with diseases of urinary tract. He will carry out an ultrasound or x-ray to recognize the cause of the persistent infection.

There is usually no need to treat asymptomatic infection, except if you’re pregnant. The benefits of home remedies like getting hydrated by increasing fluid intake and drinking cranberry juice to cure and prevent UTIs are unproven.

Common Antibiotics Used To Treat UTI

The most common antibiotic that your doctor will prescribe to treat lower UTIs is trimethophrim. Side effects are uncommon but can include nausea and skin rashes. In the case of upper UTIs, the usual antibiotic prescribed is Ciprofloxacin. However, pregnant women cannot take this and are usually given cefalexin or fosfomycin. The infection is usually cured after a week of treatment, if not a urine sample must be taken again and tested to pinpoint the actual cause of infection so as to choose the best treatment.

Recently, bacteria have become increasingly resistant to antibiotics. As a result, doctors have to prescribe quinolone antibiotics in such cases. Quinolone is gradually replacing trimethophrim as the primary treatment for UTIs.

Complications

While UTIs are a nuisance that cause discomfort, it disappears after a few days of treatment. However, it can quickly escalate into serious problems if you ignore the symptoms and leave it untreated.

  1. Kidney infection: Infection of the kidney doesn’t pose a threat to the health if treated on time. However, if it’s left untreated, it can worsen and interfere with how the kidney works and eventually result in kidney damage.
  2. Blood Poisoning: Another danger of leaving the infection untreated is blood poisoning. The infection can spread into the blood and affect other body parts.
  3. Pregnancy: UTI during pregnancy can be very risky to both mother and child. Leaving it untreated can lead to anaemia, interfere with the baby’s growth and lead to premature labor.

Therefore, it is a good idea to see the doctor as soon as symptoms of a UTI begin to surface. Pregnant women should be scanned for UTIs regularly so even when it’s asymptomatic, it is recognized early and treated before it leads to complications.

Prognosis

UTIs are usually minor, uncomfortable infections that are easily treated with antibiotics. Symptoms begin to disappear within 48 hours of treatment and can be totally gone within a week.

Prevention

banner-mid

Making a few changes to your lifestyle can reduce the risk of developing a UTI. Some of the changes can be:

  • Keeping the genital areas clean, especially before and after sexual intercourse to reduce the spread of bacteria.
  • Cleaning the genital area from front to back, instead of back to front to stop the spread of bacteria from the anus to the urethra.
  • Do not use products that might irritate the vaginal area e.g. perfumed products. They increase vulnerability to infections.
  • Avoid multiple sex partners. And when choosing contraceptives (e.g. condoms and diaphragms), try not to use ones that are coated with spermicide.
  • Avoid using tampons. They might introduce bacteria into the urinary tract. Use pads instead, and make sure you change them regularly.
  • If using a catheter, empty it regularly and make sure to wash hands before handling the catheter.
  • Stay hydrated by drinking plenty of fluids.
  • Although not scientifically proven, adding berries like cranberries and blueberries to your diet might also help prevent UTIs.

While these measures do not guarantee that you will never get a UTI, it can go a long way to reducing the risks of developing a urinary tract infection.

How Long Does A Urinary Tract Infection Last?

If treated on time, a lower UTI usually lasts between 3 to 7 days while an upper UTI can last from 7 to 14 days.

Written By Kyle Danes

Kyle Danes, MD, is a urologist certified by the American Board of Urology. He has also received a certification in the sub-specialty of Pediatric Urology. Dr. Danes earned his undergraduate degrees in Chemistry and Biology from the University of Virginia. In 1988 Dr. Danes earned his Medical Degree at Yale University School of Medicine. His urological and surgical residencies were completed at the Johns Hopkins Hospital where he also served as Chief Resident.

Share:

Comment (1)

Leave a Reply


*