To finish our series on bladder irritation, today we will talk about urinary tract infection (UTI). UTIs are very common, especially in women. About half of women will have a UTI at some point during their lives. In the US, 8-10 million people are treated for UTIs every year.
What is a UTI?
A UTI is an infection in the urinary system. This could include the:
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Bladder
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Urethra – the tube that carries urine from the bladder to the outside
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Kidneys
What are the symptoms of a UTI?
UTIs cause bladder irritation symptoms including frequency, urgency, pain with urination, and others. Review the symptoms here: Intersticial Cystitis
What causes a UTI?
A UTI happens when germs, usually bacteria, enter the urinary system. They usually enter through the urethra, then can move up to the bladder. The infection can also travel up to your kidneys through the ureters.
The most common cause of UTI is a bacteria called E. coli, which causes more than 90% of bladder infections. E. coli typically lives in the GI tract.
Who is at highest risk of UTI?
Although anyone can get a UTI, women are at higher risk. This is at least in part because a woman’s urethra is shorter and much closer to the anus, where E. coli bacteria are common.
Here are some other risk factors for UTI:
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Sexual activity
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Certain types of birth control – such as a diaphragm, and spermicides.
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Menopause – Declining estrogen levels cause changes to the urinary tract that make UTIs more likely.
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Urinary tract abnormalities – Usually something you’re born with.
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Blockages in the urinary tract – Such as kidney stones or an enlarged prostate.
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Impaired immune function
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Use of a catheter
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Recent urinary surgeries or procedures
How do you know if you have a UTI?
As we have discussed over the last couple of weeks, there are many causes of bladder irritation. UTI is just one of those causes. So how can you tell if UTI is causing your symptoms? If you have bladder irritation symptoms, there are 2 tests that you should have to confirm or rule out UTI as the cause. Both should be done. They are:
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Urinalysis – Urine is tested for things like nitrites, glucose, bilirubin, red and white blood cells, and others.
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Urine culture – A test to see what, if any, bacteria is growing in the urine, how much bacteria is present, and what antibiotic would work the best to treat it.
How are UTIs treated?
I do not recommend treatment for UTI without testing the urine first. Antibiotics are not necessary, nor are they helpful for bladder irritation from other causes.
Minor UTIs can sometimes get better without antibiotics. It is reasonable to try some conservative treatment for 2-3 days to see if that helps. Usually, the culture results will return in that time. It has worked for me in the past. This would include drinking lots of fluids, especially water, and taking some acetaminophen for discomfort. If your symptoms do not improve, and the culture grows bacteria, then you would need antibiotics.
If you have symptoms that are more severe, including fever, chills, nausea and vomiting, and the urinalysis shows signs of UTI, then you should be treated with antibiotics right away. If you have more severe symptoms, or you do not respond to treatment, you might require additional tests, such as imaging studies (ultrasound or CT scan) or a cystoscopy.
Can you prevent UTIs?
There are things you can do to decrease your risk of developing a UTI. You can:
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Practice good hygiene – Such as wiping front to back after a bowel movement and changing pads and tampons more often during your period.
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Drink plenty of fluids daily – Particularly water.
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Empty your bladder more often and always emptying your bladder immediately after having sex.
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Wear loose fitting clothing and cotton underwear.
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If you are postmenopausal, talk to your doctor about whether a vaginal estrogen cream might be helpful.
If you have any questions about urinary tract infection, please log into your account and send us your question. We are here to help.
Dr. Anita Bennett MD – Health Tip Content Editor