Urinary Tract Infection (UTI): Symptoms, Causes, and Treatment

What is Urinary Tract Infection (UTI)?

A Urinary Tract Infection (UTI) is an infection in any part of your urinary system, which includes your kidneys, ureters, bladder, and urethra. Most infections involve the lower urinary tract — the bladder and the urethra. Women are at greater risk of developing a UTI than men. Infection limited to your bladder can be painful and annoying. However, serious consequences can occur if a UTI spreads to your kidneys.

According to the Mayo Clinic, UTIs are common infections that usually require treatment with antibiotics. They can affect anyone, but they're especially common in women. It's estimated that about 40% of women and 12% of men will experience at least one UTI during their lifetime.

Common Causes

UTIs typically occur when bacteria enter the urinary tract through the urethra and begin to multiply in the bladder. The urinary system is designed to keep out such microscopic invaders, but sometimes defenses fail. Here are the most common causes:

• E. coli bacteria: The most common cause of UTIs, accounting for about 90% of cases. These bacteria normally live in the bowel and around the anus.
• Sexual activity: Sexual intercourse can introduce bacteria into the urinary tract, increasing the risk of UTIs.
• Female anatomy: Women have a shorter urethra than men, which makes it easier for bacteria to reach the bladder.
• Menopause: After menopause, a decline in circulating estrogen causes changes in the urinary tract that make you more vulnerable to infection.
• 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.
• Catheter use: People who can't urinate on their own and use a tube (catheter) to urinate have an increased risk of UTIs.
• Weakened immune system: Conditions like diabetes and other diseases that impair the immune system can increase the risk of UTIs.
• Recent urinary procedures: Urinary surgery or an exam of your urinary tract that involves medical instruments can increase the risk of developing a UTI.
• 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.

For more detailed information on causes, visit the Centers for Disease Control and Prevention (CDC) website.

Associated Symptoms

UTIs don't always cause signs and symptoms, but when they do, they may include:

• A strong, persistent urge to urinate
• A burning sensation when urinating
• Passing frequent, small amounts of urine
• Urine that appears cloudy
• Urine that appears red, bright pink, or cola-colored — a sign of blood in the urine
• Strong-smelling urine
• Pelvic pain in women — especially in the center of the pelvis and around the area of the pubic bone

In older adults, UTIs may be overlooked or mistaken for other conditions. The National Institute on Aging notes that symptoms in older adults may include:

• Confusion or delirium
• Agitation
• Other behavioral changes
• Poor appetite
• Fatigue

When to See a Doctor

Contact your doctor if you have signs and symptoms of a UTI. Also, see your doctor if UTI symptoms return after treatment. You should also see a doctor if:

• Your symptoms are severe
• You have signs of a kidney infection (fever, back pain, nausea, vomiting)
• You're pregnant and develop UTI symptoms
• You have a UTI and diabetes, a weak immune system, or another medical problem
• Your child develops UTI symptoms

According to the Urology Care Foundation, prompt treatment of UTIs can help prevent complications, including kidney damage and sepsis (a life-threatening complication of an infection).

Diagnosis

If you suspect you have a UTI, your doctor will likely ask about your symptoms and medical history. Diagnosing a UTI may include:

• Urine analysis: A sample of your urine is checked for white blood cells, red blood cells, or bacteria.
• Urine culture: This test tells your doctor what bacteria are causing your infection and which medications will be most effective.
• Imaging: If you have frequent UTIs, your doctor may use an ultrasound, CT scan, or MRI to check your urinary tract for abnormalities.
• Cystoscopy: If you have recurrent UTIs, your doctor may perform this test, which uses a thin tube with a lens to see inside your urethra and bladder.

The American Urological Association provides guidelines for the diagnosis and treatment of UTIs.

Treatment Options

UTIs are typically treated with antibiotics. The type of medication and length of treatment depend on your health history and the type of bacteria found in your urine. Common treatments include:

Medical Treatments

• Antibiotics: Drugs commonly recommended for simple UTIs include trimethoprim/sulfamethoxazole (Bactrim, Septra), fosfomycin (Monurol), nitrofurantoin (Macrodantin, Macrobid), cephalexin (Keflex), and ceftriaxone.
• Pain relievers: A heating pad and medications like ibuprofen (Advil, Motrin IB) or acetaminophen (Tylenol) can help with back or side pain.
• Hospital treatment: For severe kidney infections, you might need treatment in a hospital with intravenous fluids and antibiotics.

Home Treatments

While home remedies can't cure a UTI, they may help relieve symptoms and prevent future infections:

• Drink plenty of liquids: Especially water, to help flush out bacteria.
• Urinate frequently: Don't hold urine for long periods.
• Wipe from front to back: After urinating and during bowel movements to prevent bacteria from spreading.
• Use a heating pad: To relieve pressure or pain.
• Avoid irritating feminine products: Such as deodorant sprays or douches.

Always consult your healthcare provider before trying any home remedies, especially if you're pregnant, have a chronic illness, or are taking other medications.

Prevention Tips

You can take these steps to reduce your risk of UTIs:

• Drink plenty of fluids: Especially water, to dilute your urine and ensure you urinate more frequently.
• Wipe from front to back: After urinating and during bowel movements to prevent bacteria from spreading.
• Empty your bladder soon after intercourse: Also, drink a full glass of water to help flush bacteria.
• Avoid potentially irritating feminine products: Such as deodorant sprays or douches.
• Change your birth control method: If you experience frequent UTIs and use diaphragms or spermicide-treated condoms.
• Consider preventive antibiotics: If you have frequent UTIs, your doctor may recommend a low dose of antibiotics for a period of time.
• Use vaginal estrogen: If you're postmenopausal, your doctor may recommend vaginal estrogen therapy.

The Office on Women's Health provides additional tips for preventing UTIs.

Emergency Warning Signs

Seek emergency medical attention if you experience any of the following symptoms, which may indicate a kidney infection or other serious complication:

• High fever (above 101°F or 38.3°C)
• Shaking and chills
• Nausea and vomiting
• Severe pain in your back or side
• Confusion or extreme fatigue
• Blood in your urine
• Difficulty urinating or inability to urinate

These symptoms can indicate a severe infection that has spread to your kidneys or bloodstream, which can be life-threatening if not treated promptly. Go to the nearest emergency room or call 911 if you cannot reach your doctor.

For more information on when to seek emergency care, refer to guidelines from the American College of Emergency Physicians.