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Doctors see more patients for urinary tract infections (UTIs) than for any other type of infection that requires only outpatient treatment. Because they are so prevalent, you may experience at least one over the course of your life, and if you have certain risk factors, you are even more likely to develop one—or more occurrence. Having a clear understanding of the symptoms of a UTI will help you know when to seek medical care.

What is a UTI?

A urinary tract infection, or UTI, is an infection that starts in the urinary tract, the drainage system that removes liquid waste from the body in the form of urine. Most UTIs occur in the lower urinary tract, which includes:

  • The bladder, a triangle-shaped organ that collects urine and stores it until you’re ready to urinate. Cystitis is the name for an infection of the bladder.
  • The urethra, a small tube that carries urine from the bladder to the outside of the body so it can be released. Urethritis is the name for an infection of the urethra.
  • The prostate, a male organ responsible for supplying seminal fluid to nourish sperm and help with their mobility. Part of the prostate called the transition zone surrounds the urethra.  Prostatitis is the name for an infection of the prostate.

Upper UTIs can also occur and involve:

  • The kidneys, the bean-shaped organs that filter your blood and transform waste into urine. Pyelonephritis is the name for a kidney infection.
  • The ureters, the long tubes that transport urine from your kidneys to your bladder.

It’s also possible to have a widespread infection that affects both the upper and lower urinary tract.

What causes a UTI?

Most UTIs occur when bacteria find their way into the urinary tract. Lower UTIs often happen when bacteria present on the skin around the genital or anal area get inside the urethra. The bacteria most often responsible for UTIs are strains of Escherichia coli (E. coli). These bacteria live in the intestines and the digestive system and are usually harmless. However, the bacteria aren’t meant to be in the urinary tract.

The source of E. coli for most UTIs is trace amounts of stool left behind after you defecate. For women, wiping from back to front after using the bathroom can expose the urinary tract to bacteria. Sexual intercourse may force the bacteria into the urethra, and holding your urine may cause a UTI as well. Urinating flushes out bacteria, and if you don’t do so often enough, the bacteria may build up and give rise to an infection.

People with diabetes or a compromised immune system are more likely to develop UTIs because their bodies can’t effectively fight off bacteria. Hormonal changes that take place during pregnancy and menopause also increase the risk for UTIs. In addition, any condition that restricts the flow of urine, such as an enlarged prostate or kidney stones, can contribute to infections.

Common symptoms of a UTI and their causes

When bacteria enter the urinary tract, the body goes into defense mode. The immune system takes action to fight off the bacteria, and you may experience a number of symptoms.

Strong urge to urinate and more frequent urination

Inflammation plays a crucial role in the immune system’s defenses. When bacteria enter the urinary tract, the immune system releases inflammatory cells and cytokines that encourage the production of even more inflammation-causing cells. These inflammatory cells cause the affected area to swell in order to trap bacteria.

When inflammation occurs in the bladder or urethra, the passageway that urine usually uses to leave the body becomes smaller. As a result, the urge to urinate intensifies and occurs more frequently.

Difficulty with and discomfort during urination

Even though you feel like you need to urinate, you may find it difficult to actually go when you have a UTI. When you go to the bathroom, you may only pass a small amount of urine. You may even feel like you still need to go or, or experience the urge to urinate again soon after. These symptoms are due to swelling of the urinary tract. Even though you have urine to release, the liquid can’t flow freely from your bladder through your urethra.

A burning pain at the start of urination, known as dysuria, is another common symptom of a UTI. When the inflammatory response begins, the mucous lining along the inside of the urinary tract becomes irritated, and the pain receptors in the area grow more sensitive. When urine comes in contact with the inflamed tissue, it triggers a pain response.

Blood in urine

Blood in the urine, or hematuria, may also occur during a UTI. The inflammation of the urinary tract lining can cause red blood cells present in the area to leak tiny amounts of blood. In most cases, the blood droplets are so tiny that you can’t see them with the naked eye, but the doctor can detect them with a urinalysis.

Visible hematuria is also possible with a UTI, but it can have other causes, such as:

  • Bladder or kidney stones
  • Enlarged prostate
  • Kidney disease
  • Kidney injury
  • Cancer of the kidney, bladder or prostate
  • Sickle cell anemia
  • Medications, including the antibiotic penicillin
  • Very strenuous exercise (although this is rare)

Changes in appearance and smell of urine

When you have a UTI, your urine may look cloudy or milky. This usually means that there are white blood cells present in the urine. White blood cells are the immune system’s soldiers. They do the work of battling bacteria to clear up infections. Urinating will wash some of these white blood cells out of the body, causing them to show up in your urine. Sometimes, urine takes on a strong, unpleasant odor during a UTI. This is most often caused by the presence of bacteria, which give off strong-smelling compounds.

Pain in your abdomen or pelvis

With a UTI, you may experience widespread or localized pain in the pelvic area or lower abdomen. Like many of the other symptoms of urinary tract infections, this symptom stems from inflammation. The sensitized pain receptors in the urinary tract area can cause discomfort like aching or pressure. If you experience symptoms of an infection along with pain in your lower back or flank, you may have a kidney infection rather than a lower UTI.

Fever

Fever is another weapon in the immune system’s arsenal. When you have an infection, your immune system releases chemicals to raise your body temperature in an effort to make the urinary tract less hospitable to the bacteria. Lower UTIs can cause low-grade fevers in older adults. A high fever is more likely to be a sign of a more serious kidney infection. It’s more likely for you to have a UTI and not develop a fever.

Getting relief from UTI symptoms

Phenazopyridine hydrochloride is a medication approved by the U.S. Food and Drug Administration (FDA) for relieving urinary pain. You can buy generic forms and a brand name version called Uristat over the counter. The medication is also available in stronger prescription-strength dosages.

Taking phenazopyridine can ease painful urination and the feelings of urinary urgency associated with a UTI. However, the drug is not a treatment for a UTI. Its purpose is to help you feel more comfortable while waiting for a treatment to work or to give you temporary relief until you can see your primary care provider.

 Home remedies, such as drinking cranberry juice and taking probiotics, have not been scientifically proven to help prevent or treat a UTI.

To treat the underlying infection, you will likely need an antibiotic, such as:

  • Amoxicillin
  • Cephalosporins like cephalexin (Keflex)
  • Doxycycline
  • Fosfomycin (Monurol)
  • Nitrofurantoin (Macrodantin, Macrobid)
  • Quinolones like ciprofloxacin (Cipro)
  • Sulfonamides (sulfa drugs)
  • Trimethoprim/sulfamethoxazole (Bactrim)

Which antibiotic is best for you depends on the type of bacteria present in your urine sample and your overall health profile and history. Only a doctor can determine which antibiotic is right for treating a UTI. You shouldn’t try to treat the infection on your own with someone else’s antibiotics or leftover antibiotics from a previous infection. Using all of the prescribed medication as directed is vital to treating the infection, so continue with the recommended dosing schedule even after your symptoms subside.

Why you should never ignore UTI symptoms

Lower UTIs aren’t generally serious medical emergencies, but you should still never ignore their symptoms. When you don’t treat a lower UTI, the inflammation may cause urine to flow back through the ureters into the kidneys. If this happens, the infection can spread.

Kidney infections are much more serious than lower UTIs. They can lead to permanent kidney damage or allow the bacteria to spread to your bloodstream and cause a potentially fatal systemic infection. As a result, you should never try to simply manage your symptoms and allow your body to naturally fight the infection. Boosting your body’s defenses with an antibiotic is the best way to protect your health.

Forward simplifies treatment for UTIs

When symptoms of a UTI arise, getting prompt treatment allows you to get back to feeling your best as soon as possible and greatly reduces your risk of complications. As your primary care provider, Forward gives you the flexibility to easily schedule an appointment virtually or in person. Once we diagnose your symptoms as a UTI, you can arrange to have your prescription delivered right to your door, so you can begin treatment quickly.

No long waits. No surprise bills. No copays — ever.

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