Urinary Tract Infections

Urinary Tract Infections (UTI’s), also known as bladder infections or cystitis, are more common in women than in men.  Common symptoms include burning sensation during urination, feeling of pressure on the bladder, urinating small amounts more often, sense of urgency to urinate, cloudy urine, strong odor, and seeing blood in the urine.

The usual source of UTI’s is a bacteria called E. coli.  This is a bacteria that is normally found in the intestines, and usually does not cause problems.  However, the urinary system is a sterile system and is not used to these bacteria.  E. coli can travel up the urethra (the tube that empties the bladder) and can grow in the bladder, which leads to the symptoms.  Other types of bacteria, normally from the skin, can also infect the bladder and cause the same symptoms.  The only true way to know which bacteria is the cause is to obtain a culture which can take 48 hours to grow.  Since UTI’s are common in women, cultures are not routinely done, but may be done if you have frequent UTI’s, if you don’t respond to therapy, or if another disease process is suspected.

Therapy for UTI’s includes antibiotics for 3 to 5 days.  Common antibiotics used are Septra or Bactrim (sulfa-containing antibiotics), Cipro, or Macrobid.  Pyridium is a medication that helps with the burning sensation, is taken for 3 days at most, and turns your urine a bright orange.  Similar medications are available without a prescription which help with discomfort, but do not kill the bacteria – Uristat and Azo are the common brands used.  Along with these medications, it is important for you to keep drinking plenty of fluids (2 - 4 liters per day) – urinating helps flush out the bacteria.  Many people will drink cranberry juice to help, and this is a good alternative to water.  The cranberry juice will make the urine acidic, which bacteria do not grow well in, and some suggest that it prevents the bacteria from binding to the wall of the bladder where they can grow.  As long as you are drinking fluids and urinating often, it will be helpful.  However, if you are drinking cranberry juice and it seems to be getting worse, there may be another process going on, and you should be checked by the provider.

Many times your body is able to fight off an infection.  However, if the infection goes too long or if your body is overwhelmed, then the infection may spread to your kidneys.  This would then be called pyelonephritis.  Symptoms are similar, but also include fever, back pain, and shaking chills.  Sometimes you can also have nausea and vomiting.  In otherwise healthy people, pyelonephritis is treated with a longer course of antibiotics of up to 3 weeks.  However, this can be very serious in some individuals and may require hospitalization.

The best way to prevent a urinary tract infection is to have good hygiene and to stay hydrated by drinking plenty of water.  Women are more susceptible to these infections than men, mainly because their urethra is much shorter.  Urinating after sexual intercourse can help prevent infections.  Wearing thong underwear may cause infections in some women, so only wear thongs for short periods of time, then switch to regular cotton underwear as soon as you can.  Many women discuss wiping from front to back.  While this is probably a good practice in general, studies have actually shown that this does not help prevent infections versus women who wipe back to front. Some women are simply more susceptible to infections than others.  If you have more than 3 urinary tract infections in one year, then preventive medications may be used after a thorough evaluation for other causes.