What to Know About Urinary Tract Infections

Urinary tract infections (UTIs) are common, uncomfortable infections that can happen in any part of the urinary system, including the kidneys, ureters, bladder, and urethra. Anyone can develop a UTI, but they are more common in women. About one in five women will experience a UTI in their lifetime, and many will have repeat infections. Although symptoms are often uncomfortable, several treatment options are available to speed recovery and prevent future infections.

Some women are at a higher risk of developing a UTI, including those who are sexually active, pregnant, experiencing menopause, or use a diaphragm for birth control.

Symptoms of a UTI

Most UTIs are caused by bacteria that travel up the urethra to the bladder. As the bacteria grow, it causes inflammation which leads to irritation and pain, a common bodily response to fighting infection. Typical symptoms include:

• Burning feeling when urinating
• Frequent or intense urge to urinate, even though little comes out when you do
• Cloudy, dark, bloody, or strange-smelling urine
• Pain or pressure in your back or lower abdomen

UTI Prevention

Preventing bacteria from entering the urinary system through the urethra is the best way to reduce infection.

• Drink 6 – 8 glasses of water a day to dilute your urine and flush out bacteria.
• When you feel the need to urinate, don’t hold it in. When urine sits in the bladder for long periods of time it is more likely for bacteria to form and cause an infection.
• Empty your bladder as soon as possible after intercourse, oral sex, or any activity that may increase bacteria near your urethra.
• After urinating or a bowel movement, be careful to wipe from front to back to avoid bacteria spreading to the vagina and urethra.
• Avoid using douches and spermicides, as these can alter the normal flora in the vagina.
• If you use a diaphragm and have frequent infections, talk with your provider about alternative birth control methods.
• Avoid wearing tight pants or undergarments and change out of wet workout clothes or bathing suits.

Diagnosis and Treatment Options

Your provider will collect a urine sample and order a urine culture test to diagnose if your symptoms are caused by a UTI. This will help determine the correct course of treatment. If you get frequent or chronic UTIs, that do not improve with lifestyle changes, your doctor might recommend an ultrasound, CT scan, an MRI, or a cystoscopy, which involves using a long, thin tube with a lens to view the inside of your urethra and bladder to look for abnormalities.

Antibiotics are the most common treatment for urinary tract infections. The most common medications prescribed are:

• Trimethoprim/sulfamethoxazole (Bactrim, Septra, others)
• Fosfomycin (Monurol)
• Nitrofurantoin (Macrodantin, Macrobid)
• Cephalexin (Keflex)
• Ceftriaxone

The specific course of antibiotics is determined based on the results of your urine culture and the specific bacteria causing infection.

Relief often comes only a few days after starting treatment, but it is necessary to finish the entire dose of medication to prevent the infection from returning. Additionally, it’s important to avoid delaying treatment for a suspected UTI so it doesn’t lead to a kidney infection.

Over-the-counter medications such as Azo, Uristat, and Cystex can help control the infection and reduce symptoms. Talk with your provider before trying any of these over-the-counter options, as they can affect the results of a urinalysis.

Some claim that cranberry juice works to cure or prevent infections due to a tannin that might ward off E. coli bacteria, the most common cause of urinary tract infections. Although drinking pure, unsweetened cranberry juice may help reduce symptoms slightly, it has not been medically proven to treat or cure UTIs. Drinking cranberry juice should never replace a visit to your provider’s office to diagnose and treat a UTI.

While UTIs can be uncomfortable and inconvenient, they are easily treated if caught early. For this reason, contact your provider if you are experiencing uncomfortable symptoms or signs of a UTI.

About Jessica Ahlemeyer, CNM

Jessica Ahlemeyer is a certified nurse-midwife who joined Atrius Health in 2021. She received her MSN degree from Yale University and is board-certified by the American Midwifery Certification Board.

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