I recently saw a 36 year old woman in the clinic who was in the midst of her first urinary tract infection and was miserable. She really did not know that her symptoms originated from an infection. When I told her she had a urinary tract infection, she was alarmed.
I hope you will find helpful the following information I shared with the patient.
The urinary tract includes the kidneys (which filter the blood to produce urine), the ureters (the tubes that carry urine from the kidneys to the bladder), the bladder (which stores urine), and the urethra (the tube that carries urine from the bladder to the outside) —see drawing below. All of these parts are located in your abdomen below the belly button.
Urinary tract infections (UTI) happen when bacteria get into the urethra and travel up into the bladder. If the infection stays just in the bladder, it is called a bladder infection or cystitis. If the infection travels up past the bladder and into the kidneys, it is called a kidney infection or pyelonephritis.
Bladder infections are one of the most common infections, causing burning with urination and frequent urination (see chart – Symptoms of Bladder and Kidney Infection). Both bladder and kidney infections are more common in women than men. Men rarely have urinary tract infections unless they have other problems like kidney stones. In men, infections of the prostate gland (prostatitis) which lies close to the bladder can cause the same symptoms as bladder infections. Kidney infections can cause symptoms similar to bladder infections, but also usually come with fever, back pain, nausea or vomiting (see chart – Symptoms of Bladder and Kidney Infection).
SYMPTOMS OF BLADDER and KIDNEY INFECTION
Health providers diagnose urinary tract infections by the symptoms and the results of a urine test for white blood cells. If you have one or more of the symptoms of a kidney infection, you should see a healthcare provider as soon as possible. If white blood cells are present in the urine, a sample of urine is often taken to grow bacteria in a laboratory and to insure the right antibiotic is prescribed. It usually requires about 48 hours to get those results but treatment is started while waiting.
In healthy adolescents and adults with a bladder infection, the usual treatment ranges from a single dose to more extended courses of antibiotics. The drugs used include nitrofurantoin (Macrobid®), trimethoprim-sulfamethoxazole (Bactrim®), fosfomycin (Monurol®), ciprofloxacin (Cipro®) or levofloxacin (Levaquin®). Medicines like prescription phenazopyridine (Pyridium®) or over the counter Uristat ® can help the burning pain but are not antibiotics. It is important to take the full course of antibiotics. Symptoms should begin to resolve quickly.
No studies have been performed to prove that drinking more fluids while treating bladder infections helps. However, I recommend it anyway because drinking more fluids than usual makes good sense. I do not recommend herbals and home remedies like cranberry juice as treatment for bladder infections. Doctors who have an interest in treatment of urinary tract infections include primary care physicians, urologists, and gynecologists. If multiple urinary tract infections occur, consultation with another specialist may be suggested.
The most important thing to prevent urinary tract infections in women is good pelvic hygiene (see chart —Techniques to Prevent UTI in Women). This includes wiping front to back after bowel movements to keep bacteria away from the urinary tract opening. If infections occur when using a spermicide or diaphragm, an alternative birth control method may help. Drinking more fluids or urinating soon after intercourse may help prevent infection.
Techniques to Prevent UTI in Women
Postmenopausal women with recurrent urinary tract infections may respond to vaginal estrogen available in a flexible ring that is worn in the vagina for three months (Estring®), a small tablet (Vagifem®), or a cream (eg, Premarin® or Estrace). Preventive antibiotic treatment may help. This could include either continuous antibiotics; antibiotics following intercourse;
I told my patient a single urinary tract infection or a few urinary tract infections over the years in a healthy woman is not unusual. Those occurring more frequently require further evaluation. She was happy to hear this.
Dr. Rick uses a number of evidence-based resources to prepare Southern Remedy Health Tips. These include journal articles, online medical resources for health providers and other sources which are adapted for use here.