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Understanding Urinary Tract Infections (UTIs): Causes, Symptoms, and Treatment

Alan Lucks | MD

Medically reviewed by Alan Lucks | MD, Alan Lucks MDPC Private Practice - New York on September 9th, 2023.

Key Takeaways

  • E. coli bacteria cause 85-90% of uncomplicated bladder infections by traveling from the intestinal tract through the urethra, which is only 4cm long in women versus 20cm in men.
  • Classic symptoms include dysuria (painful urination), urgency, frequency, and suprapubic pain—but up to 30% of elderly patients present with confusion or falls instead of typical signs.
  • Sexual activity increases infection risk 60-fold within 24-48 hours due to bacterial migration; post-menopausal women face higher rates due to decreased estrogen and protective lactobacilli.
  • First-line antibiotics like nitrofurantoin (100mg twice daily) or trimethoprim-sulfamethoxazole typically resolve symptoms within 24-72 hours, but the full 3-7 day course prevents resistance.
  • Fever above 101°F, flank pain, nausea, or vomiting signals potential pyelonephritis (kidney infection), requiring immediate evaluation and often hospitalization for IV antibiotics.

Urinary tract infections (UTIs) are a common health issue that can affect anyone. These infections occur when bacteria enter the urinary system, which includes the bladder, kidneys, ureters (tubes connecting the kidneys to the bladder), and urethra (the tube that carries urine out of the body). In this article, we'll discuss the causes, symptoms, risk factors, and treatment options for UTIs.

Understanding Urinary Tract Infections (UTIs): Causes, Symptoms, and Treatment

Types of UTIs

UTIs can occur in different parts of the urinary system:

  • Cystitis: An infection in the bladder

  • Pyelonephritis: An infection in the kidneys

Causes of UTIs

Most UTIs are caused by bacteria normally found in the gut, such as E. coli. Other bacteria that can cause UTIs include:

  • Staphylococcus

  • Proteus

  • Klebsiella

  • Enterococcus

  • Pseudomonas

Some UTIs may also be caused by sexually transmitted infections (STIs) like Chlamydia trachomatis, mycoplasma, and ureaplasma, or by the parasite trichomonas.

Risk Factors for UTIs

Certain factors can increase your risk of developing a UTI:

  • Being female (due to a shorter urethra)

  • Having a history of UTIs

  • Certain medical conditions (diabetes, multiple sclerosis, Parkinson's disease, spinal cord injuries)

  • Menopause

  • Being overweight

  • Blockages in the urinary tract (tumors, kidney stones, enlarged prostate)

  • Using a diaphragm or spermicide for birth control

  • Having a catheter

  • For men: having sex with men, having HIV, or being uncircumcised

Symptoms of UTIs

Common symptoms of a UTI include:

  • A strong, persistent urge to urinate

  • A burning sensation when urinating

  • Passing frequent, small amounts of urine

  • Cloudy, dark, or strange-smelling urine

  • Pelvic pain (in women)

  • Rectal pain (in men)

If the infection has spread to the kidneys, you may also experience:

  • Fever and chills

  • Nausea and vomiting

  • Upper back and side pain

Treatment for UTIs

Most UTIs can be treated with antibiotics. Be sure to complete the entire course of antibiotics as prescribed by your healthcare provider, even if your symptoms improve. A urine culture and sensitivity may be done to determine the causative germ and the best treatment. In some cases, pain relief medication may also be recommended to manage discomfort.

If you suspect you have a UTI, it's essential to seek medical attention to prevent the infection from spreading to the kidneys or developing into sepsis. Your healthcare provider will diagnose the infection and determine the best course of treatment based on your specific situation.

Additional Resources

The Bottom Line

Most bladder infections respond quickly to oral antibiotics when caught early, but incomplete treatment leads to recurrence in 25-30% of cases. Distinguishing between simple cystitis and kidney involvement is crucial since untreated pyelonephritis can cause permanent kidney damage. If you're experiencing urinary symptoms or aren't sure about the severity, Doctronic can help you get properly evaluated and treated.

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