Urinary Tract Infection (UTI): Causes, Symptoms, Tests and Diagnosis and Treatment
Urinary Tract Infection:
Definition:
The urinary tract includes the kidneys, bladder, ureters, and urethra. A urinary tract infection, or UTI, is an infection that can happen anywhere along the urinary tract. (UTIs) are far more common in women than men. Urinary tract infections have different names, depending on what part of the urinary tract is infected.
- Bladder — an infection in the bladder is also called cystitis or a bladder infection
- Kidneys — an infection of one or both kidneys is called pyelonephritis or a kidney infection.
- Ureters — the tubes that take urine from each kidney to the bladder are only rarely the site of infection.
- Urethra — an infection of the tube that empties urine from the bladder to the outside is called urethritis
Causes:
The urinary system is composed of the kidneys, ureters, bladder and urethra. All play a role in removing waste from your body. Urinary tract infections typically occur when bacteria enter the urinary tract through the urethra and begin to multiply in the bladder. Although the urinary system is designed to keep out such microscopic invaders, the defenses sometimes fail. When that happens, bacteria may take hold and grow into a full-blown infection in the urinary tract.
Women tend to get them more often because their urethra is shorter and closer to the anus than in men. Because of this, women are more likely to get an infection after sexual activity or when using a diaphragm for birth control. Menopause also increases the risk of a UTI.
The following also increase your chances of developing a UTI:
- Diabetes
- Advanced age (especially people in nursing homes)
- Problems emptying your bladder completely (urinary retention)
- A tube called a urinary catheter inserted into your urinary tract
- Bowel Incontinence
- In addition to bladder infections, men may get infections of the prostate (prostatitis).
In fact, bacteria from the prostate can lead to recurrent UTIs in men. For infants and children, UTIs can be associated with particularly narrow urinary tracts, or with a condition where the urine is pushed back up into the kidneys.
- Kidney stones
- Staying still (immobile) for a long period of time (for example, while you are recovering from a hip fracture)
- Pregnancy
- Surgery or other procedure involving the urinary tract
Symptoms: 
Common UTI symptoms may include:
- pain or burning during urination
- frequent desire to urinate, often urgently and immediately
- unusual discharge from the urethra
- urine that looks cloudy ( a sign of blood in the urine) or smells foul
- pressure in the lower pelvis
- fever, with or without chills
- bedwetting in a person who has normally been dry at night
- nausea and vomiting
Symptoms of UTIs in Older Patients:
The classic lower UTI symptoms of pain, frequency, or urgency and upper tract symptoms of flank pain, chills, and tenderness may be absent or altered in older patients with UTIs.
Symptoms of UTIs that may occur in seniors but not in younger adults may include mental changes or confusion, nausea or vomiting, abdominal pain, or cough and shortness of breath. Concomitant illness may further confuse the picture and make diagnosis difficult.
Make an appointment with your doctor if you have signs and symptoms that worry you.
Tests and Diagnosis:
Tests and procedures used to diagnose urinary tract infections include:
- Analyzing a urine sample.
- Your doctor may ask you to turn in a urine sample that will be analyzed in a laboratory to determine if pus, red blood cells or bacteria are present. To avoid potential contamination of the sample, you may be instructed to first wipe your genital area with an antiseptic pad and to collect the urine midstream.
- Growing urinary tract bacteria in a lab.
Laboratory analysis of the urine is sometimes followed by a urine culture — a test that uses your urine sample to grow bacteria in a lab. This test tells your doctor what bacteria are causing your infection and which medications will be most effective.
- Creating images of your urinary tract.
If your doctor suspects that an abnormality in your urinary tract is causing frequent infections, you may undergo tests to create images of your urinary tract using ultrasound or computerized tomography (CT). Another test called an intravenous urinary pyelogram uses X-rays to create images. During this test, a dye is injected into a vein in your arm and X-rays are taken of your urinary tract. The dye highlights your bladder and urethra and allows your doctor to determine if you have any abnormalities that slow urine from leaving your body.
- Using a scope to see inside your bladder.
If you have recurrent urinary tract infections, your doctor may use a long, thin tube with a lens (cystoscope) to see inside your urethra and bladder. The cystoscope is inserted in your urethra and passed through to your bladder. This procedure is called cystoscopy.
Treatment:
Antibiotics are typically used to treat urinary tract infections. Which drugs are prescribed and for how long depend on your health condition and the type of bacterium found in your urine.
Simple infection
Drugs commonly recommended for simple urinary tract infections include:
- Sulfamethoxazole-trimethoprim (Bactrim, Septra, others)
- Amoxicillin (Larotid, Moxatag, others)
- Nitrofurantoin (Furadantin, Macrodantin, others)
- Ampicillin
- Ciprofloxacin (Cipro)
- Levofloxacin (Levaquin)
Usually, symptoms clear up within a few days of treatment. But you may need to continue antibiotics for a week or more. Take the entire course of antibiotics prescribed by your doctor to ensure that the infection is completely eradicated.
For an uncomplicated urinary tract infection that occurs when you’re otherwise healthy, your doctor may recommend a shorter course of treatment, such as taking an antibiotic for one to three days. But whether this short course of treatment is adequate to treat your infection depends on your particular symptoms and medical history.
Your doctor may also prescribe a pain medication (analgesic) that numbs your bladder and urethra to relieve burning while urinating. One common side effect of urinary tract analgesics is discolored urine — orange or red.
If you experience frequent urinary tract infections, your doctor may recommend a longer course of antibiotic treatment or a program with short courses of antibiotics at the outset of your urinary symptoms.
Your doctor may also recommend taking home urine tests, in which you dip a test stick into a urine sample.
For infections related to sexual activity, your doctor may recommend taking a single dose of antibiotic after sexual intercourse.
If you’re postmenopausal, your doctor may recommend vaginal estrogen therapy to minimize your chance of recurrent urinary tract infections.
For severe urinary tract infections, hospitalization and treatment with intravenous antibiotics may be necessary.
UTI Home Remedy:
Because the symptoms of a urinary tract infection mimic those of other conditions, you should see your health-care provider if you think you have a urinary tract infection. A urine test is needed to confirm that you have an infection. Self-care is not recommended.
You can help reduce the discomfort by taking the following steps:
- Follow your health-care provider’s treatment recommendations.
- Finish all antibiotic medication even if you are feeling better before the medication is gone.
- Take a pain-relieving medication.
- Use a hot-water bottle to ease pain.
- Drink plenty of water.
- Avoid coffee, alcohol, and spicy foods, all of which irritate the bladder.
