Causes of Urinary Tract Infections and What to Do?

What are the symptoms of a urinary tract infection?

UTI symptoms vary depending on age, gender, and whether the infection is in the lower (bladder and urethra) or upper (kidneys and ureters) urinary tract. Urinary tract infections can be life threatening and if symptoms warrant, medical help should be sought immediately. Symptoms or signs of a urinary tract infection may include:

UTI symptoms in adults

  • urinary urgency

  • frequent or painful, burning sensation when urinating (dysuria)

  • pain in the back, side (under the ribs) and groin

  • chills and high fever

  • nausea and vomiting

  • cloudy urine

  • blood in the urine (hematuria) which can sometimes only be seen by a microscope

  • foul or strong-smelling urine (caused by pyuria - pus or bacteria in the urine)

  • a general feeling of malaise.

  • a feeling that the bladder is not fully emptied after urinating

  • Post-void urine dribbling

  • Urinary hesitation (feel like voiding but can’t)

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UTI Symptoms in Children

Very young children (less than 2 years old) may only have a high fever and be unable to relate any discomfort or pain they feel although an adult may detect strong-smelling urine in the diaper, lack of appetite and irritability. Young children may experience bed-wetting in addition to other symptoms.

UTI Symptoms in the Elderly and Catheter Users

Elderly people or people with catheters may wet themselves, exhibit shivering or shaking, show signs of confusion, muddled speech, or have visions.

UTI Symptoms in Pregnant Women

Diabetics or people with a weak immune system are at high risk for UTIs. Pregnant women with UTIs should see their health care provider immediately as it could affect the unborn child. A kidney infection in a pregnant woman can be very serious.

Recognizing Upper Urinary Tract Infections

Upper urinary tract infections that affect the kidneys and ureters are usually more serious. Symptoms indicating that the kidneys and ureters may be involved include high fever, agitation, confusion, restlessness, back pain, pain on the sides, chills with shivering, nausea and vomiting.

The Urinary Tract and Its Importance

The urinary tract is the body’s drainage system. It includes two kidneys, two ureters, a bladder, and a urethra. Healthy kidneys work 24/7 to clean the blood and act as the body’s main filter, cleaning about 150 quarts of blood daily by pulling water and waste from the blood forming about 1 to 2 quarts of urine that is passed through the ureters into the bladder where it is then removed from the body through the urethra. Kidneys control fluid balance, electrolyte levels, waste removal, and the regulation of blood pressure as well as red blood cell counts. When the kidneys are damaged, diseased or infected, they do not function well and can cause major problems for the body.

Understanding Urinary Tract Infections

A urinary tract infection (UTI) is a bacterial infection of any part of the urinary system, including the kidneys, ureters, bladder or urethra. Most UTIs begin when bacteria enter the urinary tract through the urethra and spread to the bladder, and if untreated, to the ureters and kidneys. It is most common in women because the urethra is shorter than in men, shortening the distance the bacteria must travel to reach the bladder. Other risk factors for women include using certain types of birth control, such as diaphragms and spermicidal agents, being sexually active with more than one partner, and menopause with its declining estrogen that causes changes to the urinary tract.

Prevention and Risk Factors for UTIs in Women

For women to avoid UTIs, they should wipe from the front to the back after a bowel movement, helping to move bacteria away from the urethra opening. Urinating after sex may also help flush out bacteria in the urethra.

Types of Urinary Tract Infections

There are three types of urinary tract infections: urethritis, cystitis, and pyelonephritis:

  • Urethritis is an infection of the urethra, the hollow tube that drains urine from the bladder to outside the body.

  • Cystitis is a bacterial infection in the bladder that has moved up from the urethra.

  • Pyelonephritis is a sudden and severe kidney infection of one or both kidneys caused by bacteria that may have traveled up from the bladder through the ureters or it can be caused by a virus. Pyelonephritis causes the kidneys to swell and can cause permanent damage.

Frequent bladder infections or structural problems in the urinary tract can lead to kidney infections and does in about 1 of every 30 cases. Urine should flow only in one direction—from the kidneys to the bladder. If the flow of urine is blocked by kidney stones, tumors inside or outside the urinary tract or if there are structural problems of the urinary tract, urine may flow in the wrong direction causing infection.

Complications and Risks of Untreated UTIs

If a urinary tract infection is left untreated, serious repercussions are possible. An untreated UTI can cause a condition called sepsis, which occurs when the body tries to fight an infection but ends up causing too much inflammation. Thirty percent of sepsis cases are caused by UTIs. Sepsis is a medical emergency and must be treated as such. Also untreated urinary tract infections can lead to kidney damage, kidney disease, high blood pressure, or kidney failure.

Diagnosis and Tests for UTIs

Your health care provider will need a general health/medical history and ask about your symptoms to make a proper diagnosis since there are many problems in the pelvis and abdomen that can cause symptoms that look like those of UTIs. A physician will perform a physical exam to test your abdomen for pain and tenderness and may require the following:

  • a urine sample to be tested for signs of infection, bacteria, and high counts of white blood cells

  • blood cultures to tell if infection has spread to the blood

  • a CT scan (computed tomography) showing detailed 3D images of the urinary tract and kidneys to detect for problems such as blockages

  • a kidney ultrasound to check kidneys and ureters for wounds, stones or other blockages of the urinary tract

  • VCUG (Voiding cystourethrogram), which is an x-ray image of the bladder and urethra taken while bladder is full and during urination, using contract dye to test for problems in the urethra and bladder

  • DRE (digital rectal examination for men), which is a physical exam of the prostate to see if a swollen prostate is blocking the neck of the bladder

  • DMSA (dimercaptosuccinic acid scintigraphy) test using small amounts of radioactive material to look closely at how well the kidneys work, if they are infected, scarred or damaged

The suggested treatment will be based on a clear diagnosis of the problem. Most UTIs and kidney infections are treated with antibiotics taken as a pill unless the infection is very advanced or is accompanied by vomiting. Then, a visit may be necessary to receive antibiotics through and IV (intravenously). If the infection was caused by any kind of blockage, surgery may be indicated.

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