Do You Have a Urinary
Tract Infection?

A urinary tract infection (UTI) is an infection which may involve anywhere in the urinary system from the kidney to the bladder to the urethra. The vast majority of UTIs occur in adult women, approximately twenty percent of whom will experience a UTI sometime in their lives. Most UTIs are caused by Escheria coli, a bacteria which normally lives in the gastrointestinal tract.

Bladder infections are known as cystitis and are the most common form of UTI. People with cystitis typically experience a strong and frequent desire to urinate, burning or pain when urinating, and strong-smelling, bloody, or cloudy urine. In addition, they may have pain in the lower abdomen.

Occuring less frequently, UTIs called pyelonephritis may develop in the kidneys or upper urinary tract. Symptoms of pyelonephritis are more serious and may include fever, shaking chills, nausea, vomiting, and pain in the back or side. If left untreated, pyelonephritis can lead to kidney damage or an infection in the blood.

Many factors can make a person at increased risk for a UTI. A blockage of the urinary tract – like a kidney stone or, in men, an enlarged prostate gland – can increase the risk of infection. Catheters or tubes in the bladder can also lead to infection. People with diabetes or other diseases that weaken the immune system are particularly prone to UTIs. Women are at substantially greater risk than men, perhaps because they have a shorter urethra (the tube leading out of the body from the bladder). Many women are particularly prone to UTIs after sexual intercourse, particularly if they use a diaphragm or condoms with spermicidal foam. Finally, women who have gone through menopause are at increased risk of UTI as the tissues of the vagina and lower urinary tract become thinner and more fragile in the absence of estrogen.

If you suspect that you have a UTI, you should contact your doctor. He or she will test a sample of your urine for white blood cells and bacteria. In some cases, your urine may be sent for a culture to determine the precise type of bacteria causing the UTI as well as the most appropriate treatment.

UTIs are treated with antibiotics. For young, otherwise healthy women with cystitis, a three-day course is usually all that is required. Some people – including diabetics, most men, and people with a blockage in the urinary tract, and pregnant women – may need longer treatment. People with more severe infections and symptoms – such as nausea or vomiting which may prevent them from taking antibiotic pills, high fever, or dehydration – may require hospitalization and intravenous antibiotics. Pyridium is a drug that can decrease the pain or burning associated with UTIs. It can turn urine and tear fluid orange and should not be taken for more than three days.
You can take some steps to prevent UTIs. Don’t hold on to your urine but urinate when you need to. Drink enough water. Urinate after sexual intercourse. Wear underwear with a cotton crotch. Don’t use scented douches or feminine hygiene sprays. After urinating or having a bowel movement, wipe from front to back. Cranberry juice may help to fight bacteria but should not be taken by people who are taking the blood thinner warfarin (Coumadin).

Some women get frequent UTIs and may benefit from a specialized antibiotic regimen. A low-dose antibiotic may be taken every day for six months or longer. Alternatively, a woman might take a low-dose antibiotic two or three times a week. A single dose of antibiotic might be taken after sexual intercourse. Some women with frequent UTIs might be provided with a supply of antibiotics that they can use whenever typical symptoms develop.

Dr. McMahon, a graduate of Yale University and the University of Pittsburgh School of Medicine, is board certified in Internal Medicine. She is a member of the American College of Physicians and the Allegheny County and Pennsylvania Medical Societies. She is in solo practice in the North Hills of Pittsburgh.