A urinary tract infection (UTI) is an infection involving the kidneys, ureters, bladder, or urethra.
These are the structures that urine passes through before being eliminated from the body.
- The kidneys are a pair of small organs that lie on either side of the spine at about waist level. They have several important functions in the body, including removing waste and excess water from the blood and eliminating them as urine. These functions make them important in the regulation of blood pressure. Kidneys are also very sensitive to changes in blood sugar levels and blood pressure. Both diabetes and hypertension can cause damage to these organs.
- Two ureters, narrow tubes about 10 inches long, drain urine from each kidney into the bladder.
- The bladder is a small saclike organ that collects and stores urine. When the urine reaches a certain level in the bladder, you experience the sensation that you have to void, then the muscle lining the bladder can be voluntarily contracted to expel the urine.
- The urethra is a small tube connecting the bladder with the outside of the body. A muscle called the urinary sphincter, located at the junction of the bladder and the urethra, must relax at the same time the bladder contracts to expel urine.
Any part of this system can become infected. As a rule, the farther up in the urinary tract the infection is located, the more serious it is.
- The upper urinary tract is composed of the kidneys and ureters. Infection in the upper urinary tract generally affects the kidneys (pyelonephritis), which can cause fever, chills, nausea, vomiting, and other severe symptoms.
- The lower urinary tract consists of the bladder and the urethra. Infection in the lower urinary tract can affect the urethra (urethritis) or the bladder (cystitis).
Urinary tract infections are usually referred to as simple or complicated.
- Simple infections occur in healthy urinary tracts and do not spread to other parts of the body. They usually go away readily with treatment.
- Complicated infections are caused by anatomic abnormalities, spread to other parts of the body, are worsened by underlying medical conditions, or are resistant to many antibiotics. They are more difficult to cure.
In the United States, urinary tract infections account for more than 7 million visits to medical offices and hospitals each year.
- Urinary tract infections are much more common in adults than in children, but about 1%-2% of children do get urinary tract infections. Urinary tract infections in children are more likely to be serious than those in adults and should not be ignored (especially in younger children).
- Urinary tract infection is the most common urinary tract problem in children besides bedwetting.
- Urinary tract infection is second only to respiratory infection as the most common type of infection.
- These infections are much more common in girls and women than in boys and men younger than 50 years of age. The reason for this is not well understood, but anatomic differences between the genders (a shorter urethra in women) might be partially responsible.
- About 40% of women and 12% of men have a urinary tract infection at some time in their life.
Lower urinary tract infection (cystitis): The lining of the urethra and bladder becomes inflamed and irritated.
- Dysuria: pain or burning during urination.
- Frequency: more frequent urination (or waking up at night to urinate, sometimes referred to as nocturia); often with only a small amount of urine.
- Urgency: the sensation of having to urinate urgently.
- Hesitancy: the sensation of not being able to urinate easily or completely (or feeling that you have to urinate but only a few drops of urine come out).
- Cloudy, bad-smelling, or bloody urine.
- Lower abdominal pain.
- Mild fever (less than 101 F), chills, and "just not feeling well" (malaise).
Upper urinary tract infection (pyelonephritis): Symptoms develop rapidly and may or may not include the symptoms for a lower urinary tract infection.
- Fairly high fever (higher than 101 F).
- Shaking chills.
- Flank pain: pain in your back or side, usually on only one side at about waist level.
In newborns, infants, children, and elderly people, the classic symptoms of a urinary tract infection may not be present. Other symptoms may indicate a urinary tract infection.
- Newborns: fever or hypothermia (low temperature), poor feeding, jaundice.
- Infants: vomiting, diarrhea, fever, poor feeding, not thriving.
- Children: irritability, eating poorly, unexplained fever that doesn't go away, loss of bowel control, loose bowels, change in urination pattern.
- Elderly people: fever or hypothermia, poor appetite, lethargy, change in mental status.
Pregnant women are at increased risk for an UTI. Typically, pregnant women do not have unusual or unique symptoms. If you are pregnant, your urine should be checked during prenatal visits because an unrecognized infection can causepregnancy complications or miscarriage.
Although most people have symptoms with a urinary tract infection, some do not.
The symptoms of urinary tract infection can resemble those of sexually transmitted diseases.
The urine is normally sterile. An infection occurs when bacteria get into the urine and begin to grow. The infection usually starts at the opening of the urethra where the urine leaves the body and moves upward into the urinary tract.
- The culprit in at least 90% of uncomplicated infections is a type of bacteria called Escherichia coli, better know as E. coli. These bacteria normally live in the bowel (colon) and around theanus.
- These bacteria can move from the area around the anus to the opening of the urethra. The two most common causes of this are poor hygiene and sexual intercourse.
- Usually, the act of emptying the bladder (urinating) flushes the bacteria out of the urethra. If there are too many bacteria, urinating may not stop their spread.
- The bacteria can travel up the urethra to the bladder, where they can grow and cause an infection.
- The infection can spread further as the bacteria move up from the bladder via the ureters.
- If they reach the kidney, they can cause a kidney infection (pyelonephritis), which can become a very serious condition if not treated promptly.
The following people are at increased risk of urinary tract infection:
- People with conditions that block (obstruct) the urinary tract, such as kidney stones.
- People with medical conditions that cause incomplete bladder emptying (for example, spinal cord injury or bladder decompensation after menopause).
- People with suppressed immune systems: Examples of situations in which the immune system is suppressed are AIDS and diabetes. People who takeimmunosuppressant medications such as chemotherapy for cancer also are at increased risk.
- Women who are sexually active: Sexual intercourse can introduce larger numbers of bacteria into the bladder. Infection is more likely in women who have frequent intercourse. Infection attributed to frequent intercourse is nicknamed "honeymoon cystitis". Urinating after intercourse seems to decrease the likelihood of developing a urinary tract infection.
- Women who use a diaphragm for birth control.
- Men with an enlarged prostate: Prostatitis or obstruction of the urethra by an enlarged prostate can lead to incomplete bladder emptying, thus increasing the risk of infection. This is most common in older men.
- Males are also less likely to develop UTIs because their urethra (tube from the bladder) is longer. There is a drier environment where a man's urethra meets the outside world, and fluid produced in the prostate can fight bacteria.
- Breastfeeding has been found to decrease the risk for urinary tract infections.
The following special groups may be at increased risk of urinary tract infection:
- Very young infants: Bacteria gain entry to the urinary tract via the bloodstream from other sites in the body.
- Young children: Young children have trouble wiping themselves and washing their hands well after a bowel movement. Poor hygiene has been linked to an increased frequency of urinary tract infections.
- Children of all ages: Urinary tract infection in children can be (but is not always) a sign of an abnormality in the urinary tract, usually a partial blockage. An example is a condition in which urine moves backward from the bladder up the ureters (vesicoureteral reflux).
- Hospitalized patients or nursing home residents: Many of these individuals are catheterized for long periods and are thus vulnerable to infection of the urinary tract. Catheterization means that a thin tube (catheter) is placed in the urethra to drain urine from the bladder. This is done for people who have problems urinating or cannot reach a toilet to urinate on their own.
The usual treatment for both simple and complicated urinary tract infections is antibiotics. The type of antibiotic and duration of treatment depend on the circumstances.
Lower urinary tract infection (cystitis)
- In an otherwise healthy young female, a three-day course of antibiotics is usually enough. Some providers prefer a seven-day course of antibiotics. Occasionally, a single dose of an antibiotic is used. Your health-care provider will determine which of these options is best for you.
- Adult males with a UTI require seven to 14 days of antibiotics. If the prostate is also infected (prostatitis), four weeks or more of antibiotic treatment may be required.
- Adult females with potential for or early involvement of the kidneys, urinary tract abnormalities, or diabetes are usually given a five- to seven-day course of antibiotics.
- Children with uncomplicated cystitis are usually given a 10-day course of antibiotics.
- To alleviate burning pain during urination,phenazopyridine (Pyridium) or a similar drug, can be used in addition to antibiotics for one to two days.
Upper urinary tract infection (pyelonephritis)
- Young, otherwise healthy females with symptoms of pyelonephritis can be treated as outpatients. They may receive IV fluids and antibiotics or an injection of antibiotics in the emergency department, followed by 10-14 days of oral antibiotics. They should follow up with their health-care provider in one to two days to monitor improvement.
- If you are very ill, dehydrated, or unable to keep anything in your stomach because of vomiting, an IV will be inserted into your arm. You will be admitted to the hospital and given fluids and antibiotics through the IV until you are well enough to switch to an oral antibiotic.
- A complicated infection may require treatment for several weeks.
You may be hospitalized if you have symptoms of pyelonephritis and any of the following:
- appear very ill;
- are pregnant;
- have not gotten better with outpatient antibiotic treatment;
- have underlying diseases that compromise the immune system (diabetes is one example) or are taking immunosuppressive medication;
- are unable to keep anything in your stomach because of nausea or vomiting;
- had previous kidney disease, especially pyelonephritis within the last 30 days;
- have a device such as a urinary catheter in place;
- have kidney stones.
Urethritis in men and women can be caused by the same bacteria as sexually transmitted diseases (STDs). Therefore, people with symptoms of STDs (vaginal or penile discharge for example) should be treated with appropriate antibiotics.
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.
- Quit smoking. Smoking irritates the bladder and is known to cause bladder cancer.