Urinary tract infection — Signs, symptoms and treatment

Urinary tract infections (UTIs) are among the most common types of infection that many people complain of, accounting for 25% of all bacterial infections.1 If you’re a woman, chances are you’ve experienced it before — at least 40% to 60% of females have had a UTI in their life.2 In some cases, this condition can recur, known as a recurring or chronic urinary tract infection.3

UTIs can cause a great deal of discomfort unless you get proper treatment. Still, there are many who are not familiar with this illness and its common symptoms. Here’s what you need to know about urinary tract infections.

What is a urinary tract infection?

When any part of your urinary system becomes infected, it is known as a urinary tract infection. One study defines it as “the microbial invasion of any tissues of the urinary tract.”4 The infection may occur in your ureter or kidneys, but most commonly manifests in the lower urinary tract, or the bladder and the urethra.5 Depending on which part of your urinary tract is infected, a UTI can be given different names, such as:6

  • Cystitis — If the infection occurs in the bladder
  • Urethritis — If it occurs in the urethra
  • Pyelonephritis — This is when a kidney is infected

UTIs are some of the most common health complaints that cause patients to seek health care. In 2007 alone, symptoms of this illness were responsible for an estimated 10.5 million doctor visits, and 2 to 3 million visits to the emergency room.7 Infants, young women and the elderly are those who are at high risk of this infection. Women in particular are 30 times more likely to develop it compared to males.8

Urinary tract infection causes

Uropathogenic gram-negative bacteria are what cause urinary tract infections to occur. These bacteria are typically found in another part of your body, such as your anus9 or the perineum.10 When they find their way into your urinary tract where they can proliferate in number, they can become resistant to your body’s host defenses, leading to colonization and infection.11

The most common bacterium that causes UTI is Escherichia coli or E. coli, which causes 90% of UTIs in “anatomically normal, unobstructed urinary tracts.”12 It is typically found in your intestines and in the gut of some animals.13

In fact, a recent study found that 80% of poultry from concentrated animal feeding operations (CAFOs) contain E. coli, and a particular strain, E. coli ST131, showed up in the meat samples and in human UTI samples.14 E. coli may can also cause other diseases like food poisoning and pneumonia.15

The second most common cause of UTIs is Klebsiella pneumoniae. It thrives in various body parts as part of your normal flora, such as your mouth, skin and intestines.16 Other pathogens that may cause urinary tract infections include:17

  • S. saprophyticus
  • Enterococcus spp.
  • Pseudomonas aeruginosa
  • Candida spp.
  • Proteus spp.
  • Enterobacter spp.

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Urinary tract infection symptoms to watch out for

UTI symptoms can depend on a person’s age, gender, the part of the urinary tract where the infection occurs, and whether or not a catheter is used.18 WebMD notes some of the common symptoms of a urinary infection:19

  • Feeling an intense need to urinate, even if you produce only a small amount of pee
  • A burning feeling every time you pee
  • Urine that’s cloudy, dark, bloody or has a strange smell
  • Pain or pressure on your back or lower abdomen
  • Feeling shaky or fatigued
  • Fever or chills — this is an indication that the infection has affected your kidneys

In some cases, signs of a urinary tract infection do not manifest. Older adults who are 70 years old or older, for instance, often have asymptomatic UTIs. According to an article in Harvard Health, “[T]he symptoms of a UTI are actually caused by the immune system’s fight against the infection, and the immune systems of older people may not fight as fiercely.”20

This can be dangerous, however, because if the UTI is untreated, it can spread to the kidneys and enter the bloodstream, which can be life-threatening.21

Are urinary tract infections contagious?

Since it’s triggered by pathogens, you may wonder if you can pass on a UTI to another person, especially through intercourse. The good news is that a UTI can’t be spread to others if the organisms that caused it are bacteria that typically colonize the person, such as E. coli. They also can’t be passed on through intercourse.22 However, sexually active women23 and people who engage in anal intercourse24 have an increased risk of getting UTIs.

You also cannot get a UTI by using the same toilet seat that a person with this infection used, as the urethra doesn’t touch the seat at all. It is, however, possible to pick up infectious organisms like E. coli from a toilet seat and have it transfer to your buttocks or a scratch or wound on your thigh, which then can spread to your genitals. This is highly unlikely, though.25

Why are women most affected by urinary tract infections?

Women have a higher risk of getting urinary tract infections than men, with an 8-to-1 ratio. An average of 50% to 60% of women will suffer from a UTI at least once in their life and, by age 24, 1 in 3 will have a UTI that will require antibiotic treatment.26 But why does this happen?

According to the American Academy of Family Physicians, women are more prone to UTIs due to their anatomy — mainly having a short urethra, which allows the bacteria a much easier access to the urinary tract. The urethra is also closer to their rectum, where pathogenic bacteria like E. coli reside.27 Other potential risk factors that may lead to urinary tract infections in women include:28

  • Being sexually active
  • Use of diaphragms and spermicidal agents
  • Low estrogen levels due to menopause — this can lead to changes in the urinary tract, potentially increasing your vulnerability to UTIs

Another significant risk factor is pregnancy. Urinary tract infections in pregnancy usually occur because of the hormonal and mechanical changes in a woman’s body. For example, having a large belly may make it difficult to perform hygienic actions, such as cleaning the genitals properly.29 A pregnant belly may also press on the bladder, making it difficult to expel all the urine. Leftover urine in the bladder may cause this infection.30

UTIs are among the most common bacterial infections during pregnancy,31 but they should never be taken lightly, and must be addressed immediately. According to a study published in the American Family Physician journal:32

“The maternal and neonatal complications of a UTI during pregnancy can be devastating. Thirty percent of patients with untreated asymptomatic bacteriuria develop symptomatic cystitis and up to 50% develop pyelonephritis. Asymptomatic bacteriuria is also associated with intrauterine growth retardation and low-birth-weight infants.

[T]he presence of UTI was associated with premature labor (labor onset before 37 weeks of gestation), hypertensive disorders of pregnancy (such as pregnancy-induced hypertension and preeclampsia), anemia (hematocrit level less than 30%) and amnionitis.”

Urinary tract infections in men: Who’s at risk?

Male urinary tract infections are more infrequent, thanks to the structure of men’s urethras. Since their urethra is longer, bacteria have to travel a long distance before reaching the urinary tract.33 But despite having a lower risk, men may still experience UTIs, although only certain age groups are prone to having it.

In young men, UTIs occur rarely, although this is not the case among infants — in the first few months of life, male babies actually have a higher risk of UTIs than girls, with a 1.5-to-1 ratio. Elderly men are also prone to UTIs; 10% of senior males aged 65 years old and above may experience this condition.34

According to Harvard Health, UTIs can develop in the urethra, prostate, bladder and kidney.35 Many of the symptoms of male urinary tract infections are similar to what women experience, and include pain while peeing, cloudy, strong-smelling urine and releasing only small amounts of pee. If you’re a male, take note of the following risk factors to avoid developing this condition:36

  • Being diabetic or having kidney stones
  • Having an enlarged prostate
  • Not being circumcised
  • Having an abnormally narrow urethra or other urinary tract abnormalities that keep the bladder from completely emptying
  • Not being able to control urination voluntarily
  • Failing to completely empty the bladder
  • Not drinking enough liquids
  • Having a past diagnosis of a UTI
  • Performing anal intercourse
  • Having a immunosuppressing illness
  • Undergoing a procedure that uses instruments on the urinary tract, such as a cystoscopy.

Urinary tract infections can also occur in children

As mentioned, UTIs can occur at any age — even during childhood. According to a study in JAMA, 1% of boys and 3% of girls will experience this problem by the time they turn 11 years old. Girls have a threefold higher risk of developing it than boys.37

The best way to tell if your child is dealing with a UTI is to have them undergo a urine test. Urinary tract infections in babies and toddlers aged 2 or younger can be difficult to pinpoint because there often are no telltale symptoms or they can’t tell you what’s wrong. Indicators also may be vague, which include:38

  • Fever (sometimes this is the only symptom)
  • Diarrhea
  • Vomiting
  • Being irritable or fussy
  • Poor appetite and weight gain

Are antibiotics still ideal for urinary tract infection treatment?

Antibiotics like ceftriaxone, fosfomycin, nitrofurantoin and cephalexin39 are usually prescribed for urinary tract infections, but they can have side effects that you may want to discuss with your doctor before taking them. Some of the side effects may include diarrhea, nausea, vomiting and rashes, as well as abdominal pain and photosensitivity.40 Additionally the bacteria treated by these antibiotics are increasingly becoming antibiotic resistant. For example, E. coli in particular is of great concern.41

One study published in Annals of Emergency Medicine reviewed the urinary cultures of patients with UTI and found that 6% of the infections were brought on by antibiotic-resistant bacteria.42 A press release from the American College of Emergency Physicians (ACEP) notes:

“The bacteria analyzed in this study were mostly E coli, that were resistant to cephalosporin antibiotics. Historically, such resistant bacteria were found in hospital-based infections. But, the authors note that they have been infecting more people outside of the hospital, particularly those with urinary tract infections.

More than 2-in-5 (44%) of the infections analyzed were community-based (contracted outside of the hospital), the highest proportion reported in the United States to date.

The authors urge some immediate changes to clinical practice such as wider use of urine culture tests and a more reliable follow-up system for patients who turn out to have a resistant bug.”

Because of the potential risks linked to antibiotics, you and your doctor may choose to opt for alternative techniques to ease your UTI. One 2018 study delves into this, suggesting there may be a way to prevent the bacteria from adhering to the bladder cells, and offering hope for treatment without the use of antibiotics.

According to the researchers, E. coli creates a chemically modified type of cellulose, phosphoethanolamine, which has a mortar-like function that allows the bacteria to attach to the bladder cells. By inhibiting this cellulose instead of directly targeting the bacteria, there may be ways to treat urinary tract infections without antibiotics.43

5 home remedies for urinary tract infections

There are certain herbs and plants that may help work against urinary tract infections. A study published in the International Journal of Drug Development and Research noted that these may work against urinary tract infections by “combating the bacteria, decreasing irritation and healing urinary tract tissues.” Some of the herbal urinary tract infection remedies the researchers highlighted include:44

Cranberry (Vaccinium Macrocarpon) — It was previously thought that cranberry’s ability to help prevent and ease UTI came from its acidity, but the real active ingredients are its proanthocyanidins (PACs), which are potent antioxidants. You can take cranberry pills or drink cranberry juice, but make sure you’re ingesting sugar-free varieties, and in moderate amounts. The authors note:

“The PACs in cranberry have a special structure (called A-type linkages) that makes it more difficult for certain types of bacteria to latch on to our urinary tract linings … By making it more difficult to cling onto the urinary tract linings, cranberry’s PACs help prevent the expansion of bacterial populations that can result in outright infection.”

One study found that when elderly adults in long-term care facilities were given cranberry capsules twice daily, the incidence of UTI decreased by 26% compared to those who only received a placebo.45

Golden seal (Ranunculaceae) — Known for its anti-inflammatory and antimicrobial properties, golden seal contains berberine, a plant alkaloid that’s been used in medicine for hundreds of years. Its direct antibacterial effect may work against a number of bacteria, including E. coli,46 both sensitive and resistant. Golden seal can be bought in tincture or powdered form; root extracts are also available, or you can drink it as tea.

Buchu (Agathosma Betulina) — This South African plant contains mucilage, flavonoids (mainly diosmin) and resins, and is said to have a flavor that’s similar to black currant. It’s known to be a diuretic and antiseptic that works for the urinary tract, and has anti-inflammatory properties that can help address urinary issues.47

Uva ursi (Arctostaphylos Uva-Ursi) — The leaves of uva ursi, also called bear berry, contain arbutin, a derivative of hydroquinone. When absorbed the stomach, it’s transformed into a substance that has antimicrobial, astringent and disinfectant properties.48 Other active ingredients include isoquercitrin and ursolic acid. As a remedy for urinary tract infections, it can be taken as a leaf extract.49

Aside from plants and herbs, using essential oils is an ideal option for treating urinary tract infections. Many herbal oils have antibacterial effects that can help combat the infection and lead you toward recovery. According to MedicalNewsToday, some recommended oils for UTIs include:50

  • Clove oil
  • Oregano oil
  • Lavender oil
  • Cinnamon oil
  • Eucalyptus oil
  • Cumin oil
  • Coriander oil

You can use these oils by mixing a few drops in a bath and then soaking in it. You can also add them to a sitz bath.51 Remember to use only high-quality essential oils and to dilute them in a safe carrier oil before use. Make sure to do a skin patch test prior to using any essential oil.

There are also talks on how drinking apple cider vinegar may help ease urinary tract infections to help make urine more acidic in hopes of “killing” the bacteria.52

And while there isn’t any scientific evidence showing ACV can cure a UTI, a 2018 study suggests that ACV may help eliminate E. coli and other types of pathogenic bacteria that lead to UTIS.53 The study authors encourage “further work on dietary ACV supplementation investigating its antimicrobial role and the constituents that could be responsible for this activity.” So, while there’s still no conclusive data, the potential of ACV to ease this type of health problem should not be easily dismissed.

How to prevent a urinary tract infection

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The most basic urinary tract infection prevention strategy is to make sure you stay hydrated. Drinking sufficient amounts of pure water every day helps your urinary tract organs to efficiently eliminate waste from your system, while ensuring you maintain vital nutrients and electrolyte levels.54

By getting enough water in your system, you also dilute your urine, helping expel it from your body much faster. This inhibits the bacteria from reaching your urinary organs and causing an infection. Read this article, “How Much Water Should I Drink?” to know the other benefits of staying hydrated. Here are other tips on how to prevent a urinary tract infection, according to WebMD:55

  • Relieve yourself frequently — By expelling urine frequently, you’re able to flush out bacteria from your bladder and urinary tract.
  • Wipe from front to back — E. coli and other UTI-causing bacteria are often found in the anus. If you wipe from back to front, there’s a chance of spreading these bacteria to your urethra and inside your urinary system.
  • Do not use feminine products that can lead to irritation — Avoid deodorant sprays, douches and scented powders.
  • Wash yourself before and after sex — This will help eliminate bacteria and keep it away from the urethra. You should also pee after intercourse, to expel any bacteria that may have entered your urinary tract.
  • Reconsider your birth control method — Spermicides, spermicide-lubricated condoms and diaphragms may cause bacterial growth, leading to UTI.
  • Take showers instead of soaking in baths — When cleaning your genitals, you should use a bidet instead of just wiping with toilet paper.
  • Opt for breathable cotton underwear — avoid wearing tight pants and undies that can trap bacteria near your urethra.

Urinary tract infection diet

What you eat matters, especially if you’re dealing with a UTI. Your diet can make or break your body’s defenses against any infection. Some foods that may help boost your immunity and help fight UTIs include:

  • Yogurt The good bacteria in yogurt may help enhance your immunity.56 Fermented vegetables like sauerkraut, kefir and fermented soy products like natto and tempeh are also wonderful sources of probiotics.
  • Fresh fruits and vegetables like peppers and broccoli The capsaicin in peppers may help support immune function,57 while broccoli contains sulforaphane, which works as an immune stimulant.58 Spinach and other leafy greens like kale are also great choices.
  • Oysters — They contain good amounts of zinc, which may help improve your immune function.59 Other zinc-rich foods include kefir, chickpeas, almonds, mushrooms and pumpkin seeds.
  • Garlic and onions Dubbed as “Mother Nature’s antibiotics,” they can help ward off any bacteria and support your immune function.60,61
  • Beta-carotene-containing foods like pumpkins, carrots and sweet potatoes One study found that getting beta-carotene from your diet can “enhance cell-mediated immune responses within a relatively short period of time.”62

There are also foods you should avoid, such as like processed products, which are often loaded with added sugars, preservatives and colorings. You should also choose organic, free-range chicken as opposed to those in concentrated animal feeding operations (CAFOs).

One study suggests that the E. coli bacteria that cause most UTI cases may be found in conventionally raised chicken, meaning the meat can “serve as a vehicle for human exposure and infection.”63 To read more about this topic, check out “Most Urinary Tract Infections Are Caused by Raw Chicken.”

Frequently asked questions (FAQs) about UTIs

Q: How do you get a urinary tract infection?

A: A UTI occurs when uropathogenic gram-negative bacteria like E. coli enter your bladder, urethra or any part of your urinary system, where they can proliferate and turn resistant to your body’s defenses.

Q: What does a urinary tract infection feel like?

A: A person with a UTI may feel pain or burning during urination. There may also be pain in their lower abdomen.

Q: Can a urinary tract infection go away on its own?

A: Yes. According to Medical News Today, some UTIs can resolve on their own or with primary care.64

Q: How do I get rid of a UTI without antibiotics?

A: You can consider home remedies like cranberry, golden seal, buchu and uva ursi. Essential oils like clove, lavender and eucalyptus may also help ease UTIs.

Q: How do doctors check if you have a urinary tract infection?

A: A urine test is the best way to determine if you have a UTI. If you experience any of the symptoms mentioned above, have your doctor conduct this diagnostic test.

Q: Will urinating after sexual intercourse help prevent a urinary tract infection?

A: It’s possible — peeing after having sex will help expel any bacteria that may have entered your urinary tract.

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