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If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.
What are UTIs?
If it turns out that the pain and discomfort you are feeling is a UTI or urinary tract infection, know this: you are certainly not alone.
In the United States, UTIs are the second most common infection of any organ system, with more than 10.5 million visits to healthcare professionals (Flores-Mireles, 2015).
In a UTI, a pathogen, like Escherichia coli (commonly known as E. coli bacteria), manages to start growing on the urinary tract. The urethra, ureters, bladder, and kidneys are all parts of your urinary tract. UTIs are categorized based on where the infection develops—either the kidneys (pyelonephritis) or the bladder (cystitis). Kidney infections are usually more serious than bladder infections (Flores-Mireles, 2015).
Common symptoms of a UTI include (CDC, 2019):
- Burning or pain while urinating (dysuria)
- Feeling the need to urinate even if you just went to the bathroom
- Needing to urinate frequently (urinary frequency)
- Lower abdominal pain or cramping
- Blood in your urine (hematuria)
UTIs are also divided into uncomplicated and complicated UTIs. Uncomplicated UTIs occur in otherwise healthy people with no abnormalities of their urinary system. However, complicated UTIs come with an associated condition that can make the infection worse, including kidney stones, urinary obstruction, kidney failure, kidney transplant, or pregnancy (Flores-Mireles, 2015).
Is an untreated UTI dangerous?
Known for their infamous symptom of burning during urination, UTIs can—to put it mildly—be a nuisance. While it is possible for the infection to go away on its own, you should always see a healthcare provider when you think you have a UTI. Most of the time, these can be treated outside of the hospital.
Since most UTIs are caused by bacteria growing uncontrollably in your urinary tract, your healthcare provider will most likely prescribe a course of antibiotics to manage the growth. If left untreated, the infection could spread and cause serious, permanent damage.
What can happen when a UTI is untreated?
Most UTIs occur in the bladder, but they can also occur anywhere along the urinary tract, like the urethra, ureters, or kidneys (NIDDK 2017). Initially, UTI symptoms usually affect your ability to urinate. You might feel a burning sensation when you urinate. Alternatively, you may feel the need to urinate even though you just went to the bathroom. In severe cases, you might even see blood in your urine (CDC, 2019). However, if your symptoms worsen, your UTI may have traveled up to the kidneys and caused a kidney infection, a severe health problem. Symptoms of a kidney infection include (NIDDK 2017):
- Pain in your lower back or your lower abdomen
- Nausea or vomiting
- High fever with or without chills
UTIs can spread from the bladder to one or both kidneys if not controlled with antibiotics (NIDDK, 2017). Kidney infections can cause high blood pressure, or worse, kidney failure. Kidney infections can also leave permanent renal scarring (NIDDK, 2017).
Complications of untreated UTIs
If left untreated, a UTI can turn into a kidney infection, also called pyelonephritis. Pyelonephritis can cause serious complications, like kidney scarring, high blood pressure, and renal failure, which is why treatment is essential. Kidney infections can also trigger an inflammatory response called sepsis that can affect numerous organ functions permanently or even cause multiple organs to fail (NIDDK, 2017).
Kidney scarring is another serious complication of an untreated UTI, especially in those UTIs that are bad enough to cause a fever. The risk of scarring goes up after multiple episodes of febrile UTIs. One study showed that after one UTI with a fever in children, the rate of renal scarring was almost 3%; however, after the second UTI with a fever, over 25% of children had renal scarring (Shaikh, 2019). Treating UTIs as soon as they are discovered may prevent kidney infection and potential kidney scarring (NIDDK, 2017).
Once the scarring happens, there is no recovering of the scarred tissue, and the kidney is permanently damaged. Scarred tissue cannot function properly and cannot filter blood as effectively—this may lead to chronic kidney disease.
What are some risk factors for UTIs?
People with vaginas are 30 times more likely to develop a UTI than people with penises due to a shorter urethra in the vagina and its proximity to the rectum. However, anyone with a urethra can develop a UTI! People with penises are less likely to develop UTIs, but when they do, they are more likely to be complicated ones. Thus, regardless of your genitalia, you should see a healthcare provider if you feel like something is wrong.
Other risk factors for developing UTI include (CDC, 2019; NIDDK, 2017):
- Age (older adults and younger children)
- Previous or recurring UTI
- Sexual activity
- Certain kinds of birth control, such as spermicide or diaphragms
- Diabetes or other conditions that affect your immune system
- Poor hygiene
- Urinary tract obstructions like kidney stones or an enlarged prostate
- Using a urinary catheter
What causes UTIs?
A wide range of pathogens may cause UTIs, but most cases tend to be due to Escherichia coli (E. coli) bacteria. Because the urethra is open to the outside world, bacteria can enter the urinary system. From there, they can travel up the urethra to the bladder, where they multiply and form a biofilm. This biofilm (bacterial colony) releases toxins and damages tissues. If left untreated, the germs can travel to the kidneys and lead to a kidney infection (pyelonephritis) and potential kidney scarring (Flores-Mireles, 2015).
How to prevent UTIs
There are some things you can do at home to avoid getting a UTI.
Urinating is a natural way your body flushes out germs from your urinary tract. That’s why you need to go to the bathroom when you feel the urge— don’t hold it in, and don’t rush it out. The American Urological Association (AUA) recommends drinking plenty of water (nearly half a gallon daily) to ensure that your urinary system has plenty of fluid. Water is the healthiest place to hit your fluid intake (AUA, 2019).
You may have heard the advice to pee after sex—this is excellent advice! If you have penetrative or even oral sex, it’s a good idea to urinate afterward to clean any unwanted germs that may have moved around during your business. Uropathogenic E. coli is known to hang out around the rectum and genital area, and sexual intercourse could push E. coli into the urethra (Foxman, 2013). It’s also been suggested to avoid going from anal intercourse to vaginal intercourse without washing the penis, as doing so could directly transfer germs into the urinary tract (Lema, 2018).
After talking with your healthcare provider, you might also consider vitamin D supplements. In one study, researchers found that premenopausal women with recurrent UTIs also had lower vitamin D levels than women who did not experience recurring UTIs. Vitamin D plays a role in boosting your immune system (Nseir, 2013). The data on cranberry is mixed—some studies show that cranberry juice or cranberry supplements may prevent recurrent UTIs in otherwise healthy women (Fu, 2017). Others show no benefit (Jepson, 2012).
How are UTIs treated
Do not rely on home remedies as UTI treatment. There are currently no known home remedies that can treat a UTI. Seek out professional medical attention if you think you have a UTI. Your provider may perform testing like a urine test (urinalysis) or urine culture to confirm the diagnosis.
To treat UTIs, healthcare providers typically prescribe a course of antibiotics. Any medication comes with the risk of side effects—be sure to discuss these with your healthcare provider. Most side effects of antibiotics are mild, like a rash or an upset stomach. However, in some instances, antibiotics can lead to more serious health problems like Clostridium difficile (C. diff) diarrhea or antimicrobial-resistant infections. (CDC, 2019)
It’s important to take your antibiotics exactly as your healthcare provider prescribes them. Pathogens like bacteria can develop microbial drug resistance. Microbial drug resistance means that pathogens can develop a resistance to the same medications we use to fight them, meaning that our medicines can be rendered useless. This forces scientists to search for new drugs because ours no longer work—a very costly and time-consuming venture.
Here are some tips the Centers for Disease Control and Prevention published to help fight this problem (CDC, 2020):
- Do not share your antibiotics. Your healthcare provider prescribed them to you after considering a handful of factors that are specific to you and no one else.
- Do not take antibiotics prescribed for someone else. Taking someone else’s antibiotics could make you even sicker, on top of your pre-existing infection.
- Do not save them for later—take all of the pills and finish the antibiotic course, even if you feel better. The pill count is specifically designed to ensure that any remnant germs are dead. Just because you feel better does not mean all the pathogens are gone.
- If you have any questions or concerns about antibiotic side effects, seek medical advice from your healthcare provider rather than just stopping the medication.
- American Urology Association (AUA) – Urology Care Foundation: Understanding UTIs Across the Lifespan (2016). Retrieved on 1 August 2020 from https://www.urologyhealth.org/patient-magazine/magazine-archives/2016/summer-2016/understanding-utis-across-the-lifespan
- American Urology Association (AUA) – Urology Care Foundation: What is a Urinary Tract Infection in Adults (2019). Retrieved on 1 August 2020 from https://www.urologyhealth.org/urologic-conditions/urinary-tract-infections-in-adults
- Centers for Disease Control and Prevention. (2019). Urinary Tract Infection. Retrieved August 01, 2020, from https://www.cdc.gov/antibiotic-use/community/for-patients/common-illnesses/uti.html
- Centers for Disease Control and Prevention. (2020). Antibiotic Resistance Questions. Retrieved August 01, 2020, from https://www.cdc.gov/antibiotic-use/community/about/antibiotic-resistance-faqs.html
- Flores-Mireles, A., Walker, J., Caparon, M., & Hultgren, S. (2015). Urinary tract infections: Epidemiology, mechanisms of infection and treatment options. Nature Review Microbiology, 13(5), 269-284. doi:10.1038/nrmicro3432 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4457377/
- Foxman, B., & Buxton, M. (2013). Alternative Approaches to Conventional Treatment of Acute Uncomplicated Urinary Tract Infection in Women. Current Infectious Disease Reports, 25(2), 124-129. doi:10.1007/s11908-013-0317-5 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3622145/
- Fu, Z., Liska, D., Talan, D., & Chung, M. (2017). Cranberry Reduces the Risk of Urinary Tract Infection Recurrence in Otherwise Healthy Women: A Systematic Review and Meta-Analysis. The Journal of Nutrition, 147(12), 2282–2288. https://doi.org/10.3945/jn.117.254961
- Jepson, R. G., Williams, G., & Craig, J. C. (2012). Cranberries for preventing urinary tract infections. The Cochrane database of systematic reviews, 10(10), CD001321. https://doi.org/10.1002/14651858.CD001321.pub5
- Lema, V., & Lema, A. (2018). Sexual Activity and the Risk of Acute Uncomplicated Urinary Tract Infection in Premenopausal Women: Implicationsfor Reproductive Health Programming. Obstet Gynecol Int J, 9(1). doi:10.15406/ogij.2018.09.00303 https://medcraveonline.com/OGIJ/sexual-activity-and-the-risk-of-acute-uncomplicated-urinary-tract-infection-in-premenopausal-women-implicationsfor-reproductive-health-programming.html
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) – Bladder Infection (Urinary Tract Infection) in Adults. (2017) Retrieved August 01, 2020, from https://www.niddk.nih.gov/health-information/urologic-diseases/bladder-infection-uti-in-adults/all-content
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) – Kidney Infections (Pyelonephritis). (2017, April). Retrieved August 01, 2020, from https://www.niddk.nih.gov/health-information/urologic-diseases/kidney-infection-pyelonephritis/all-content
- Novelli, A., & Rosi, E. (2017). Pharmacological properties of oral antibiotics for the treatment of uncomplicated urinary tract infections. Journal of Chemotherapy, 29(Sup1), 10-18. doi:10.1080/1120009x.2017.1380357 https://www.tandfonline.com/doi/full/10.1080/1120009X.2017.1380357
- Nseir, W., Taha, M., Nemarny, H., & Mograbi, J. (2013). The association between serum levels of vitamin D and recurrent urinary tract infections in premenopausal women. International Journal of Infectious Diseases, 17(12), 1121-1124`. doi:https://doi.org/10.1016/j.ijid.2013.06.007 https://www.sciencedirect.com/science/article/pii/S1201971213002191
- Shaikh, N., Haralam, M. A., Kurs-Lasky, M., & Hoberman, A. (2019). Association of Renal Scarring With Number of Febrile Urinary Tract Infections in Children. JAMA pediatrics, 173(10), 949–952. Advance online publication. https://doi.org/10.1001/jamapediatrics.2019.2504
- Urology Care Foundation. (2019). What is a Urinary Tract Infection (UTI) in Adults? Retrieved August 01, 2020, from https://www.urologyhealth.org/urologic-conditions/urinary-tract-infections-in-adults
- Wennerström, M., Hansson, S., & Jodal, U. (2000). Renal Function 16 to 26 Years After the First Urinary Tract Infection in Childhood. Archives of Pediatric and Adolescent Medicine, 154(4), 339-345. doi:10.1001/archpedi.154.4.339 https://jamanetwork.com/journals/jamapediatrics/fullarticle/348983