June 29, 2020

What to know about urinary tract infections (UTIs)

by

They are more common in women than men. Sometimes urinary tract infections bring surprises.

Urinary tract infections (UTIs) are infections in the bladder or kidney. Usually people get the infection in the lower part of the urinary tract. The Vanderbilt Health Walk-In Clinics treat many people for UTIs. Candice Lewis, FNP, one of the clinic healthcare providers, explains this common condition and what to do if you’re feeling symptoms.

Many types of bacteria can cause UTIs. E coli are a common cause because they live in the colon and can easily travel to the urinary tract. Other bacteria can also cause UTIs.

A UTI typically causes painful urination, or the need to urinate frequently, or possibly not urinating often enough, Lewis said. There can be blood in the urine. In women, a UTI can cause inflammation of the bladder, causing constant pelvic pain. The infection can also move up the urinary tract to infect the kidneys, which causes pain in the side or lower back, fever and possibly vomiting.

UTIs are rare in men, so if a man has these symptoms, he should see a doctor or go to a walk-in clinic promptly, because this kind of pain could be from a different problem, such as a sexually transmitted disease. A man with a UTI may also have penile discharge, redness or swelling, or difficulty starting to urinate. But a simple UTI is not typical in men, Lewis said – usually their symptoms are due to a problem with their prostate gland or some other condition.

How UTIs are diagnosed and treated

At Vanderbilt’s walk-in clinics, staff will collect a urine sample and check it for infection using a dipstick test. This might be the only test needed to check for a UTI. If the test indicates an infection, the patient will be given antibiotics. Symptoms usually go away within 48 hours, Lewis said. In some cases, the urine sample may also be sent to a lab for culture, to see which bacteria is causing the infection and whether it is a type that’s resistant to certain antibiotics. This test takes two to three days. The patient’s antibiotic may be changed after this is completed.

If symptoms continue despite the antibiotics, Lewis advises that the patient should follow up with the clinic or a primary care doctor. Ongoing urinary symptoms can be signs of other problems, she said, such as cancer, prostate problems, kidney stones or sexually transmitted infections that may need further evaluation and treatment. Sometimes a referral to a urologist is needed.

When to go to a walk-in clinic vs. the emergency department for UTI symptoms

Walk-in clinic staff can test anyone for a UTI, but if an infection is severe, the person may need to go to the hospital, Lewis said. Anyone who believes they have a UTI but cannot produce a urine specimen should go to the emergency room. A severe UTI may cause urinary retention, meaning the bladder doesn’t empty — especially in men with enlarged prostate; these patients probably need a urinary catheter.

Anyone with urination-related symptoms, fever, back pain and vomiting should also go to the ER, Lewis advised. These are signs of a kidney infection or kidney stone and may require treatment with IV medications. Another group of patients needing special care are infants infants and toddlers. If you believe your baby or toddler has a UTI, you should take your child to the pediatrician or the emergency department, Lewis said.

Elderly patients can have atypical symptoms with UTIs, Lewis noted — such as confusion, feeling unusually tired or not eating well. If an elderly family member is showing such symptoms they will likely need evaluation in the emergency room.

How to prevent UTIs

Drinking lots of water keeps the urinary tract flushed, so the bacteria that occur there naturally don’t have a chance to build up. Avoid consuming too much caffeine and spicy foods, Lewis said; they can also contribute to UTIs.

Conventional wisdom advises people to drink cranberry juice to get rid of a UTI. Cranberry juice can in fact decrease some bacteria’s ability to reproduce in the urinary tract, Lewis said, so it’s possible that drinking cranberry juice can prevent a buildup of bacteria from becoming a full-blown infection. But usually once someone is feeling the symptoms of a UTI, they need antibiotics to cure it. It doesn’t hurt to drink cranberry juice, but the best treatment besides antibiotics is drinking a lot of water, to flush the urinary tract.

Who is most likely to get UTIs

UTIs are most common in women, starting in their teen years. There is also an increased risk of UTIs among those age 65 and older, for numerous reasons, Lewis explained. Their immune systems can be less responsive. Decreased estrogen production puts older women more at risk for bacteria to thrive in the urinary tract. Older men tend to get more swelling in the prostate, leading to pain that can also be a sign of a UTI. An enlarged prostate can make it difficult or impossible to empty the bladder, which makes it easier for bacteria to multiply in the urine and cause a UTI.

In children, especially girls, UTIs can be associated with poor hygiene when they go to the bathroom, such as not wiping themselves correctly, or if they hold their urine for long periods of time.

Finally, Lewis pointed out, anyone who has frequent UTIs should see their primary care doctor or a urologist. Repeated UTIs can be a sign of something else, such as a sexually transmitted disease. In children, frequent UTIs could mean there is a stricture (a narrowing) in the ureter, which a specialist can diagnose.

Vanderbilt Health operates a variety of walk-in clinics in Middle Tennessee, including some with Williamson Medical Center, to take care of everything from sprains and sport injuries to flu shots, fevers, coughs and rashes. Search locations and learn more about the conditions treated there.