A burning sensation while peeing, bladder pain, uncomfortable urgency and cloudy, foul urine — few things are less pleasant than a urinary tract infection. It’s even worse when your kidneys are affected and fever, lower back pain, vomiting and nausea arise. For some women, UTIs are the aggravating aftermath of having sex. In men, prostate issues can lead to urine pools in the bladder, ideal for bacteria growth. In seniors, unsuspected UTIs may trigger sudden confusion and bouts of dementia that can take weeks from which to fully recover. Here’s what you need to know to spot, treat, and possibly prevent urinary tract infections.
No Honeymoon
The urinary tract or system consists of the urine-producing kidneys; the pair of tubes called the ureters; and the bladder, which stores urine and empties it from the body through the urethra.
Among younger adults, UTIs are more common in women, for a variety of reasons, says Dr. Michael O’Leary, a urologist at Brigham and Women’s Hospital. “Some women who get repeat infections can tell they are associated with sexual activities,” he says. “But it’s not the sexual activity itself that’s causing it.”
Instead, he says, women can thank their anatomy. “The female urethra is very short. It’s a couple centimeters long, and bacteria can traverse it pretty easily, especially with intercourse,” he says. “But we don’t consider it a sexually transmitted disease because it’s usually the woman’s own bacteria, rather than bacteria from a partner.”
“Honeymoon cystitis” is the charming nickname for UTIs caused by frequent sexual activity. (Cystitis means bladder inflammation.) Young women are at higher risk for developing urinary tract infections if they’ve had a previous UTI, use birth control with spermicidal foams or gels, have diabetes or are pregnant.
If you think you have a urinary tract infection, see your health care provider. You’ll be asked to provide a urine sample, which will be checked for white blood cells — a sign of infection. A urine culture will confirm whether bacteria is the culprit. Because similar symptoms can result from a yeast infection or from inflammation of the urethra, it’s important to rule out other causes.
Treatment for “common, garden-variety” urinary tract infections is straightforward and hasn’t changed much in the past 10 or 20 years, O’Leary says: “Physicians treat [patients] with oral antibiotics for a short period of time, and the symptoms resolve and they go on their way.”
Staving Off UTIs
Drinking plenty of water may help prevent repeat UTIs by keeping the bladder empty and free of bacteria. Cranberries can help, too. That’s not just folklore, O’Leary says: “There’s pretty good data that there’s something in cranberry, the fruit and the juice, that is bacteriostatic — that prevents the growth of bacteria.” There are less data to support cranberry extracts, he says.
As a rule, taking antibiotics to prevent UTIs — rather than treat them — is not recommended. Preventive antibiotics may be considered if a patient has more than two UTIs in the course of a year, O’Leary says.
Looks Like UTI …
Jennifer Zuzelski, 44, has had a “touchy bladder” since her teens, with occasional flare-ups of urinary frequency and urgency. Yet when she’d go in for a urine culture, signs of infection were absent. Sometimes she was treated with antibiotics anyway. It wasn’t until nine years ago, after the birth of her son, that she got the right diagnosis. Zuzelski has interstitial cystitis, a condition involving chronic inflammation of the bladder lining.
While interstitial cystitis is often confused with urinary tract infections and overlap exists, the two are quite different, says Zuzelski, information specialist for the nonprofit Interstitial Cystitis Association. Believed to be an autoimmune condition, interstitial cystitis can be extremely painful and debilitating in severe cases.
“Diet plays a huge role in keeping IC under control,” she says, adding that acidic foods and beverages are “fire” for sensitive bladders. Although it can help for UTIs, “cranberry juice is completely off the table” with interstitial cystitis, she says.
UTI Misconceptions
With urinary tract infections, patients who believe it’s a matter of cleanliness may feel needless embarrassment. Hygiene is hardly ever the issue in UTIs, O’Leary says. “That’s a common misunderstanding,” he explains. “Urinary tract infections don’t come from poor hygiene.”
Bacteria in the urine (or bacteriuria) does not equal infection, he emphasizes. Unfortunately, he says, some patients receive antibiotics they don’t need because bacteria show up in routine urine samples, even though they’re not having any symptoms.
Void to Avoid?
One “reasonable” strategy to prevent UTIs is voiding (urinating) after sexual intercourse, O’Leary says, particularly for women who know there’s a connection for them. Being prone to UTIs is “just luck of the draw,” he says. “There’s no good way to prevent infections — they occur. Some people are more prone to them than others because they don’t shed bacteria for some reason.”
Older men and women can be vulnerable to UTIs for a different reason: Their bladders may not empty as well. “Stagnant urine, or urine that’s not emptied properly from the bladder, just increases the risk of infection,” he says. In men, bladder-outlet obstruction can occur and is most commonly related to benign prostate disease.
“Try to empty the bladder as well as you can,” O’Leary recommends. “For older men, that sometimes means when they’re done, they’re not actually done. So stand there for an extra minute and try to get properly empty.” Some older women may also not empty their bladders quite as well as they used to, and they’re not aware of it, O’Leary says, adding that this is something a physician can diagnose.
Older Adults — Different Effects
For seniors, unsuspected and untreated UTIs can cause alarming changes in mental status. People who were mentally clear may show signs of confusion and even dementia. Those with existing dementia may worsen. And UTIs can easily be missed. “Frequently in elderly folks, the only manifestation of a urinary infection is change in mental status,” O’Leary says. In that case, he says, bacteria in the urine would be a reason to treat with antibiotics, even without physical symptoms.
Once treated, recovery from UTI tends to be much slower and gradual for seniors. “Older folks don’t heal as readily as younger people do,” O’Leary says. And they’re more likely to have conditions such as diabetes or peripheral vascular disease that prevent quick healing, he adds. “It’s not surprising they don’t bounce back as quick.”
If you notice sudden, unexpected confusion in an older relative, see a health care provider immediately and ask about the possibility of UTI.
More from U.S. News
Easy Ways to Protect Your Aging Brain
How College Students Can Avoid Getting Sick
10 Embarrassing Problems You Don’t Want to Tell Your Doctor, But Should
The Burning Truth About Urinary Tract Infections originally appeared on usnews.com
