Frequent urination with an accompanying burning sensation can signal a urinary tract infection, and anyone who’s ever had one will say it’s an aggravating condition that’s not only inconvenient because of repeated trips to the bathroom, but it can be painful as well.
Dr. Carin Nielsen, with Little Traverse Primary Care in Harbor Springs, helped clarify the causes of urinary tract infections, symptoms and treatment options in both women and men.
And yes, stocking up on cranberry juice can help.
PNR: First, what’s the difference between a urinary tract infection and a bladder infection?
Dr. Nielsen: The term “urinary tract infection” refers to any infection in the urinary tract. The urinary tract includes the kidneys, ureters, bladder and urethra. Most urinary tract infections involve the lower urinary tract (bladder and urethra) and are referred to simply as “bladder infections,” although the terms “bladder infection” and “UTI” are often used interchangeably.
The term “pyelonephritis” or “kidney infection” refers to an infection of the upper urinary tract and is more serious.
PNR: What causes the infection?
Dr. Nielsen: Urinary tract infections usually start when bacteria enter the urinary tract through the urethra and multiply in the bladder. Most UTIs are caused by Escherichia coli (E. coli), a bacteria commonly found in the gastrointestinal tract, although sometimes other bacteria may be responsible. There are also several sexually transmitted infections that can mimic symptoms of a UTI.
PNR: What are the symptoms?
Dr. Nielsen: Symptoms of a bladder infection include pain with urination, a frequent urge to urinate (often with very little urine coming out) and/or frequent urination, pressure in the lower abdomen, and/or foul-smelling urine.
Signs of a pyelonephritis include fever, flank pain, and/or nausea and vomiting.
PNR: Do UTIs affect both men and women similarly?
Dr. Nielsen: UTIs are far more common in women.
(Additionally), for reasons we don’t always understand, some people, especially women, are prone to repeated UTIs.
PNR: Does each condition require a physical exam to determine whether it's one type of infection or another?
Dr. Nielsen: A physical exam is helpful to differentiate a straightforward bladder infection from a more complicated kidney infection (pyelonephritis). Even with a seemingly straightforward bladder infection, it is helpful to perform a culture and sensitivity of the urine in order to verify that it is sensitive to the prescribed antibiotics. It is not uncommon to see bacteria that are resistant to certain commonly prescribed antibiotics.
PNR: What are the treatments available and how long until the patient gets some relief?
Dr. Nielsen: There are several antibiotic choices for treating UTIs. Common choices include Sulfamethoxazole-Trimethoprim/Bactrim, Nitrofurantoin/Macrodantin, and Ciprofloxacin/Cipro. Patients usually get relief in two to three days. While waiting for antibiotics to kick in, you can take Pyridium to help ease bladder symptoms. Pyridium doesn’t treat the infection, it just masks the symptoms. Patients who use Pyridium to treat their UTI symptoms without seeking other care may end up with a worse infection.
PNR: Does cranberry juice or do cranberry supplements help to ward off UTIs or bladder infections?
Dr. Nielsen: Yes! Cranberry has been shown to have bacteria fighting properties and has evidence to support its use to prevent UTIs from developing. I do not, however, recommend cranberry for treating an already established symptomatic UTI.
PNR: Any other thoughts on the subject?
Dr. Nielsen: The best things you can do to prevent UTIs are to 1. Drink plenty of water/fluids. 2. Urinate often (don’t hold it in). 3. Wipe from front to back. 4. Empty your bladder after intercourse. 5. Avoid potentially irritating feminine hygiene products.