Urinary tract infections (UTIs) are a common health issue that many people experience. These infections can be painful and, if left untreated, lead to more serious complications.
We talked with Lisa Ravindra, MD, a primary care doctor at Rush, about what causes UTIs, how you can get treated for one and whether those rumors about cranberry juice are true.
Typical UTI symptoms
When you have a UTI, you may experience one or more of these symptoms:
- Pain or burning with urination
- Increased urinary frequency and urgency
- Pelvic pain or pressure
- Blood in the urine
“If you don’t seek treatment for UTI symptoms promptly,” says Ravindra, “there is a small risk of progression to a kidney infection, called pyelonephritis.”
If your symptoms become severe or escalate to include fever, pain in the area between your upper abdomen and back (flank) and fatigue, you might have pyelonephritis, and you should contact your primary care physician right away.
Causes of UTI
A UTI typically occurs when bacteria enters the urinary tract through the urethra. Most UTIs are caused by E. coli, which is a bacteria found in the GI system.
UTIs are more common in women because the urethra and rectum are close in proximity. E. coli from the rectum can contaminate the urethra and spread to the vagina. This can happen through sexual intercourse or from wiping the wrong way (the correct way is front to back).
While UTIs are less common in men because they have longer urethras and a less “hospitable” environment for bacteria, men can still get UTIs. Men have a less hospitable environment for bacteria because the area surrounding men’s urethras is drier than women’s, and bacteria tend to like moist areas; there are also antibacterial substances that come from the prostate.
Unlike other medical conditions that require a physical exam or test to make a diagnosis, most UTIs in women can be diagnosed based on symptoms alone.
How do you know if you have a UTI?
Unlike other medical conditions that require a physical exam or test to make a diagnosis, most UTIs in women can be diagnosed based on symptoms alone. The probability of a UTI in women who report urinary frequency and pain or burning with urination (without vaginal discharge) is over 90%.
“Telemedicine (either via video visit or E-Visit questionnaire) is particularly useful for addressing UTIs in women since providers can usually easily diagnose them based solely on a patient’s description of symptoms and without a hands-on exam,” Ravindra says.
And if you do have a UTI, a Rush On Demand virtual care provider can send antibiotics to treat the infection directly to your pharmacy electronically.
It’s important to note that while UTIs are easily diagnoseable in women, reported symptoms alone aren’t sufficient for men. Men will need a urinalysis and urine culture ordered by a provider to confirm the diagnosis.
If you see a provider in-person for your UTI, they may ask for a urine sample to check for signs of a UTI. Your doctor can then check if the urine sample has any leukocyte esterase and nitrites in it. If it does, you likely have a UTI.
Over-the-counter tests (such as Azo test strips) can also tell you if you have a UTI. These tests detect the presence of leukocyte esterase and nitrites as well — but again, if you’re a woman, your doctor may be able to diagnose you based on reported symptoms alone, so an over-the-counter test may not be necessary.
Treatment options
According to Ravindra, antibiotics are very effective in treating UTIs and can start to relieve symptoms even within a few hours of the first dose. Your doctor can prescribe you antibiotics, either virtually or in-person, if you have a UTI.
Over-the-counter treatments that contain phenazopyridine (like Azo) help the pain caused by UTIs but do not treat the bacteria that is responsible for the symptoms. “These types of pain relievers are fine to take while waiting to talk to a doctor about getting an antibiotic prescription but should not be used for more than two days,” Ravindra explains.
The over-the-counter treatments mentioned can be toxic if you take too much — they can lead to issues like kidney failure and liver inflammation. Additionally, not getting prompt treatment for a UTI can also lead to prolonged symptoms and a small risk of a kidney infection.
Addressing common rumors about UTI
Does cranberry juice help?
It’s an age-old question: Does cranberry juice help prevent or treat UTIs, or is that just a myth?
It’s not exactly a myth, says Ravindra. An active ingredient in cranberries, called proanthocyanidins, may prevent bacteria (particularly e. coli) from sticking to bladder walls, which is why it’s thought that consuming cranberry juice or supplements may help prevent or treat UTIs.
“However,” Ravindra cautions, “there are no definitive studies that confirm this. There is likely little harm in taking cranberry products, unless it’s the sugary kind of juice, but there is no proven benefit, either.”
The same thing is true for probiotics and a natural sugar supplement called D-mannose. Says Ravindra, “If an individual finds these helpful, we don’t discourage using them.”
Just make sure you don’t rely on cranberry juice to treat your UTI. Seek care if you experience symptoms, either through telemedicine or in-person.
What about drinking lots of water?
If you feel the symptoms of a UTI infection, can drinking lots of water “flush out” the infection?
Possibly, says Ravindra. If you’re experiencing mild symptoms that might be exacerbated by dehydration, drinking lots of water might help you. “But, if your symptoms don’t go away within a day, definitely contact your physician,” she says.
If you experience recurrent UTIs (more than two infections in six months or three infections in one year), increasing your water intake to two to three liters per day can help dilute and clear bacteria in urine and reduce your incidence of UTIs.
How to prevent UTI
While cranberry juice may or may not have protective powers, there are a few things that have been proven to reduce UTI in women:
- Urinate immediately after sexual intercourse.
- Wipe only from front to back after using the restroom.
- In women who have gone through menopause, topical estrogen has been shown to decrease the incidence of recurrent UTIs.
Diaphragms or spermicide used for contraception may contribute to recurrent UTIs — so if you use these contraceptive methods and experience recurrent UTIs, talk to your doctor about possibly switching to a different method of contraception.
If you have a severe case of recurrent UTIs, your doctor may recommend taking antibiotics on a daily basis or after sexual intercourse to help prevent UTIs. It’s important to make sure that the benefits of frequent antibiotic use outweigh the potential risks, like vaginal yeast infections, nausea, diarrhea and creating resistant bacteria. So don’t start using antibiotics daily unless prescribed by a doctor.
The important thing to know is that whether you have a UTI or any other urologic issue, help is just a click away.
