Urinary tract infection (UTI): causes, symptoms and treatment

The classic signs of a UTI are hard to miss: pain with urination, a frequent urge to go to the bathroom (even if you just went) and intense discomfort that can disrupt your daily life. It’s up there when it comes to “least fun things to figure out.”

Also, sometimes the symptoms of a UTI can be more subtle or share commonalities with other conditions. Even when you’re sure it’s a UTI, finding the right treatment can be a hassle. Should you wait it out at home? What about cranberry juice? And what should you do if your UTI keeps coming back?

Not to worry – Dr. B has answers to all of your questions about UTIs, from symptoms to treatments to knowing when to get to the doctor (and when to wait it out).

What is a UTI?

UTI stands for “urinary tract infection.” Under normal circumstances, the body can flush bacteria out of the urinary system (including the kidneys, ureters, bladder and urethra) through urination. But if the bacterial load is overwhelming, or you are unable to clear the bacteria, this causes a UTI.

What causes a UTI?

UTIs are one of the most common health conditions, particularly in people with female anatomy. That’s because in females, the urethra is short, so bacteria doesn’t have far to go before it reaches the bladder. Also, in females, the urethra is closer to the vagina and anus, making it easier for bacteria to reach the urethra.

Any activity that introduces bacteria into your system–from sexual activity to wiping incorrectly after a bowel movement–can increase the risk of developing a UTI. Most of the time, your body prevents this from occurring by peeing out bacteria.

However, if the amount of bacteria is too great, or if you don’t pee often enough to flush out bacteria (either from dehydration or structural blockages like a kidney stone, for example), you can develop a UTI.

Factors that contribute to UTIs include:

• Sexual activity
• Some kinds of birth control
• Hormone changes, including pregnancy and menopause
• Structural problems or anatomical differences in the urinary system (like kidney stones or an enlarged prostate)
• Dehydration
• Diabetes or other conditions that impact the immune system
• Catheter use (a thin plastic tube that drains urine from the bladder)

Learn more about what causes UTIs.

What are the main UTI symptoms?

The symptoms of a UTI are hard to miss. Classic symptoms include pain or burning when you go to the bathroom or feeling like you have to pee all the time. These symptoms reflect what’s happening inside: the lining of the urethra and bladder becomes irritated and inflamed. Your body starts sending signals to pee more often in an effort to get rid of the bacteria.

Common UTI symptoms include:

• Pain or burning with urination
• Feeling like you have to pee often, even after going to the bathroom
• Peeing small amounts very often
• Cloudy or strong-smelling urine
• Pink, brown or red-tinged urine (which may be a sign of blood in the urine)
• Pelvic pain

It’s important to know that symptoms may be different depending on the type of UTI you have and where the bacteria is growing. Most UTIs develop in the lower part of the urinary tract (the urethra or bladder). These infections tend to be milder.

An infection in the urethra may only include burning with urination. If the infection moves up the urinary system into the bladder (also known as cystitis), symptoms can be more intense. Pelvic pain, pelvic pressure, frequent urination or blood-stained urine may occur with these infections.

Generally, kidney infections are the most severe. If you have symptoms of a kidney infection, it’s important to seek medical treatment right away as these can be serious and require more advanced therapies.

Talk to a medical provider right away if you experience any of the following signs of a kidney infection:

• High fever
• Chills or shaking 
• Side or back pain 
• Nausea or vomiting

How are urinary tract infections treated?

Simple UTIs are usually treated with a round of antibiotics. Most people start to feel better after just a few doses of medication, but there are also medications that can help with the pain and discomfort associated with UTIs. Phenazopyridine (brand name: Pyridium) is a prescription that can relieve UTI symptoms, but over-the-counter pain relievers like Acetaminophen and Ibuprofen can also help.

Antibiotics can cause some side effects, like diarrhea and nausea. If antibiotics are used too often, there is also a risk of developing resistance. This means that an antibiotic may stop working against a particular type of bacteria.

It can also be difficult to get a prescription if your symptoms start after office hours or while you’re traveling. Thankfully, online services like Dr. B are making it easier to access treatments for UTIs and other routine conditions, no matter where you are.

If your UTI symptoms are mild and you don’t have any signs of a serious infection (like fever, chills or nausea), it’s reasonable to wait a day or two to see if your body can clear the infection on its own. Note that people who are pregnant or who have other conditions (like diabetes) should talk to their provider, no matter how mild their symptoms are.

If you choose to wait and see how your body handles the infection on its own, be sure to drink plenty of water and use the bathroom frequently. Some people also try cranberry juice or cranberry tablets, although the research on this method is still mixed.

If your symptoms do not improve in 1-3 days, or if your symptoms get worse, it’s important to talk to a medical provider right away. Without treatment, the infection can move to the kidneys and potentially cause serious damage.

Read more about how to treat a UTI.

How do you prevent a UTI? 

It’s not always possible to prevent a UTI. If you develop a UTI, it doesn’t mean you’ve done anything wrong or that you have poor hygiene. However, it’s possible to follow some simple steps to make UTIs less likely.

Follow these tips to decrease the risk of developing a UTI:

• Drink lots of fluids, especially water: This helps flush bacteria out of your urinary system through frequent urination.
• Wipe front to back: Always wipe from front to back after using the bathroom. This minimizes the chance that bacteria from the anus and vagina can enter the urethra. 
• Check your birth control: Diaphragms, unlubricated condoms and spermicides (including condoms treated with spermicide) may increase the risk of UTIs. Your medical provider can help you find a different form of birth control if you get frequent UTIs.
• Avoid potentially irritating feminine hygiene products: Douches, deodorant sprays and powders may irritate delicate tissues, making it easier for bacteria to invade.
• Pee after sex: After sexual activity, be sure to empty your bladder fully as soon as possible. This can help flush out any bacteria that may have been introduced.
• Drink cranberry juice: Some studies suggest that drinking cranberry juice or taking cranberry supplements can help protect against UTIs. This can be expensive, and it may not be the right choice for everyone.

What are some complications of a UTI?

A UTI can turn into a more serious problem if it’s not treated or if it spreads to the kidneys. UTIs are also potentially more dangerous for people with other conditions that impact their immune systems.

If you have symptoms of a UTI – even mild symptoms – it’s important to talk to a medical provider sooner rather than later if you also:

• Are pregnant
• Have diabetes
• Have other conditions that affect the immune system

UTIs can sometimes cause other symptoms in the elderly, especially those with dementia. In this group of people, UTIs can cause symptoms like confusion, restlessness, aggression or hallucinations. Any behavior changes should be checked out by a medical provider, regardless of age or medical status.

When to contact a doctor

Most UTIs are easily treated by a short course of antibiotics. If you get UTIs often, your provider can help you understand ways to prevent them, from lifestyle changes to daily antibiotics.

UTIs can cause significant pain and discomfort. Without treatment, they can move to the kidneys and potentially cause kidney damage or more widespread infection.

You should also speak to a provider if you are being treated for a UTI and your condition gets worse. If you develop signs of a more serious infection, like nausea, vomiting, fever, chills or blood in the urine, make an appointment today. This could indicate that the infection has reached the kidneys.

Convenient, online relief from UTIs 

If you have symptoms of a UTI, you don’t have to wait any longer to get relief. Skip the hassle of the waiting room and get convenient, online treatment for your UTI with Dr. B.

Sources:

AHFS Patient Medication Information [Internet]. Bethesda (MD): American Society of Health-System Pharmacists, Inc.; c2022. Phenazopyridine; [updated 2018 Feb 15; cited 2022 Dec 29].

Balogun, S. A., & Philbrick, J. T. (2013). Delirium, a Symptom of UTI in the Elderly: Fact or Fable? A Systematic Review. Canadian geriatrics journal : CGJ, 17(1), 22–26. https://doi.org/10.5770/cgj.17.90

Cunningham C. (2011). Systemic inflammation and delirium: important co-factors in the progression of dementia. Biochemical Society transactions, 39(4), 945–953. https://doi.org/10.1042/BST0390945

Foxman, B., & Buxton, M. (2013). Alternative approaches to conventional treatment of acute uncomplicated urinary tract infection in women. Current infectious disease reports, 15(2), 124–129. https://doi.org/10.1007/s11908-013-0317-5

Hisano, M., Bruschini, H., Nicodemo, A. C., & Srougi, M. (2012). Cranberries and lower urinary tract infection prevention. Clinics (Sao Paulo, Brazil), 67(6), 661–668. https://doi.org/10.6061/clinics/2012(06)18

Imam, T. H. (2022). Bladder infection. In Merck Manual Commercial Version. Merck & Co., Inc. Retrieved December 27, 2022.

Imam, T. H. (2022). Kidney infection. In Merck Manual Commercial Version. Merck & Co., Inc. Retrieved December 27, 2022.

Imam, T. H. (2022). Overview of urinary tract infections. In Merck Manual Commercial Version. Merck & Co., Inc. Retrieved December 27, 2022.

Imam, T. H. (2022). Urethritis. In Merck Manual Commercial Version. Merck & Co., Inc. Retrieved December 27, 2022.

Medina, M., & Castillo-Pino, E. (2019). An introduction to the epidemiology and burden of urinary tract infections. Therapeutic advances in urology, 11, 1756287219832172. https://doi.org/10.1177/1756287219832172

Plüddemann, A. (2019). Can drinking more water prevent urinary tract infections? The evidence says yes. BMJ Evidence-Based Medicine 24, 191-192.

Urinary tract infections (UTIs). The American College of Obstetricians and Gynecologists. Retrieved December 27, 2022.

Zhang, Y., Wu, J.-G., Zhou, H.-J., Huang, W.-X. & Jia, B. (2020).Efficacy of Nonsteroidal Anti-inflammatory Drugs for Treatment of Uncomplicated Lower Urinary Tract Infections in Women: A Meta-analysis. Infectious Microbes & Diseases 2(2): 77-82.