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Tracking down relief for a urinary tract infection

February 17, 2014

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In the world of urgent care medicine, life is full of surprises. But there’s one thing urgent care providers can depend on: every day, someone will walk in with a urinary tract infection (UTI).

If you are a woman, chances are you’ve had a UTI yourself. Millions of women every year get these infections (which are relatively rare in men). But even if you’ve been there before, a new UTI can leave you wondering, “How did I get this?” and “Should I go to the doctor now or wait it out?”

Nick Bird, MD, is a Duke Urgent Care provider. About the “waiting it out” question, he says, “Antibiotics have only been around since the 1940s. What did women do before then? The infection may or may not progress to a more serious infection.” Then Bird adds a compelling reason to see your doctor right away: “A day or two after you start taking antibiotics, the pain goes away,” he says. “Plus, you reduce the risk of kidney infection.”

The pain of a UTI is hard to ignore. In addition to the discomfort when urinating, UTIs can also cause strong urges to go—without much success when you actually try. Another common symptom is cloudy or strong-smelling urine.

What's going on?

A UTI is an infection in any part of the urinary tract, which goes from the kidneys to the ureter to the bladder to the urethra (urine exits the body by the urethra).

According to Bird, most cases of UTIs are actually cystitis—infection in the bladder. “The urethra and bladder become inflamed and irritated,” Bird says. “And the infection can move up the ureter into the kidneys.” A kidney infection can bring with it symptoms that are not typical to cystitis: fever and back pain. If left untreated, it can progress to sepsis (a whole-body infection).

The cause of a UTI is bacteria that find their way into the urinary tract through the urethra. And the reason UTIs are far more common in women than men is simple anatomy. “Most commonly, UTIs are caused by bacteria from feces,” Bird says. “So women are more at risk because of the physical proximity of that bacteria to the urethra.”

Healthy habits

Bird’s #1 recommendation for preventing a UTI is to drink more water. “Bacteria are like mosquitoes—they populate in still waters, not flowing rivers,” Bird says. “If you drink a lot, you’ll urinate a lot, and the bacteria get washed out.”

How do you know if you are drinking enough water? “Your urine should be pale-yellow to clear,” Bird says. “Also be sure to urinate when you have the urge. Avoid holding your urine for prolonged periods.”

Cranberry juice has long been touted as preventive medicine for UTIs, but drinking enough to make a difference takes commitment. “Drinking cranberry juice several times a day is expensive, and people tend to stop,” Bird says. “Plus, it could upset your stomach and may be associated with kidney stones.”

Good hygiene is important. For women, that means wiping front to back. And the old story about “honeymoon cystitis”? It’s true. Sexual intercourse is a risk factor for UTI, so urinating after sex can help flush bacteria out of the urethra. The use of spermicides, especially in conjunction with condoms and diaphragms, is also associated with recurrent UTIs.

An antibiotic is the only medication that will cure a UTI. If you think you have a UTI and can’t easily get to a doctor, drinking lots of water can go a long way toward turning the tide, Bird says. If you can get to a doctor, a prescription for an antibiotic can have you feeling like yourself in no time.

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