Why Do I Get UTI?

Have you ever experienced pain or a burning sensation when peeing or had the need to pee suddenly or more urgently than usual? 

Then you probably have experienced urinary tract infection (UTI) symptoms; it is an infection of the bladder, kidneys or the tubes connected to them (urethra). UTI symptoms can impact your daily life but there are plenty of ways to prevent UTIs.

What is the main cause of UTIs? 

A urinary tract infection is caused when bacteria enters the urethra (the tube through which urine leaves the body) and spreads into the bladder, infecting the urinary tract. Women are greatly affected by UTI infections compared to men and this is due to the physiological differences; women have a shorter urethra than men, meaning there is a shorter  distance for the bacteria to reach the bladder.¹ Healthcare providers often treat UTIs with antibiotic courses. However, there are steps that you can take to reduce your chances of getting a UTI in the first place.

Detecting a UTI by symptoms can save your well-being since an untreated UTI can cause complications  involving having a repeated UTI or permanent kidney damage. Therefore, it is crucial to not overlook a UTI to prevent severe complications. 

What is Urinary Tract Infection?

Urinary tract infections or UTIs are a major health problem worldwide, the estimated incidence rate approaches 150 million new cases annually.² A UTI is defined as an infection in any part of the urinary system. The urinary system comprises kidneys, bladder, and urethra.¹ It causes a large financial cost to healthcare systems and is one of the most common reasons for the use of antibiotics worldwide.² The growing problem of antimicrobial resistance means that finding non-antibiotic alternatives for the treatment and prevention of UTIs is critical.²

Causes of urinary tract infection

A UTI can affect anyone, however, women are at greater risk of experiencing a UTI compared to men.¹ This is one of the most common bacterial infections in adult women.³ This is because women have a shorter urethra which further contributes to their increased susceptibility to UTIs compared to men.⁴ Therefore, it is easier for bacteria to reach the bladder which causes an infection. A UTI usually develops when bacteria enter the urinary tract through the urethra and begin to spread in the bladder. Typically, it is caused by the bacteria known as Escherichia coli (E. coli).⁴ E. coli is a type of bacteria commonly found in the gastrointestinal (GI) tract. However, other bacteria can also be the cause. ^1,4

While the pain of UTIs may tempt you to hold it in, it is important to follow through on that urge. This is because emptying the bladder helps the body eliminate bacteria that cause infection and speeds up recovery.⁵ Urine is an ideal medium for bacterial growth. Thus, frequent urination and increased urine output are also known to reduce the risk of urinary tract infections.^2,4

The most common reasons why UTIs occur: 

• Having sex
• Not drinking enough fluids
• Pregnancy
• Poor genital hygiene

Signs and symptoms of urinary tract infection

Each type of UTI may result in different symptoms. The symptoms depend on  which part of the urinary tract is affected.³ For example, an infection of the bladder (cystitis) or urethra (the tube that carries urine out of the body).

The first signs of a UTI that you should not ignore are: 

• A need to pee more frequently than usual
• Discomfort or pain while urinating 
• Feeling that you are unable to empty your bladder
• Pain in the lower part of your tummy
• Lower back pain, especially just under your ribs (where the kidneys are located)
• Urine that is cloudy or smelly or contains blood

If you are experiencing any of these symptoms at the moment, speak to your doctor. Undiagnosed or untreated UTIs might lead to severe consequences such as recurrent UTIs or kidney inflammation and therefore kidney damage.^1,4

Management and treatment for urinary tract infection

To ease symptoms of urinary tract infection (UTI):

• Take painkillers (paracetamol, ibuprofen) up to 4 times a day to reduce pain
• Some people take cystitis sachets and cranberry drinks and products daily to prevent developing urinary tract infections. However, there is no evidence that it helps relieve symptoms or treat UTIs after an infection has started
• Rest and drink plenty of fluids (especially water) so you pass pale urine regularly during the day.⁶
• Try to avoid drinking too much alcohol  or coffee ⁷ – they may aggravate your bladder 
• Do not have lots of sugary foods or drinks ⁷ – it can cause bacterial growth 

Treatment has historically varied from 3 days to 6 weeks. There is an excellent recovery  rate with a ‘mini-dose regimen’ that includes 3 days of treatment with an antibiotic.⁴ Although, there is still a chance of UTIs lasting for several days while being on a course of antibiotics.^4,8 Quality of life may be reduced in women with recurrent urinary tract infections. Therefore, it is crucial to treat a UTI appropriately since it may become chronic. 

If UTIs come back, the following tips may help:

• D-Mannose - a sugar that can be purchased as a daily powder or tabletCranberry products - available in juice, tablets, or capsules suitable for daily use

FAQs

How common is urinary tract infection?

Urinary tract infections are very common bacterial infections in women. Onset usually occurs between the ages of 16 and 35 years, 10% of women become infected each year, and 40% to 60% or more become infected at least once in their lifetime. Recurrence is common, with nearly half having their second infection within a year. Urinary tract infections are at least four times more common in women than in men. ^9,10 The incidence of UTI in men is considerably lower than that in women, with an estimated lifetime prevalence of 13.7%.¹¹

In addition, there is something called a recurrent urinary tract infection (rUTI). This type of UTI has a high prevalence. An estimated 20-40% of women who have had a previous episode of cystitis are likely to experience another episode, and 25-50% of those will experience multiple recurrent episodes.¹² 

How is urinary tract infection diagnosed

Diagnosis of UTI can be made by a combination of symptoms and a positive urine test or culture.⁸ However, depending on the cut-off value used, up to 20% of women with classic urinary tract symptoms may have negative cultures⁸. If the urine test comes back negative despite having UTIs there are different tests could be done to diagnose UTI which include: 

• Growing urinary tract bacteria in a lab
• Creating images of the urinary tract
• Using a scope to see inside the bladder

How can I prevent urinary tract infection

Some things that can help you avoid UTI such as: 

• Wipe from front to back when you go to the toilet
• Keep the genital area clean and dry
• Drink plenty of fluids, especially water - to urinate regularly throughout the day and keep you from feeling thirsty
• Shower before and after sex
• Pee as soon as possible after sex (Although there is no scientific evidence to this, it is recommended for women to urinate post-intercourse because bacteria in the bladder can increase by tenfold after intercourse)⁴

Try to avoid these things: 

• Do not use scented soap
• If you feel the urge to pee, don't hold back your urine
• Do not rush when going for a pee – make sure your bladder is empty
• Do not wear tight synthetic underwear, such as nylon
• Do not drink a lot of alcoholic beverages as they can irritate the bladder
• Avoid sugary foods and drinks as they can encourage bacterial growth
• Do not use condoms, diaphragms, or caps with spermicidal lubricants. Try a non-spermicidal lubricant or another form of birth control

When should I call my doctor 

You should always contact your doctor if you are experiencing any symptoms mentioned above. 

Summary

UTI is one of the most common bacterial infections, with a much higher incidence in women than in men. Diagnosis of UTI can be made based on a combination of symptoms and several tests. If you have any of these symptoms, or your symptoms continue after treatment, contact your healthcare provider. A UTI can spread to the urinary tract and other parts of the body. However, treatment is very effective and can relieve symptoms quickly.