BURNING WHEN URINATING? DO YOU HAVE A URINARY TRACT INFECTION?
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A urinary tract infection (or UTI for short) is a condition usually caused by pathogenic bacteria, and rarely by viruses or fungi. Urine is normally sterile, so when a microbe enters the urinary tract, it can cause an infection. UTIs are common and can happen to anyone.
Our urinary tract is made up of several parts: the kidneys, the ureters, the bladder, and the urethra. Doctors call the kidneys and the ureters the upper urinary tract, while the bladder and urethra are called the lower urinary tract. This is important since upper urinary tract infections tend to be more severe and require a longer treatment course.
Once diagnosed, urinary tract infections are treated with antibiotics administered either orally or through an IV line. The choice of treatment depends on several factors, most importantly the severity of the infection and the type of the germ causing it.
What are the symptoms of UTI?
There are several symptoms that might raise suspicion of a urinary tract infection. The severity of symptoms usually correlates with the severity of the infection and depends on the part of the urinary tract infected (upper or lower). Lower urinary tract infections (bladder and urethra) are usually less severe and cause more local symptoms:
- Burning sensation when you urinate
- Odorous urine
- Dark or cloudy urine color
- Pain in your pelvis (in women) or anal region (in men)
- Frequently feeling the need to pee (frequency)
- An intense sensation of needing to urinate (urgency)
- Penile or vaginal discharge (in urethral infections)
As opposed to lower urinary tract infections, upper urinary tract infections are more severe, and can even become life-threatening if the microbes disseminate into the blood. In addition to the symptoms of lower urinary tract infections, upper urinary tract infections can cause:
- Flank and back pain
- Nausea and vomiting
- Low blood pressure (in case of sepsis and shock)
- Confusion (in elderly patients)
Sepsis and shock is when the bacteria goes into your blood and causes a full-blown immune reaction, which can be harmful to your body. Symptoms and signs of sepsis and shock include low blood pressure, altered mental status, and multi-organ failure. Sepsis can be life-threatening and requires rapid in-hospital treatment.
What are the risk factors for developing urinary tract infections?
Doctors have identified a few factors that may put you at risk of developing urinary tract infections. These include:
- Age: People who are older are at higher risk
- Restricted mobility: like after surgery or an accident
- Kidney stones
- Obstruction in the urinary tract, like a large prostate or a stone lodged in your ureter
- Usage of urinary catheters
- Diabetes Mellitus
- Urinary tract malformations
- Immune deficiency
How are urinary tract infections diagnosed?
Urinary tract infections can be diagnosed by a urologist, infectious disease specialist, or a general practitioner. Your doctor will start by asking you about your symptoms. The location of pain and intensity of symptoms can help identify how severe the infection is. He or she will perform a full physical examination to try to identify the issue. This is usually enough to establish a preliminary diagnosis of urinary tract infection. Your doctor will then order one or more tests to confirm their suspicion:
- Urine analysis and culture: This is one of the most important tests in diagnosing urinary tract infections. You will be asked to pee in a cup, and the urine is sent to the lab. A urinalysis will be quickly done to see if there are blood cells, immune cells, or bacteria in your urine. Culture results will take more time, usually 2 days, before they come out. A culture identifies the exact type of bacteria that you have in your urine. This helps your doctor confirm the diagnosis and adjust your antibiotic treatment accordingly.
- Routine blood work: Your doctor might order a blood count and a C-reactive protein (CRP) level to see how your immune system is reacting to the infection. White blood cell count and CRP are usually more elevated in severe infections.
- Imaging: A CT scan or ultrasonography might be ordered if you have severe symptoms and your doctor is still unsure of the diagnosis. Imaging is helpful in diagnosing upper urinary tract infections.
How are urinary tract infections treated?
Since urinary tract infections are usually caused by bacteria, antibiotics are the cornerstone of treatment. Depending on your general health and the severity of symptoms, your doctor will choose whether you need hospital admission or can receive treatment at home.
After confirming the diagnosis, your doctor will prescribe a special class of antibiotics used to treat UTIs. If you’re admitted to the hospital, you will receive an intravenous antibiotic initially, and if you’re going home, he or she will prescribe an oral antibiotic. In both cases, once the urine culture result is confirmed, your doctor will adjust your medications to the results. Treatment can range from a single dose to up to 2 weeks of antibiotics depending on the severity of your infection.
Urinary tract infections are common and can happen to anyone, especially if they have one or more risk factors. Treatment is fairly straightforward and antibiotics are usually enough. If you are feeling a burn when urinating or have frequency, urgency, or pelvic or flank pain, you should check with your doctor and ask about the possibility of having a urinary tract infection.
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