Uncomplicated Urinary Tract Infection (UTI) in Women 

Urinary Tract Infections are caused by the overgrowth of bacteria in the urinary tract. Escherichia coli is the most common uropathogen, accounting for about 80% of all cases. All parts of the urinary tract can be affected: kidneys (infection is then called pyelonephritis), ureters, bladder (cystitis) and urethra (urethritis).

While UTIs can have multiple causes and can strike anyone, the most common type, and the one we will be focusing on here, is the uncomplicated bladder infection affecting healthy, nonpregnant women.

UTI-causing bacteria are increasingly becoming resistant to the standard, antibiotic, therapy. For this reason, effective prevention of UTIs with healthy diet and good hygiene is of utmost importance. 

Risk Factors

 

Female anatomy itself predisposes women to UTIs. The shortness of the urethra (the tube that conveys urine from the bladder out of the body) and the closeness of the urethral (urinary) opening to the anus increase the chance of bacteria entering the urinary tract.  Several additional factors increase the risk of UTI in women: 

 

  • Sexual activity

  • Use of spermicides/diaphragm as contraceptives

  • Diabetes

  • Recent UTI

  • Menopause

Symptoms

 

Although sometimes UTI causes no symptoms (asymptomatic UTI), in majority of cases bladder infection is easy to recognize:

 

  • Intense, frequent urge to urinate

  • Urge to pass small amounts of urine

  • Painful, burning sensation while urinating

  • Altered appearance and smell of urine (cloudy, pink or reddish in color due to presence of blood, strong-smelling)

  • Pain in the bladder area (just above the pubic bone)

 

Kidney infection, which occurs when the bacteria move up the urinary tract, produces additional symptoms:

 

  • Fever

  • Chills

  • Pain in the upper back and on the side (underneath the ribs)

  • Nausea and vomiting

 

Contact your doctor immediately if you experience symptoms of UTI. Urinary tract infections need to be treated promptly to avoid the risk of serious complications. 

Diagnosis

 

UTIs are diagnosed based on the above symptoms and the results of urine analysis.

In healthy people, urine contains a very low number of bacteria. Urine analysis aims to determine the number of bacteria and to detect the presence of white blood cells that have been recruited to fight the infection.

 

To avoid contamination that leads to false results, when submitting urine sample make sure you use the “clean-catch” method. This method requires cleaning the intimate area with soap and water or a sterile wipe before collecting midstream urine (do not collect the initial or ending stream). Pay attention not to touch your body with the opening of the collecting container. Submit your sample right away, or store it in the fridge. Urine sample should not be left at room temperature for long.

 

Treatment

 

Antibiotic therapy is the standard treatment for uncomplicated UTIs. Increased intake of water or other suitable liquids is also often recommended. Symptoms begin to resolve within a day or two after starting the antibiotic therapy. Contact your doctor if your symptoms do not resolve within three days after starting the treatment.

Lifestyle Medicine

Stay well hydrated

 

If your health allows, drink water or other suitable liquids throughout the day. This will cause frequent urination, which will, in turn, flush out harmful bacteria from the bladder.

 

Many vegetables and fruits, such as cucumbers, watermelon, tomatoes, and celery have high water content. Add these to your diet as an additional water source. 

Improve your bathroom habits

 

Do not hold urine. Although delaying a visit to the bathroom every now and then will not lead to an infection, frequent and timely urination will reduce the chances of an infection by flushing out bacteria from the bladder. Because sexual intercourse introduces bacteria into the urinary tract, make a habit of always emptying your bladder after sex.

 

Regulate your bowel movement. The rectum and the bladder are closely situated in the body. During constipation, a large amount of stool in the rectum can cause incomplete emptying of the bladder. Retained urine is an ideal environment for bacterial growth, which leads to infection. Constipation can be relieved by making adjustments to your diet, consuming more fiber, and being physically active.  

Wipe from front to back. The most common uropathogen, Escherichia coli, is part of the normal gut flora and is removed from the body with the stool. To avoid contamination of the urethral area with fecal matter and bacteria, always wipe from front to back.

Change your birth control method

Several studies have shown that the risk of UTIs is higher in women who use contraceptives with spermicides.  Spermicides are agents that stop sperm from moving, but they also inhibit the growth of beneficial vaginal bacteria that are responsible for protection against pathogens.   At the same time, spermicides have little effect on the growth of infection-causing bacteria such as Escherichia coli. This misbalance in vaginal flora leads to the proliferation of pathogenic bacteria that cause UTIs.

Spermicides are present in many contraceptives: diaphragm, condoms, gels, creams, etc. If you are prone to recurrent infections, consider switching to a spermicide-free contraceptive. 

UTI prevention diet

 

A healthy diet is vital for your overall wellbeing. While it is known that certain diets successfully reduce the risk of many diseases, specific dietary advice on how to prevent urinary tract infections is limited. This is surprising as there is a direct link between urine composition and what we eat and drink. In fact, many UTI causes can very effectively be addressed with diet. We outline here specific dietary recommendations that are most relevant for UTI prevention.

Boosters

Cranberries

 

Popular fruit at the holiday table, cranberries have been used in UTI prevention for a long time. In traditional medicine, cranberry juice has been used to prevent (not cure!) urinary tract infections (UTIs). Clinical studies suggest that cranberries can be used as a natural alternative to antibiotics as prophylactic agents. The existence of such alternatives is crucial in light of the growing problem of “superbugs” - bacteria resistant to the currently available antibiotics. 

Last updated: September 12, 2016

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