Urinary Tract Infections (UTI) – Dr. David Long

Have you ever had those symptoms where you have the urge to go to the bathroom so bad, it just is driving you crazy? You go to the bathroom and not five minutes later, you feel like you got to go again. I’m Dr. David Long. I want to spend a few minutes today talking to you about urinary tract infections.

UTIs are very common. One out of every two, women will get a urinary tract infection at some time in their life. And when I’m speaking to patients about urinary tract infections, I break them down into three categories, based on where the infection is causing the symptoms. 

The first would be urethritis. The urethra is inflamed or infected. That person typically just complains of a lot of burning with urination. Commonly it’s right at the end of the urine stream, right when they’re done, they have a lot of stinging and pain, but that may be their only symptom. And that could be the urinary tract that’s infected at the very end, the very bottom part. 

If the infection makes it up into the bladder, well, that’s the person that might be complaining of having to get up in the night multiple times to go to the bathroom, urinary frequency during the day, some lower abdominal pain, cloudy, urine, and, the urgency. When you have to go, you have to go now.That’s a typical bladder infection, which is also a version of UTI. 

And the last group, if the infection makes it from the bladder up into one of the kidneys, that’s called pyelonephritis, technically white blood cells inflaming the kidneys: pyelonephritis. That’s usually a really sick person. You have fever, achiness, back pain, nausea, oftentimes accompanying those other urinary symptoms. Those patients sometimes even require hospitalization because if the nausea is so bad that they can’t tolerate fluids and they can’t keep down an oral antibiotic, then they have to go to the hospital and get hydrated and maybe some IV antibiotics for a few days. So for those three kinds of urinary tract infections that we call acute urinary tract infections, there’s many reasonable treatments. It usually requires an antibiotic, fortunately for an uncomplicated urinary tract infection, meaning not a kidney infection, not pyelonephritis and not a particularly sick person to begin with.

You can usually get away with just three to five days of antibiotics, and that will completely cure that infection. If somebody comes into the infection with a history of urinary problems, or they recently had a different infection, or they are having kidney involvement, then the typical course is about 10 days, but it responds really well to a few different antibiotics.

Sometimes it requires us to get a culture, to find out exactly what bacteria we’re dealing with. And then we can match that up against a list of antibiotics to find out exactly which antibiotic would be the most useful. There’s a few antibiotics that are used commonly in urinary tract infections because urinary tract infections are usually caused by a particular group of bacteria. So rather than give some person a very broad spectrum, antibiotic, meaning a very strong antibiotic that covers a long list of bacteria, we’d prefer if we have to give that patient an antibiotic to give them an appropriate antibiotic that maybe covers a small list of bacteria, but a list that we can feel competent will cover your infection without affecting your digestive system or your immune system and other ways, because as is well understood, bacteria are absolutely essential for us. And so we’d rather not kill any more than we have to. 

Another kind of urinary tract infection worth mentioning would be chronic UTI. This is the person who seems to always have some low level irritation in their urinary tract, or they get infection one after another. For these patients, they can require long courses of antibiotics, much longer than the three or 10 day course. Sometimes if we can identify things that cause a urinary tract infection for women, sometimes that’s intercourse, we’ll recommend taking an antibiotic right after intercourse to help minimize the likelihood of getting another infection. 

The last thing I’d like to mention is the idea of prevention, because anytime we can prevent us from getting a urinary tract infection, that’s obviously preferable to exposing our bodies to antibiotics or just being sick in general. So some of the things we like to recommend to help prevent urinary tract infections is to don’t hold it when you need to go, go. This can be a problem when you’re traveling sometimes, but if we can empty our bladder regularly, we have a much less likelihood of getting infection. Women, when you’re going to the bathroom, we recommend wiping front to back. Drink lots of water, prefer showers over baths, avoid feminine hygiene sprays and scented bath products. And we recommend that women get up and urinate after intercourse. That will also decrease the risk of a urinary tract infection.

 I hope you found some of this useful today. If you have any more questions or thoughts, feel free to contact us at the Lubbock Cooper health center, or you can click the link below for more information.

 

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