Urinary Tract Infections

Tracy's experience is not unusual. Her problem, a urinary tract infection, is one of the most common reasons that teens - especially girls - visit a doctor.

What Is a Urinary Tract Infection?
A bacterial urinary tract infection (UTI) is the most common kind of infection affecting the urinary tract. Urine, or pee, is the fluid that is filtered out of the bloodstream by the kidneys. Urine contains salts and waste products, but it doesn't normally contain bacteria. When bacteria get into the bladder or kidney and multiply in the urine, a UTI can result.

There are three main types of UTI. Bacteria that infect only the urethra (the short tube that delivers urine from the bladder to the outside of the body) cause urethritis (pronounced: yur-ih-threye-tis). Bacteria can also cause a bladder infection, which is called cystitis (pronounced: sis-tie-tis). Another, more serious, kind of UTI is infection of the kidney itself, known as pyelonephritis (pronounced: pie-low-nih-fry-tis). With this type of UTI, a person often has back pain, high fever, and vomiting.

The most common type of UTI, the bladder infection, causes mostly just discomfort and inconvenience. Bladder infections can be quickly and easily treated. And it's important to get treatment promptly to avoid the more serious infection that reaches the kidneys.

Bacteria Are to Blame
UTIs are usually caused by E. coli, bacteria that are normally found in the digestive tract and on the skin around the rectal and vaginal areas. When the bacteria enter the urethra, they can make their way up into the bladder and cause an infection.

Girls get urinary tract infections much more frequently than guys, most likely due to differences in the shape and length of the urethra. Girls have shorter urethras than guys, and the opening lies closer to the rectum and vagina where bacteria are likely to be. Some people seem to get frequent UTIs, but they often have other problems that make them more prone to infection, like an abnormality in the urinary tract structures or function. The most common functional problem of the urinary tract is called vesicoureteral reflux (pronounced: veh-zi-coe-you-ree-tur-al), a condition in which some urine flows backward, or refluxes, from the bladder into the ureters and even up to the kidneys.

There are several ways bacteria can get into the urethra. During sexual intercourse, the bacteria in the vaginal area may be pushed into the urethra and eventually end up in the bladder, where urine provides a good environment for the bacteria to grow. This is the reason why females who are sexually active often get UTIs (UTIs are not contagious, so you can't catch a urinary tract infection from someone else). Bacteria may also be introduced into a girl's bladder by wiping from back to front after a bowel movement, which can contaminate the urethral opening. The use of spermicides (including condoms treated with spermicide) and diaphragms as contraceptives may also increase the risk of getting a urinary tract infection.

Sexually transmitted diseases (STDs) may cause UTI-like symptoms, such as pain with urination. This is due to the inflammation and irritation of the urethra or vagina that's sometimes associated with chlamydia and other STDs. If untreated, STDs may lead to serious long-term problems, including pelvic inflammatory disease and infertility. Unlike UTIs, STDs are contagious.

Symptoms of UTIs
There are a number of symptoms associated with UTIs. With bladder infections, symptoms may include:

• frequent urination
• burning or pain during urination
• the feeling of having to pee even though little or no urine actually comes out
• pain in the lower abdomen
• pain above the pubic bone (in women)
• a full feeling in the rectum (in men)
• bloody or foul-smelling urine
• mild fever
• a general feeling of shakiness and fatigue

A kidney infection may involve more serious symptoms, including:

• high fever
• chills
• nausea and vomiting
• abdominal pain
• cloudy or bloody urine
• pain in the back, just above the waist

If you have any symptoms of a urinary tract infection, you'll need to go to a doctor right away. The symptoms won't go away if you ignore them - they'll only become worse. The more quickly you begin treatment, the less uncomfortable it will be.

Call your doctor's office or clinic immediately. If you can't reach your doctor, you can visit an urgent care center or hospital emergency room. The most important thing is to take action as soon as possible.

Battling the Bacteria
Only your health care provider can treat urinary tract infections. The first thing a doctor will do is confirm that a person has a UTI by taking a clean-catch urine specimen. At the doctor's office, you'll be asked to clean your genital area with disposable wipes and then urinate into a sterile (bacteria-free) cup.

If an infection is suspected when the specimen is examined, a doctor will probably prescribe antibiotics. Because there are many different antibiotics available, the doctor may send the urine specimen for a urine culture, which is a test to identify the exact type of bacteria causing your infection. It takes about 48 hours to get results from a urine culture, and a doctor may ask patients to switch antibiotics depending on the results.

Although antibiotics begin fighting the infection right away, they can't stop all the symptoms immediately. If someone has a lot of pain from a UTI, the doctor may recommend a medication to help relieve the spasm and pain in the bladder. This will turn urine a bright orange color, but it's harmless and will usually make a person much more comfortable within hours. In the case of a kidney infection, a doctor may prescribe pain medication.

For some infections, a person may only have to take antibiotics for 3 days, but usually people with UTIs stay on medication for 7 to 14 days. It's important to take the antibiotics until the prescription is finished. Many people stop taking medication when they begin to feel better, but that doesn't allow the antibiotics to completely kill the bacteria, which increases the risk that the infection will reappear. If you've been diagnosed with a UTI and symptoms continue after you've used up all your medication or if your symptoms aren't much better after 2 to 3 days of treatment, contact your doctor.

It's important to drink lots of water during and after treatment because each time you urinate, the bladder cleanses itself a little bit more. Cranberry juice may also be helpful. People with UTIs should avoid coffee and spicy foods. And, while it's always a good idea to quit smoking, this is especially true for people who have a UTI or are prone to getting UTIs because smoking is linked to bladder problems.

People who get a doctor's help for a UTI right away should be clear of symptoms within a week. For a more serious kidney infection, most people have to return to the doctor's office for a follow-up visit to ensure that the infection has responded completely to the medication.

In either case, a doctor may tell people with UTIs to avoid sexual intercourse for a week or so, which allows the inflammation to disappear completely.

Preventing UTIs
There are several ways people may be able to prevent urinary tract infections. After urination, girls should wipe from front to back with toilet paper. After bowel movements, be sure to wipe from front to back to avoid spreading bacteria from the rectal area to the urethra.

Another thing both girls and guys can do to prevent UTIs is to go to the bathroom frequently. Avoid holding urine for long periods of time.

Males and females should also keep the genital area clean and dry. Girls should change their tampons and pads regularly during their periods. Frequent bubble baths can cause irritation of the vaginal area, so girls should take showers or plain baths. Avoid prolonged exposure to moisture in the genital area by not wearing nylon underwear or wet swimsuits. Wearing underwear with cotton crotches is also helpful. And girls should skip using feminine hygiene sprays or douches - these products can irritate the urethra.

If you are sexually active, go to the bathroom both before and within 15 minutes after intercourse. After sex, gently wash the genital area to remove any bacteria. Avoid sexual positions that irritate or hurt the urethra or bladder. For girls who need lubrication during sex, use a water-soluble lubricant such as K-Y Jelly.

Finally, drinking lots of water each day keeps the bladder active and bacteria free.

Remember that although urinary tract infections are uncomfortable and often painful, they are very common and easily treated. The sooner you contact your doctor, the sooner you'll be able to get rid of the problem.