- What Are The Symptoms Of A UTI? 6 Surprising Signs You Have One But Don’t Know It
- Advanced Tests
- Urinary Tract Infection (UTI) Symptoms and Diagnosis
- UTI Signs and Symptoms
- UTI Signs and Symptoms in Children and Older Adults Are Different
- UTI Tests and Diagnosis
- Tests and Diagnosis for Recurrent UTIs
- UTI Tests and Diagnosis in Pregnant Women
- UTI Testing and Diagnosis in Children
- Testing Negative for UTI
- Why Is There Blood in My Urine?
- Urination: Frequent Urination
What Are The Symptoms Of A UTI? 6 Surprising Signs You Have One But Don’t Know It
Being sick is never enjoyable, but some illnesses tend to be worse than others. One that can be particularly nasty is a urinary tract infection (more commonly called a UTI). Few things are more frustrating than constantly feeling like you have to pee… but not really being able to. The symptoms of UTIs are usually painful, aggravating, and they can really mess up any plans you might have. More importantly, UTIs can be dangerous, and if left untreated, can lead to some serious issues. On top of that, there’s one thing you didn’t know about UTIs — and that’s that they can come with silent symptoms, making them even more dangerous.
A UTI is exactly what it sounds like: an infection in the urinary tract system, including the kidneys, bladder, and urethra. Most of the time, UTIs occur in the lower urinary tract. They are caused by bacteria that gets into the urethra, usually from the rectal area, but this can vary. You’re probably already aware of the usual symptoms that come along with a UTI: these can include a burning sensation when you urinate, feeling like you have to urinate immediately even if nothing or just a little comes out, pain or pressure in your lower back or stomach, bloody or strong-smelling urine, feeling tired or shaky, and in some cases, even a fever. If you feel any of these things, you would hopefully know that you probably have a UTI, then head to a doctor for medication to get better. Problem (probably) solved!
But what if you don’t feel any of those things? It is totally possible to have a UTI without feeling the usual symptoms, especially if you’re an older woman. UTIs can and often do have really subtle symptoms that don’t include the burning and pain often associated with the infection. According to Harvard Medical School’s Harvard Health Publishing, this is common in older women — “some experts think that is because the symptoms of a UTI are actually caused by the immune system’s fight against the infection, and the immune systems of older people may not fight as fiercely,” — but, theoretically, an asymptomatic UTI could affect anyone who is immunocompromised. Seemingly unrelated symptoms, the journal reported, range from the following:
- loss of appetite
Of course, these are all symptoms of many other conditions and infections — so without the classic urinary tract symptoms like burning or pain, it’s easy to overlook a UTI as the culprit. This is known as a silent UTI, and it’s where things can get dangerous; after all, if a UTI isn’t caught early, the infection won’t be treated accordingly. According to Harvard Health Publishing, “A lack of symptoms may result in a UTI going untreated and then spreading to the kidneys, and then the bloodstream — a potentially fatal condition.”
Of course, you can’t always assume exhaustion means you have a silent UTI, or you’d be spending all of your time at the doctor. Instead, if you feel any of the aforementioned symptoms and other test results aren’t coming up with any reason for them, ask your doctor to check you for a UTI.
You can also work at preventing UTIs to begin with. According to Harvard Health Publishing, both Dr. George Flesh, director of urogynecology and pelvic reconstructive surgery for Harvard Vanguard Medical Associates, and Dr. Suzanne Salamon, a geriatrician and instructor at Harvard Medical School, recommend drinking more fluids throughout each day to flush out urine and bacteria. You should always make sure you pee after having intercourse — right away, not an hour later. If you know you’re prone to UTIs, Dr. Flesh says to try vaginal estrogen cream, saying, “It is the most effective preventive treatment, resulting in 70 percent to 90 percent fewer infections.”
Remember: UTIs aren’t just annoying, they can also be very dangerous. Don’t let a silent UTI lead to a serious kidney infection or worse. Stay on top of your health!
Getting a bladder infection once in a while may be a bother, but it’s not usually a serious health concern. Sometimes, though, it’s important to know the cause of the infection, because medicine alone may not be enough to treat it.
You may get more advanced tests if you belong to one of these groups:
- Men (Because they tend not to get bladder infections, it could be a sign of something else.)
- People who have kidney damage
- Women who get three or more bladder infections in a year or have blood in their urine
To find the cause of a bladder infection, your doctor can use:
- Cystoscopy. Your doctor inserts a cystoscope – a thin tube with a camera — into your urethra to look for problems or to get a tissue sample for more testing (biopsy).
- Imaging. An ultrasound, CT scan, and MRI can show tumors, kidney stones, and other issues.
- Intravenous urogram (IVU). This is an X-ray that uses contrast dye to take images of the kidneys, ureters, and bladder.
- Voiding cystourethrography. Your doctor puts a dye into your bladder to see if any urine flows backward from the bladder toward the kidneys.
- Retrograde urethrography. This test uses contrast dye to find problems in the urethra.
Urinary Tract Infection (UTI) Symptoms and Diagnosis
Symptoms of a UTI may include a constant urge to urinate, frequent urination, or discomfort while urinating.
Urine test strip results are compared with a key. Thinkstock
A UTI or urinary tract infection occurs when harmful bacteria take root anywhere in the urinary tract, including the kidneys, ureters, bladder, and urethra.
Symptoms of a UTI can vary, and it’s not entirely uncommon for someone to experience no symptoms of a urinary tract infection. But for many, UTIs can be uncomfortable and very painful.
UTI Signs and Symptoms
While some people don’t experience any symptoms with a urinary tract infection, most will encounter at least one of the following indicators:
- A strong, consistent urge to urinate
- Pain or burning when urinating
- Passing only small amounts of urine
- Cloudy or strong-smelling urine
- Red or pink-tinged urine, indicating the presence of blood
- Pelvic pain, in women
- Mucus- or pus-like urethral discharge, usually in men
- Wetting problems after being toilet trained, in children
- Incontinence, particularly in the elderly
When the kidneys are infected, other noticeable symptoms may include:
- Fever, shaking, and chills
- Nausea and vomiting
- Upper back, side, or groin pain (1)
UTI Signs and Symptoms in Children and Older Adults Are Different
Signs and symptoms of urinary tract infections in newborns generally include poor feeding, lethargy, diarrhea, failure to thrive, vomiting, mild jaundice, and fever. Older babies who are still under 2 years old may experience similar symptoms, plus foul-smelling urine. Meanwhile, older children generally have similar symptoms to adults, including urgency, incontinence, and pain during urination.
For older adults, it’s more common to experience asymptomatic bacteriuria (ASB), which is a UTI without the classic symptoms. It’s estimated that 1 to 5 percent of younger women have dealt with ASB, while 6 to 16 percent of women older than 65 have been found to have ASB. That number grows to almost 20 percent for women over 80. (It’s important to note that the use of urinary catheters predisposes both men and women to ASB.) (2)
Unlike asymptomatic UTI, ASB should NOT be treated, unless the patient is pregnant or is going to undergo a urologic procedure.
UTI Tests and Diagnosis
You or your physician may suspect that you have a UTI based on the symptoms you report, such as painful urination or having a frequent urge to urinate. At that point, your general practitioner or a physician at an urgent care office will test a sample of your urine for both bacteria and other components of urine that could indicate a UTI.
Because UTIs are usually detected using urine you’ve collected yourself (you’ll probably be sent to the restroom at your doctor’s office), it’s important to use the proper technique. First, wash your hands thoroughly with warm soapy water. Next, clean your genital area with a special antiseptic wipe that the nurse has given to you. Finally, carefully urinate into a small, sterline plastic jar or similar container. Rarely, a catheter may be used to collect urine. This is more common in young children and older adults. Testing includes:
- Urinalysis Here, a midstream urine sample is collected then examined under a microscope; your healthcare provider looks for white blood cells, red blood cells, protein, sugar, nitrites, and some other important urine components. Urinalysis is the preferred first-step in diagnosing UTIs. (3)
- Dipstick test A thin plastic stick containing chemicals is placed into urine to detect abnormalities. The chemical strips change color if certain substances are detected. Results are available quickly. (4)
- Urine culture Urinalysis is sometimes, but not always, followed by a urine culture. Here, the specific bacteria causing the infection is detected. That information is then used to decide which medications will be most effective by testing different antibiotics against the bacteria. (While this is considered the gold standard for diagnosing a UTI, it’s expensive and requires at least 48 hours to produce results.) (5)
In some cases, your healthcare provider may also do a pelvic exam to rule out other infections. While diagnosing a UTI doesn’t usually require imaging tests, an ultrasound of the kidneys or an X-ray while urinating may be performed on children to learn more about the infection and check for kidney damage. Imaging may also be used on those who experience recurrent UTIs.
Tests and Diagnosis for Recurrent UTIs
Recurrent urinary tract infections (defined as having three or more UTIs within 12 months, or two or more occurrences within six months) is very common among women. In fact, it’s estimated that 30 to 44 percent of all women will experience a second UTI within six months of an initial infection. And healthy women with normal urologic anatomy account for the majority of those with recurrent UTIs. (6)
If you’ve repeatedly experienced UTIs in the past, your healthcare provider may refer you to a urologist, a physician who specializes in urinary tract conditions. At that point, he or she may order tests such as:
- Cystogram If you’re experiencing frequent UTIs, your physician may want to rule out a urinary tract abnormality by way of a special X-ray of the the bladder and lower urinary tract. For this exam, a catheter is placed into your urethra and used to fill your bladder with an X-ray dye (contrast). (7)
- Ultrasound or computerized tomography (CT) scan
- Cystoscopic exam Here, a long, thin tube fitted with a lens is inserted into the urethra and passed through to the bladder.
UTI Tests and Diagnosis in Pregnant Women
Because pregnant women are especially susceptible to urinary tract infections, it’s recommended that all pregnant women get screened for UTIs. For this population, a urine culture is considered the most reliable test, especially for asymptomatic bacteriuria (ASB), which is a UTI without symptoms. The current guidelines recommend a single urine culture taken between 12 and 16 weeks of pregnancy or at one’s initial prenatal appointment. Since there is a high rate of false positives for this group, often a positive test result leads to a second testing a week later in order to avoid unnecessary treatment. (8)
UTI Testing and Diagnosis in Children
According to the most recent clinical practice guidelines by the American Academy of Pediatrics, a UTI diagnosis in a child requires both a urinalysis and a urine culture. In order to gather a proper urinary sample from a very young child, catheterization or a suprapubic aspirate (inserting a needle into the bladder just above the pubic bone) is often recommended. On the other hand, your healthcare provider may simply leave the child diaper-free in order to obtain a sample when the child urinates. While some physicians collect urine using a bag, samples obtained in this way have a high a rate of contamination, making results unreliable.
For children who are potty-trained, a midstream urine sample should be collected. It’s often recommended that girls sit backward on the toilet, in order to widen the labia and prevent contamination. (9)
Testing Negative for UTI
While urinalysis is useful, it is not always definitive in terms of diagnosis of a UTI. False-negative results can and do occur. False-negative cultures can appear for a variety of reasons, including mishandling of the urine specimen and a too-dilute urine sample. However, many women who experience typical UTI symptoms and receive a negative urine culture actually do have a UTI and should discuss antibiotic treatment with their healthcare provider. (10)
At the same time, women with symptoms of a UTI, but whose tests don’t show any infection, may have:
- Pelvic inflammatory disease (PID)
- Interstitial cystitis (also called painful bladder syndrome) (11)
- Kidney stones
- Food allergies
- Irritation of the vulva
- Sexually transmitted infections such as chlamydia, gonorrhea, or trichomoniasis. (12)
Additional reporting by Mark Henricks.
You might know that urinary tract infections during pregnancy are potentially dangerous, but did you know they’re also often asymptomatic?
Usually, UTI symptoms can include:
- Frequent urination
- Difficulty urinating
- Burning sensation or cramps while urinating
- Cloudy urine, or urine with an odor
But during pregnancy, women aren’t as likely to be tipped off to a UTI by these clues.
That’s because, during pregnancy, symptoms of a UTI actually can mimic pregnancy itself: the feeling that you have to use the restroom more often, pelvic pressure and lower back pain.
What’s scary is that although often asymptomatic, UTIs during pregnancy are common.
During pregnancy, hormones cause changes in the urinary tract, which makes women more susceptible to infection.
“There is a lot of the progesterone hormone circulating,” said Dr. Susan Oakley, director of female pelvic medicine and reconstructive surgery with St. Elizabeth Physicians. “The hormone relaxes our pipes and plumbing and slows things down, which invites bacteria to come in and start swimming around. I always say it’s like mosquitos to a puddle. If you leave water sitting there for long enough, they’ll find their way to it.”
Also, because things are closer together down there during pregnancy, there’s a greater likelihood for bacteria to spread.
“It may creep some women out to know that the No. 1 bacteria in a UTI is E. coli, but it really shouldn’t,” Oakley said. “It’s just something that’s way more common during pregnancy.”
So, why are UTIs so dangerous during pregnancy?
They can cause kidney infections or acute respiratory distress syndrome (ARDS) in the mother, both of which can lead to preterm labor and delivery.
If you suspect a UTI during pregnancy, seek medical advice as soon as possible at your gynecologist’s office.
Why Is There Blood in My Urine?
There are many possible causes for hematuria. In some cases, the blood may be from a different source.
Blood can appear to be in the urine when it’s really coming from the vagina in women, the ejaculate in men, or from a bowel movement in either men or women. If the blood is truly in your urine, there are several potential causes.
Infection is one of the most common causes of hematuria. The infection could be somewhere in your urinary tract, your bladder, or in your kidneys.
Infection occurs when bacteria move up the urethra, the tube that carries urine out of the body from the bladder. The infection can move into the bladder and even into the kidneys. It often causes pain and a need to urinate frequently. There may be gross or microscopic hematuria.
Another common reason for blood in the urine is the presence of stones in the bladder or kidney. These are crystals that form from the minerals in your urine. They can develop inside your kidneys or bladder.
Large stones can cause a blockage that often results in hematuria and significant pain.
In men who are middle-aged and older, a fairly common cause of hematuria is an enlarged prostate. This gland is just beneath the bladder and near the urethra.
When the prostate gets bigger, as it often does in men at middle age, it compresses the urethra. This causes problems with urinating and may prevent the bladder from emptying completely. This can result in a urinary tract infection (UTI) with blood in the urine.
A less common reason for seeing blood in the urine is kidney disease. A diseased or inflamed kidney can cause hematuria. This disease can occur on its own or as part of another disease, such as diabetes.
In children ages 6 to 10 years, the kidney disorder post-streptococcal glomerulonephritis may cause hematuria. This disorder can develop one to two weeks after an untreated strep infection. Once common, it’s rare today because antibiotics can quickly treat strep infections.
Cancer of the bladder, kidney, or prostate can cause blood in the urine. This is a symptom that often occurs in advanced cancer cases. There may not be earlier signs of a problem.
Certain medications can cause hematuria. These include:
- blood thinners like heparin and warfarin (Coumadin)
- cyclophosphamide, which is a drug used to treat certain types of cancer
Less common causes
There are a few other causes of hematuria that aren’t very common. Rare blood disorders such as sickle cell anemia, Alport syndrome, and hemophilia can cause blood in the urine.
Strenuous exercise or a blow to the kidneys can also cause blood to show up in the urine.
Urination: Frequent Urination
What is frequent urination?
Inconvenient and disruptive to your daily life, frequent urination is when you need to urinate many times throughout a 24-hour period. This is a symptom of many different conditions and can have a wide variety of solutions. At some points in your life, like during pregnancy, you may need to pee more frequently. This can be a normal symptom of something like pregnancy and it usually passes after birth. However, frequent urination can be linked to other health issues that aren’t normal parts of life and don’t fade over time. It can be a symptom of more serious conditions like diabetes, overactive bladder syndrome, UTIs or prostate problems. Needing to urinate frequently can even disturb your sleep. That full bladder that keeps waking you up in the middle of an otherwise good night’s sleep is a condition called nocturia.
In many cases, your healthcare provider can help relieve this symptom by treating the underlying condition.
Who experiences frequent urination?
The need to urinate is something that everyone feels. This shared experience isn’t always consistent though. Sometimes you may need to urinate much more often than what is typical for you. This can happen to anyone. Men, women, and children can all have this symptom. However, it’s more common at certain times in your life or when you have other conditions. You’re more likely to frequently urinate if you’re:
- A middle-age or old adult.
- Have an enlarged prostate.
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A strong and sudden desire to urinate is one sign of an overactive bladder. Symptoms include urinating more than eight times a day and more than once at night.
An overactive bladder can cramp your style, but it doesn’t have to. Here are five tips to take control over your trips to the bathroom.
Tips to Manage Frequent Urination
1. Take note of what you drink.
Alcohol and beverages with caffeine such as coffee, tea and soft drinks are diuretics and can increase the frequency of urination. According to Ariana Smith, urologist and associate professor at the University of Pennsylvania, “Eight ounces of coffee seem to be harder on the bladder than 8 ounces of water, so go with water.”
2. Exercise your pelvic muscles.
Flex the muscles surrounding your lower bladder and urethra to strengthen them. With an empty bladder, practice tightening your pelvic floor, hold for five seconds and then relax. Work your way up to 10 seconds. These are called Kegel exercises. According to the Mayo Clinic, “For best results, focus on tightening only your pelvic floor muscles. Be careful not to flex the muscles in your abdomen, thighs or buttocks. Avoid holding your breath. Instead, breathe freely during the exercises.”
3. Change your diet.
Adjust your diet and decrease foods that act as bladder irritants. Some foods such as apples, cranberries, and citrus fruits and juices can increase urination. Here’s a list of bladder irritants. Tomato-based foods and spicy foods also can be the cause of an increased urge to urinate.
4. Manage medications.
Muscle relaxants, sedatives, antidepressants and blood pressure drugs can trigger an overactive bladder. You may want to make adjustments to the time of day when you take certain medications, according to Sandra Valaitis, an expert at treating urinary incontinence at the University of Chicago Medicine.
5. See your doctor.
If your urge to urinate seems out of control, it is time to consult your doctor. If there is no beverage or food link to your urges, or the issue is disruptive to your everyday movements, or you have other problematic symptoms or pain, it’s also time to consult a doctor.
According to the Mayo Clinic, you should contact your doctor if you experience frequent urination along with any of the following signs and symptoms they have listed on their website.
- Blood in your urine
- Red or dark brown urine
- Painful urination
- Pain in your side, lower abdomen or groin
- Difficulty urinating or emptying your bladder
- A strong urge to urinate
- Loss of bladder control
These symptoms are signs of urinary tract disorders and may be a warning of other, more serious health conditions. If symptoms persist, it is best to seek medical advice to get to the cause so that a treatment plan can be formulated.