There Are A Lot Of Variables To Consider When Diagnosing A Uti
Women who have had UTIs before most likely recognize their symptoms. However, something that causes you to urinate more frequently and causes discomfort isnt necessarily a UTI.
My first goal when speaking with a patient is to get as much information as I can, so I can determine the best diagnosis and treatment plan, says Dr. Talbott. Urinary tract infections can be confused with sexually transmitted diseases, or they can be more complicated if you have diabetes or other diseases that contribute to a suppressed immune system. It is also challenging when addressing a pediatric patient, or in the elderly with multiple complex health issues.
If youre experiencing fever, nausea, or pain, you most likely have a kidney infection. However, if you have thick white discharge, you might have a yeast infection. Blood in the urine may also suggest a bladder infection, while a discharge with a fishy odor may indicate bacterial vaginosis.
Giving your doctor as much information as you can helps him or her determine the most likely way to get you feeling better fast, says Dr. Talbott.
How Are Recurrent Utis Treated
Treatment for recurrent UTIs depends on what’s causing them. Sometimes the answer is as simple as teaching a child to empty their bladder as soon as they have the urge to go.
If a condition like VUR is causing the infections, the solution is a bit more complicated. Kids with VUR must be watched closely, because it can lead to kidney infection and kidney damage. Most kids outgrow the condition. Some might need surgery to correct the reflux.
Some kids with VUR benefit from daily treatment with a small amount of antibiotics, which can also make surgery unnecessary. Kids with VUR should see a pediatric urologist, who can decide if antibiotic treatment is the best option.
In some cases, surgery is needed to correct VUR. The most common procedure is ureteral reimplantation, in which one or both of the ureters are repositioned to correct the backflow of urine from the bladder. This procedure requires only a small incision and, in some children, can be done using robotic-assisted laparoscopy. When surgery is necessary, the success rate is high, but not everyone is a good candidate for it.
Kids may be candidates for ureteral reimplantation if they:
- have an intolerance to antibiotics
- get recurrent infections while on antibiotic treatment
- have severe, or “high-grade,” reflux
- are older kids and teens with reflux
What Is A Bladder Infection
Cystitis is inflammation of the bladder thats generally caused by a bacterial infection. Bladder infections occur when bacteria from the area between the vagina/penis and rectum enter the urethra and travel into the bladder.
Bladder infections are the most common type of urinary tract infection . UTIs can occur in any part of the urinary tract in the kidneys, ureters, bladder or urethra. They account for more than 8.1 million visits to health care providers every year. Approximately 60% of women and 12% of men will have at least one UTI during their lifetime.
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Are Home Remedies Effective For A Bladder Infection
People have used cranberry products to prevent bladder infections. Cranberries contain a substance that can prevent bacteria from sticking on the walls of the bladder. A Cochrane Database systematic review of cranberries for preventing UTIs in 2012 concluded that the evidence for cranberry products, particularly cranberry juice, over the long term is small and that cranberry juice could not be recommended at that time for the prevention of UTIs. Further studies need to evaluate other cranberry preparations.
Probiotics are preparations that contain live bacteria, for example, lactobacillus, that can prevent other bacteria from growing and moving up from the bladder to the kidney. The probiotic decreases the ability of the infecting bacteria from sticking to the bladder and growing and may also affect the ability of the individuals own body to fight off bacteria. A Cochrane Database review in 2015 demonstrated no significant difference in the risks of recurrent UTIs for probiotics compared with placebo or antibiotic prophylaxis in either women or children, however, there were a limited number of good-quality studies.
Adhering to the prescribed antibiotic regimen and staying well hydrated are essential components of home remedies for bladder infection.
Why Its Important To Find The Right Practitioner
While you may be able to request UTI testing independently, the results have limited usefulness without a practitioner who can interpret the information and prescribe an appropriate treatment regimen.
Because the types of UTI testing covered above are not widely available, many practitioners may not be aware of them at all. Or they may be aware of them but have no experience using them, or may believe them to be unhelpful.
Always find a practitioner to work with before ordering testing. Weve covered recurrent UTI treatment approaches in a separate article, so dive in there for more insight.
| With Microbiome testing, you dont often get one bacteria. Certainly, I have found the usual suspects like E. coli. Ive even detected some STIs, and anaerobes that cant be grown by culture. Sometimes, you get long lists of bacteria that we know very little about, and Ill do extensive literature searches and sometimes barely come up with one or two papers. And so what I generally do in that situation is to try and figure out which are likely to be pathogenic, and treat those. This is a really different way of prescribing antibiotics compared to when I was trained. |
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Symptoms That Mimic A Urinary Tract Infection
An irritated bladder accompanied me and my endometriosis all throughout my 20s, right after I became sexually active. When I experienced symptoms of unrelenting burning and frequent urination for the first time, I headed to the doctor. My urine culture confirmed I had a urinary tract infection a bacterial infection, usually caused by E.coli that enters the urethra. But as time passed and my sex life continued, my painful symptoms persisted often without any bacteria in my pee.
My doctors were at a loss for why I would have UTI-like symptoms if it wasnt an infection. But as it turns out, many women feel like they have persistent UTIs without a positive urine culture, says Dr. Christina E. Lewicky Gaupp, a urogynecology and pelvic reconstructive surgeon at Northwestern Memorial Hospital in Chicago. She explains that there are several other possible conditions that cause UTI-like symptoms, like pelvic floor dysfunction and dehydration.
Thankfully, there are treatments that can help resolve your constant bathroom runs. Here are five reasons why you might feel like you have a UTI when you dont and what to do to feel better.
Try Drinking Some Unsweetened Cranberry Juice
While the research is a bit unclear, cranberries have been used as a prevention of UTI for generations. Studies have shown that cranberries actually make it harder for the bacteria that cause UTIs to stick to the urinary tract walls. So, while not really a remedy, if you frequently get UTIs, it might be worth drinking a couple of glasses of unsweetened cranberry juice, or snacking on the actual fruit .
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Can You Get Rid Of A Uti Naturally At Home Or Do You Need Antibiotics
Sometimes, you can get rid of a UTI naturally by resting, drinking lots of water, taking dietary supplements, and giving the infection some time to heal. Research from 2017 suggests that somewhere between 25% and 42% of UTIs resolve naturally without the use of antibiotics.
However, there are certain situations where wait and see just isnt an acceptable approach. Untreated UTIs can cause potentially life threatening complications, including .
Practice Good Hygiene After Sex And Ask Your Partner To Too
Overall health with increased water intake and exercise is the best way to improve health and help with decreasing UTIs, Dr. Shepherd shares. This includes good hygiene and being diligent about cleaning all of your lady parts. And make sure your partner does, too. Bacteria from sexual intercourse is one of the most common ways women can get a UTI, Dr. Shepherd explains.
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What Is A Uti
A urinary tract infection is an infection of the bladder which is part of the urinary tract . Cystitis is another name given to a UTI or inflammation of the urinary tract. Its origins are in the Greek terms cyst, meaning bladder and itis, meaning inflammation. It is one of the most common bacterial infections in the world and an estimated 1 in 3 women suffer a UTI in their lifetime.
Try Taking A Probiotic
Introducing a probiotic to your system may help to replenish the naturally occurring, healthy bacteria that live in the gut. It is thought that probiotics may prevent harmful bacteria from attaching to the urinary tract cells, and may also lower the urine Ph, making it less hospitable to harmful bacteria. And, if you have taken an antibiotic to treat a UTI, taking a probiotic is a great way to build up the healthy bacteria that may have been killed during your course of treatment. Probiotics are found in supplement form , or they occur naturally in some types of food, including certain yogurts, kombucha, or kefir.
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When To Get Medical Advice
It’s a good idea to see your GP if you think you might have a UTI, particularly if:
- you have symptoms of an upper UTI
- the symptoms are severe or getting worse
- the symptoms haven’t started to improve after a few days
- you get UTIs frequently
Your GP can rule out other possible causes of your symptoms by testing a sample of your urine and can prescribe antibiotics if you do have an infection.
Antibiotics are usually recommended because untreated UTIs can potentially cause serious problems if they’re allowed to spread.
You Can Get Help Without Going To A Doctors Office
In the past, receiving treatment for a UTI required scheduling an office visit and suffering through your symptoms until you can see a doctor. Now, telemedicine services like MDLIVE allow you can talk to a doctor via phone or videowherever you arein an average of 10 minutes or less. And if you need a prescription, you can have it in your hands that same day.
When it comes to UTIs, there are tests a doctor can run a urinalysis and culture, which can get quite expensive. However, if youre a healthy female between the ages of 18 and 65 with the symptoms of a UTI and without any complications, these tests most likely arent going to change the initial treatment a doctor prescribes, says Dr. Talbott.
If your doctor sees anything complicated in your symptoms, it does make sense to do a urinalysis and possibly other laboratory tests. But in a majority of cases, its reasonable to initiate treatment and forgo the cost and inconvenience of testing, and delay in treatment, because most of the time it wont change the antibiotic thats prescribed.
This makes telemedicine a more convenient and inexpensive way to get the treatment you need to minimize your discomfort and start feeling better, faster.*
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How To Culture Urine
Bacteria will continue to multiply in the warm medium of freshly voided urine. It is therefore mandatory that urinalysis and culture tests should be performed without delay. The average time of replication of E. coli is n minutes, so that the number of bacteria increases exponentially with time . If bacterial examination is delayed by more than 2 h, specimens must be stored at 4°C, but for no more than 48 h. Dip-slide culture or a similar semiquantitative method of culture is generally preferable. These methods offer the advantage of reflecting the true approximate concentration of bacteria at the time the sample is taken so that storage at low temperature is unnecessary.
Occasionally, unusual or fastidious bacteria may induce UTI. These bacteria are difficult to detect without examination of the urine using Gram stain . For example, Haemophilus influenzae and Haemophilus parainfluenza do not grow well in culture media commonly used for enteric bacteria and as a result may go undetected. Other unusual organisms include Pneumococcus, Campylobacter, Legionella pneumophila, Salmonella, Shigella, Corynebacterium group D2, acid-fast bacilli , and fungi . Gram and acid-fast stains should be performed for patients with urinary symptoms and pyuria when routine cultures are reported to be negative.
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Pain But Nothing On Tests
Chronic UTI is not a universally accepted diagnosis, but James Malone-Lee, Emeritus Professor of Medicine at University College London, believes most people diagnosed with interstitial cystitis, also known as bladder pain syndrome, actually have chronic UTIs.
The National Institute of Diabetes and Digestive and Kidney Diseases reports that IC is common. The condition may affect between 3 million and 8 million women and between 1 million and 4 million men in the United States.
Though there is no standard treatment for such cases, David Kaufman, a New York urologist specializing in treating bladder and pelvic pain, says he believes new tests could help many people get diagnosed and treated.
I think the failure to diagnose these patients definitively with chronic, low-grade infections is a result of the inability of two-to-three day commercial cultures to identify the infection. This will hopefully soon change as labs begin using molecular systems to identify microbial DNA and RNA in urine, Kaufman says. I do think the DNA sequencing testing is going to be a game-changer.
Dipsticks and cultures are being advocated in protocols and guidelines all over the world, so those guidelines are hopelessly deficient, Malone-Lee says. It is women who pay the price being denied treatment and told that they do not have a UTI when they do have a UTI.
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Is It Possible To Have A Uti Without Any Symptoms
Yes. Symptoms of a UTI can vary, and it’s not entirely uncommon for someone to experience no symptoms of a urinary tract infection. Its estimated that 1 to 5 percent of younger women experience asymptomatic bacteriuria , which is a UTI without the classic symptoms. While its unclear why the bacteria involved with urinary tract infections sometimes don’t cause symptoms for these people, we do know that instances of symptom-free UTIs increase with age. Up to 16 percent of women older than 65 have been found to have ASB, and that number grows to almost 20 percent for women over 80. Other factors that increase your chances of an asymptomatic UTI are:
- Urinary catheter use
Treatment From A Gp For Utis That Keep Coming Back
If your UTI comes back after treatment, or you have 2 UTIs in 6 months, a GP may:
- prescribe a different antibiotic or prescribe a low-dose antibiotic to take for up to 6 months
- prescribe a vaginal cream containing oestrogen, if you have gone through the menopause
- refer you to a specialist for further tests and treatments
In some people, antibiotics do not work or urine tests do not pick up an infection, even though you have UTI symptoms.
This may mean you have a long-term UTI that is not picked up by current urine tests. Ask the GP for a referral to a specialist for further tests and treatments.
Long-term UTIs are linked to an increased risk of bladder cancer in people aged 60 and over.
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Utis Can Be Caused By Multiple Pathogens
Another issue with the standard mid-stream urine culture, or Kass test, is that it looks for a single pathogen, and does not take into account the possibility of multiple infection-causing pathogens.
Instead, if multiple pathogens are found, it is generally assumed that the urine sample was contaminated.
This is a problem because some chronic infections have been found to be caused by multiple pathogens co-existing in the bladder. And each pathogen may require a different treatment approach.
| Our biological studies reveal mixed microbial infections hiding inside the cells of the bladder. Located there, the microbes seem quiescent but cause low-grade inflammation that may cause various bladder symptomsCloistered, inside cells bacteria escape antibiotic and immune attack. |
When To See A Gp
You should see a GP if you have persistent pelvic pain or you notice a change in your usual peeing pattern.
These symptoms can have a number of causes, so its a good idea to get a proper diagnosis.
The GP can refer you to a hospital specialist like a urologist, a specialist in conditions affecting the urinary system, for further tests, such as a cystoscopy. A cystoscopy is a procedure to examine the inside of the bladder.
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Ive Gained My Life Back: New Tests May Help Those With Persistent Urinary Tract Infections
In 2015, Jessica Price, a 29-year-old Air Force veteran in Illinois, started experiencing urinary tract infection symptoms, including an unrelenting urge to urinate and bladder pain. But standard dipstick testing, where a doctor dips a plastic stick into a urine sample to check it for signs of bacteria, kept coming back negative. Based on her symptoms and the negative tests, doctors told Price she had interstitial cystitis , an incurable syndrome of unknown cause and suggested several invasive procedures that only worsened her pain.
I was on more medications than I can remember, none of which helped and some which made the symptoms worse, she remembers. The urologists told me things such as, This is just like having blue or brown eyes you were destined to have it.
But when a nurse practitioner turned to a new type of test that used DNA analysis of her urine, she found bacteria she said was abnormal, and Price began two years of antibiotic treatments that after some time finally brought her relief.