Urinary Tract Infections
It was only third period, but Tracy had already visited the bathroom six times
that morning. Sometimes she barely had time to ask the teacher for permission because
the urge to pee was so intense. Did she drink too much orange juice for breakfast?
Nope — although she really had to go, only a little urine came out each time.
And every time she peed, she felt a burning sensation. What was going on?
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.
Bacteria can get into the urethra several ways. During sexual intercourse, for
example, 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 also may increase the risk of UTIs.
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 can lead to serious long-term problems, including pelvic inflammatory disease (PID)
and infertility. Unlike UTIs, STDs are contagious.
Symptoms of UTIs
A number of symptoms are associated with UTIs, including:
- 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 need to stay on medicine 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, which can irritate
the bladder. Smoking also irritates the bladder, and cause bladder problems later
on.
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. Couples who use
lubrication during sex should 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.
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