Understanding UTIs

Urinary tract infections (UTIs) occur when bacteria, and sometimes fungi, enter the urinary tract from the urethra. From there, the bacteria can often travel up into the bladder or kidneys, causing additional issues and symptoms. UTIs are most common in women, but men can also get UTIs, especially as they get older.

Primary Symptoms of UTIs

Most women are likely familiar with the symptoms of a UTI: a strong urge to urinate, a burning feeling when urinating, frequently urinating in small amounts, cloudy urine, or pelvic pain.

Depending on what part of the urinary tract is affected, the symptoms can be different. For a UTI that affects the kidneys, symptoms may include upper back and side pain, a fever, shaking, chills, nausea, or vomiting. A UTI that affects the bladder may be associated with pelvic pressure, lower abdomen discomfort, frequent urination, pain when urinating, or blood in the urine. A UTI that affects the urethra may be characterized by a change in vaginal discharge or a burning sensation with urination (Mayo Clinic, n.d.).

Nutrients and Supplements for UTIs

Cranberry juice and cranberry products may help prevent UTIs along with probiotics, specifically Lactobacillus strains. There is some evidence that vitamin C and a sugar called D-mannose may each be beneficial at preventing UTIs.

Cranberry

Cranberry use is widespread for the prevention of UTIs. The benefits of cranberry juice are believed to come from their acidity as well as the various plant compounds they contain such as proanthocyanidins, which give the fruit its red color and may have antibacterial properties.

The results of clinical studies on cranberry have been mixed¬: Some studies have shown that cranberry products are almost as beneficial as low-dose antibiotics at preventing UTIs, while other studies have found no benefit of cranberry products in UTI prevention (Chih-Hung Wang et al., 2012; Jepsen et al., 2012). This is likely due to inconsistencies in the dose depending on whether the cranberry product comes in the form of a juice, tablet, syrup, or powder. And the amount of proanthocyanidins found in products may vary, too. The strongest evidence for cranberry’s ability to prevent UTIs is among women with recurrent UTIs and among children (Sihra et al., 2018).

Since there are minimal side effects associated with cranberry products and they are fairly low-cost, it may be worthwhile to start taking a cranberry supplement or drinking cranberry juice, especially if you are prone to UTIs.

Probiotics

A disrupted microbiome could potentially be associated with higher frequency of UTIs and other infections. Researchers have suggested that optimizing the microbiome with beneficial probiotics (live microorganisms) may help prevent UTIs (Aragón et al., 2018). However, the evidence has been mixed regarding the benefits of probiotics.

How UTIs Are Diagnosed

You may be alerted to a UTI by the obvious symptoms, such as pain when urinating or a frequent need to urinate in small amounts. These symptoms are often sufficient for doctors to make an accurate diagnosis. However, these symptoms may not always be present, and your doctor may request a urine sample to confirm diagnosis. A urine test will often screen for the presence of nitrites, which are usually symptomatic of an infection. If diagnosis is not clear from the urine analysis, a urine culture may be carried out to see whether live bacteria are present. It can also determine which bacteria are causing the infection. Your doctor may perform a swab or a blood test to determine if there is an alternative diagnosis, such as a sexually transmitted infection (K. Gupta et al., 2017).

If you have frequent UTIs, your doctor may use a scope (cystoscopy) to look inside of your urethra and bladder to make sure everything is healthy.

Vaginal Bacteria and UTIs

Frequent sexual activity is the biggest risk factor for developing a UTI. It’s previously been believed that this is likely due to the spread of bacteria during sex. A new study from researchers at Washington University School of Medicine exposes another possible reason: Gardnerella vaginalis, a type of bacteria that lives in the vagina. The study used a mouse model to show that exposing mice’s bladders to G. vaginalis damages cells on the bladder’s surface and reactivates latent E. coli bacteria, making the mice more susceptible to infection (Gilbert et al., 2017). Thus, UTIs may be driven by a complex interplay between multiple bacteria, especially during sex, when bacteria is more likely to move from the vagina to the bladder.

Lifestyle Changes for UTIs

Certain types of birth control, such as diaphragms and spermicide-treated condoms, may increase your risk of UTIs. To prevent UTIs, you’ll want to maintain proper hygiene.

Birth Control

Certain forms of birth control, such as diaphragms, which push against the urethra and make it hard to empty the bladder, as well as spermicide-treated condoms, have been associated with an increased risk of UTIs (Fihn et al., 1996; Foxman et al., 2000).

Hygiene

Anatomically, women have a shorter urethra than men do and also have a shorter distance between their anus and urethra, which increases women’s risk of getting UTIs. Thus, proper hygiene is important to prevent infection. Wipe carefully from front to back after using the toilet to avoid contaminating your urethra with bacteria. Avoid feminine products or cleanses that contain irritants that may inflame the urethra or change the vaginal environment (CDC, 2019; Crann et al., 2018).

Hydration

Theoretically, drinking more liquids could help flush bacteria out of the urinary tract before it spreads and causes infection. However, studies have shown conflicting results about fluid intake, and overhydration may actually worsen some urinary symptoms (Bergamin & Kiosoglous, 2017). If you have a UTI, you may find that certain drinks such as alcohol, caffeine, or citrus juices irritate your bladder and increase your need to urinate.

Sexual Activity

Having frequent sexual intercourse is the strongest risk factor for developing a UTI. If you are suffering from recurrent, troubling UTIs, you may want to consider avoiding sexual activity until you have spoken to your health care practitioner and fully recovered from the recurring UTIs. You may have heard the common advice to pee after sex, but studies have failed to show that this is helpful at preventing UTIs in any significant way (Bergamin & Kiosoglous, 2017). Despite the lack of evidence for urinating after sex, many health care practitioners still recommend doing so because there’s no harm in it. What you can also try: Avoid spermicide-treated condoms (see birth control section above) and avoid feminine products such as lotions and soaps that contain chemical irritants that may cause vaginal discomfort.

Maintaining a Healthy Weight

Several studies have shown that adult women and men as well as children with higher body mass index (BMI) are significantly more likely to suffer from a UTI, although it’s not clear why (Hsu & Chen, 2018; Nseir et al., 2015; Semins et al., 2012).