Why do I keep getting urinary tract infections (UTI’s)?

What is a urinary tract infection (UTI)?

A urinary tract infection refers to a condition where there is overgrowth of bacteria in the urinary system. This is a general term that can include any portion of the urinary system including the kidneys, the ureters, the bladder, and the urethra.

What is the difference between a bladder infection and a kidney infection?

A bladder infection is the most common type of urinary tract infection, and is also known as bacterial cystitis. Symptoms of a bladder infection are typically irritative and localized. Symptoms can include painful urination, pain in the lower abdomen or lower back, urgency and frequency of urination. We note that your body is able to eliminate some bladder infections on its own without antibiotic use.

A kidney infection is also known as pyelonephritis. Symptoms of a kidney infection tend to be systemic. These can include fevers, chills, back pain in addition to the symptoms of a bladder infection such as painful urination urgency and frequency. Kidney infections are more serious than a bladder infection and require prompt treatment with antibiotic therapy to prevent progression to a more serious infection known as urosepsis.

Where do the bacteria that cause urinary tract infections come from?

The majority of bacteria that cause urinary tract infections come from the bowel system. The distance between the vagina and anus is quite close in women and colonization of the opening of the vagina occurs quite easily. This has nothing to do with hygiene, the majority of our patients who have recurrent urinary tract infections do practice good hygiene. Since it is impossible to sterilize the skin, even with hygienic behaviors, colonization of the opening of the vagina can occur. The distance between the urethra and the opening of the vagina is quite short, and it is quite easy for bacteria to be pushed from the vaginal opening into the urethra either with intercourse or with daily activities.

Less commonly, bacterial infections can be related to concurrent conditions such as very large kidney stones, abnormal connections between the bowel and the bladder, abnormalities of the anatomy of the urinary tract, or incomplete bladder emptying.

How do antibiotics treatment urinary tract infections?

Antibiotics typically are processed either through the liver or the kidneys, excreted into the blood which then achieves therapeutic levels in the urine. There are numerous antibiotics, and each has a different mechanism of action that results in either stopping growth of bacteria or destroying the bacteria.

When we obtain urine tests for infection, we commonly will obtain a test called a urine culture, which shows us which bacteriuria is causing the infection and also gives us a list of antibiotics that the bacteria is sensitive to.

What are the risks of using antibiotics too frequently?

There are many healthy bacteria that exist in every organ system in our body. Antibiotics act fairly indiscriminately, and result in destruction of both healthy and unhealthy or pathogenic bacterial colonies. As a result of this, antibiotic use can result in disruption of bowel function, overgrowth of yeast, and overgrowth of bacteria on the skin. The worst complication can be overgrowth of a bacteria in the gut known as C. Dificile. This bacteria results in severe inflammation of the lining of the intestine, loss of the intestines ability to absorb fluid and nutrients, severe diarrhea and can be life-threatening.