A urinary tract infection (UTI) is an infection anywhere along the urinary tract. The urinary tract includes the urethra, bladder, ureters, and kidneys. A UTI can develop when bacteria enter the urinary tract and begin to multiply. The infection most commonly affects the lower urinary tract, including the urethra and bladder, but it can also spread to the ureters and kidneys. Here’s an overview of the first signs and symptoms you may notice when a UTI is developing.
Pain or Burning During Urination
One of the first and most common symptoms of a UTI is a burning pain or discomfort when urinating. You may feel the burning sensation while you are peeing or right after. The technical term for this is dysuria. The burning results from inflammation in the urethra caused by the infection. In some cases, the pain and stinging during urination may be severe.
Increased Urgency and Frequency
Along with pain and burning when peeing, you may suddenly feel a strong and frequent urge to urinate. This urgent need to pee is also called urinary urgency. You may only urinate a small amount when you go, even though it feels as though your bladder is full. The infection leads to these symptoms because the bladder becomes irritated and inflamed. Your body is trying to flush out the bacteria, leading to the urge to go more often.
Cloudy, Bad Smelling Urine
UTIs often cause changes in the look and smell of urine. Your urine may take on a cloudy or murky appearance, instead of being clear. The cloudiness results from the presence of bacteria and white blood cells. Your urine may also start to have a strong or foul smell, which is not typical for healthy urine. The change in odor occurs from the bacteria multiplying and releasing certain waste products and gases.
Pelvic Pain or Pressure
Some women with a UTI experience pelvic pain or pressure. The pain may be felt in the lower abdomen, in the area around the pubic bone, or in the lower back. This pelvic discomfort and pressure results from the bladder infection. The nerves in the bladder can become irritated and inflamed, causing pelvic pain. You may notice the pelvic pain is worse when your bladder is full.
Blood in Urine
Hematuria refers to blood in the urine. While not everyone with a UTI has blood in their urine, it can sometimes happen. The blood results from inflammation and irritation to the walls of the urinary tract. Small blood vessels become damaged and bleed. The blood may make your urine appear pink, red, or brown in color.
Feeling Tired and Unwell
You may start to feel generally unwell as a UTI develops. Along with the urinary symptoms, you may experience fatigue, muscle aches, and flu-like symptoms. A mild fever is also possible. This results from your body’s immune response to fight the infection. Chemicals called cytokines are released, causing fever, fatigue, and muscle aches.
Lower Back Pain
It’s common to feel pain or tenderness in your lower back with a bladder infection. This occurs because the nerves that supply the bladder also supply the lower back. The inflammation from the UTI can radiate along these nerve pathways, leading to back discomfort. The pain often feels worse when pushing or straining on the bladder, such as during urination.
When to See a Doctor
You should make an appointment with your doctor right away if you suspect a UTI based on symptoms like:
- Burning with urination
- Pelvic pain
- Increased frequency and urgency of urination
- Cloudy or foul-smelling urine
- Blood in urine
Quick treatment with antibiotics helps ease symptoms and prevent complications. Let your doctor know if your symptoms come on suddenly and severely or if you have recurrent UTIs. You should also seek prompt medical care if UTI symptoms are accompanied by:
- Fever above 101°F (38.3°C)
- Chills and shaking
- Nausea and vomiting
- Flank (side) back pain
- Mental status changes or confusion
These signs may indicate the infection has reached your kidneys. UTIs that spread to the kidneys (called pyelonephritis) can quickly become serious.
What Causes a UTI?
UTIs are usually caused by bacteria from the gastrointestinal (GI) tract, such as E. coli, entering the urinary opening and traveling up to the bladder. Some factors that increase UTI risk include:
- Female anatomy – Shorter urethra makes it easier for bacteria to enter
- Sexual intercourse
- Use of diaphragms or spermicides
- Menopause
- Pregnancy
- Blockages, such as kidney stones
- Catheter use
- Weakened immune system
- Prior UTIs
How is a UTI Diagnosed?
Your doctor can usually diagnose a UTI based on your symptoms and a urine test. The urine sample is sent to a lab and examined under a microscope to look for bacteria and signs of infection, such as white blood cells. A urine culture may be ordered to confirm the bacteria causing the infection and test antibiotic sensitivity.
Urine Tests for Diagnosing UTIs
- Urinalysis checks for signs of infection, like bacteria, blood, and white blood cells.
- Urine culture identifies the precise bacteria causing the infection.
- Antibiotic sensitivity testing determines the best medication to treat the UTI bacteria.
How is a UTI Treated?
Most uncomplicated UTIs can be treated with a short course of oral antibiotics, usually for 3 to 7 days. Antibiotics commonly used for UTIs include:
- Trimethoprim/sulfamethoxazole
- Ciprofloxacin
- Nitrofurantoin
- Fosfomycin
Your doctor will select the antibiotic based on the lab test results for susceptibility. Be sure to finish all prescribed antibiotics, even if you start feeling better. In addition to antibiotics, your doctor may recommend:
- Drinking more fluids
- Urinary pain relievers like phenazopyridine
- Over-the-counter pain medications
For symptom relief, many people also find success using at-home remedies for UTIs like:
- Drinking cranberry juice
- Taking probiotics
- Applying a warm compress on the perineum
See your doctor right away if your symptoms don’t improve within two days of starting antibiotics. You may need a different antibiotic or longer course of treatment.
How Can UTIs Be Prevented?
Some key ways to help avoid recurring UTIs include:
- Drink plenty of fluids, especially water
- Urinate before and after sex
- Take showers instead of baths
- Avoid feminine products that can irritate the urethra
- Wear cotton underwear and loose-fitting clothes
- Empty your bladder fully when you urinate
- Take probiotics
If you get frequent UTIs, your doctor may recommend low-dose antibiotic prophylaxis to prevent infection. Postmenopausal women may benefit from vaginal estrogen therapy. Maintaining good hygiene and hydration habits can go a long way in stopping UTIs from developing.
Can UTIs Lead to Complications?
Most uncomplicated lower UTIs resolve readily with medical treatment without complications. However, some potentially serious complications can occur if UTIs spread to the kidneys or upper urinary tract. Possible UTI complications include:
- Acute pyelonephritis – Kidney infection that causes flank pain, fever, nausea/vomiting
- Emphysematous pyelonephritis – Rare, life-threatening kidney infection
- Sepsis – Body-wide systemic infection
- Kidney abscess – Pockets of pus infection in the kidneys
- Kidney damage – Permanent scarring of kidney tissue
Recurrent UTIs, even when mild, can also lead to rare serious outcomes like renal hypertension or end-stage renal disease. That’s why prompt UTI treatment and prevention methods are crucial.
When to Seek Emergency Care for a UTI
A kidney infection can rapidly progress to sepsis or life-threatening complications. Seek emergency medical care if you have signs and symptoms such as:
- High fever with temperature over 102°F (39°C)
- Uncontrolled shivering and shaking chills
- Rapid heart rate and breathing
- Acute (sudden) flank or lower back pain
- Nausea, vomiting, and inability to keep fluids down
- Mental confusion, delirium, or lethargy
- Severe pelvic pain
These emergency warning signs indicate the UTI may have reached the kidneys or spread to the bloodstream. Sepsis can lead to organ damage and require ICU care. Older adults and those with weakened immune systems have an increased risk of complications.
Conclusion
A UTI can develop when bacteria infect any part of the urinary tract, most often starting in the bladder. The first symptoms are typically a burning feeling when urinating, pelvic discomfort, and needing to urinate more often. Other common early signs include cloudy urine, low back pain, and feeling unwell. Without treatment, the infection can spread to the kidneys and lead to complications. Seek prompt medical care if you suspect a UTI based on symptoms. Your doctor will diagnose the infection through a simple urine test and antibiotic treatment can begin immediately.