What is a UTI and what causes a UTI?
Many people mistakenly think that a UTI is an STD (sexually transmitted disease) or that it is caused by drinking too much caffeine or alcohol. UTI stands for urinary tract infection and may occur in any part of the urinary system. The urinary system consists of the kidneys (filters blood and creates urine from filtered waste), ureters (tubes that urine travels from kidneys to bladder in), bladder (stores collected urine until full) and urethra (tube that urine travels from the bladder to outside the body during urination). (1) In men, the prostate, which sits just under the bladder and around the urethra, can also get infected. But what is most commonly the root cause of a UTI?
First, when you ingest water, it travels to the stomach and intestines where most of it gets absorbed through the stomach and intestinal walls into the cells and blood and then moves throughout the body providing hydration. The remaining water that is not absorbed during digestion continues moving through the intestines and passes with any unabsorbed food material in the stool. (2)
Then as your blood travels through the body it collects waste and ultimately makes it to the kidneys where it gets filtered and cleaned of any excess liquid and waste. This waste is called urea. As the blood passes through the kidneys, whatever urea is filtered out and not useful to be reabsorbed is left behind as waste fluids and is what becomes urine. Urine then leaves the kidneys via the ureters (tubes that connects the kidneys to the bladder) and collects in the bladder. When the bladder becomes full it sends a signal indicating that it needs to be emptied and the urine then finally travels through the urethra and exits the body during urination. (3)
When any part of the urinary system becomes infected it is generally referred to as a urinary tract infection. Most urinary tract infections happen in the lower portions of the urinary tract in the urethra (urethritis) or the bladder (cystitis) and in men, also the prostate (prostatitis). Any urinary tract infection can spread up the urinary system into the kidneys (pyelonephritis) and lead to permanent damage or sepsis if not treated. (4)
So, if urine starts as waste fluids from your kidneys, why does a urinary tract infection usually start at the other end of the system where the urine exits? This small hole where urine exits the body can also allow bacteria to enter into the system. When bacteria makes its way into your urethra, bladder or kidneys it can multiply and cause infection and is the main cause of UTIs.
Common bacteria that causes Urinary Tract Infection
UTIs are most frequently caused by the bacteria Escherichia coli (E. coli) that is found naturally in your gut and fecal matter. Because of the close proximity of the anus to the urethral opening in women, UTIs are much more common in women than men. This proximity allows for the E. coli naturally found in your feces to make its way to the urethral opening and penetrate the urethra. Because the urethra is much shorter in women than men, it is much easier for the bacteria to colonize and move to the bladder and cause infection. In fact, approximately 50% of all women will have at least one UTI in her life. (5) One in four women will experience recurrent urinary tract infections. These rates drop considerably in men because of the longer urethra and prostrate excretions that have anti-bacterial properties. While UTi in men happens at a much lower instance when they are younger the occurrence does rise in older men. (6)
Bacteria, such as Klebsiella pneumoniae (7) and Staphylococcus saprophyticus, (8) and other bacteria can contribute to urinary tract infection but do so much less. Furthermore, when the naturally occurring vaginal bacteria Gardnerella vaginalis is introduced into the urinary tract it is believed to reactivate dormant E. coli that remain in the folds of the urethra and bladder and contribute to reinfection by the E. coli. (9)
It has also recently been shown that the E. coli from your grocery store chicken may also be contributing to people contracting urinary tract infections. (10) The overuse of antibiotics and unsanitary conditions in factory food production has caused many superbugs and many illnesses in the humans handling, preparing and consuming it. Recent studies showed matches between the DNA of E. coli found in the local grocery store chicken to the strains of E. coli found in UTI patients in the area. We will dig deeper into this in another post but when possible always purchase from your local farmers that commit to raising antibiotic free and pastured raised animals. If you don’t have local access to responsibly raised meat you can purchase it online to have it shipped. Crowd Cow and US Wellness Beef both have excellent options. This may not the most cost-effective option but it can sometimes be difficult to find high-quality meat products locally. Of course, proper caution should always be taken when handling any raw meat products.
Contributing factors of UTI
Bacteria is the main cause of UTIs but contributing factors can include physical abnormalities, kidney stones, enlarged prostate, and diabetes for example. While a UTI is not an STD (sexually transmitted disease), sexual activity can contribute to urinary tract infections by spreading naturally occurring E. coli around and by pushing it into the urethra opening in women. So, as the bacteria is generally the cause of an infection, there are many things that can contribute to being more susceptible to the bacteria. I have mentioned several of the physical complications that can make a person more susceptible.
Some of these factors are physical and cannot be changed. As mentioned previously, women, in general, are more prone to urinary tract infections because of physical make up. In addition, contributing anatomical abnormalities may include blockages, such as an enlarged bladder or kidney stones, preventing emptying the bladder completely or structural abnormalities such as diverticula that can harbor bacteria in the bladder. Sometimes it comes down to genetics that makes some people more prone than others to bacteria adhering to their urethra lining. (11)
Medical factors may also cause an increase in UTI occurrence. Diabetic people and people with compromised immune systems will be more prone as their systems are not as capable of fighting off invasive bacteria. (11) Another medical factor that can cause a person to be more prone to a bacterial infection in the urinary system is catheter use. If a person uses a catheter only occasionally the catheter always needs to be cleaned and stored properly so that it does not introduce bacteria on the next use. Closed system catheters are less likely to contribute. (12) In addition, being post-menopausal can contribute to getting a UTI because the reduction of estrogen that naturally helps to protect the urinary tract by promoting the balance of the healthy vaginal bacteria, lactobacilli, contributes to an imbalance of the good vs. bad bacteria. Using a prescribed vaginal estrogen cream and taking good probiotics can help keep this balance healthy. (12) UTI in men can be brought on by an enlarged prostate (13) and generally, the frequency of urinary tract infection in men raises amongst older men.
Steps to take to help prevent a UTI
There are many factors that may exacerbate susceptibility of getting a urinary tract infection that can be addressed through lifestyle changes. First and foremost, you want to always be mindful to wipe front to back in a way that minimizes spreading E. coli to the urethra opening and vagina. Using unscented wipes, changing undergarments or incontinence pads frequently and avoiding thong style underwear can also help prevent the unwanted spreading of bacteria. (12) Sexual activity can also promote a urinary tract infection for the same reason and therefore you want to urinate before sex and after sex to flush as much bacteria from the area as possible. E. coli uses hooks, called FimH, to cling to the lining of the bladder and urethra during urination so, cleaning the area with soap and water or unscented wipes is also a prudent step before and after sex. (14)
Diet plays a large role in overall health and no less so with contributing to or helping to prevent a urinary tract infection. Several foods and beverages are considered to be bladder irritants. When the bladder or urethra lining is irritated, just like an abrasion on your skin, the bacteria can enter and adhere to the lining tissues easier. Some commonly known bladder irritants are caffeine, alcohol, chocolate and sugar. Spicy foods, citrus and carbonated beverages are among the list as well. (15) By limiting foods and beverages that cause irritation to the bladder you can help create a healthier environment for your body to fight off and flush out bad bacteria. A very simple thing to add to your diet to help maintain a healthy urinary tract is water. Drinking plenty of water keeps urine from being too concentrated. Highly concentrated urine is also an irritant to the bladder and can be diluted by staying properly hydrated, and therefore not as irritating. (16)
Other changes that can be made include changing birth control if you use a diaphragm, spermicidal or unlubricated condoms. A diaphragm can contribute to bacterial growth and spread, while spermicides and unlubricated condoms can contribute to irritation. (17)
Last, but not least, always go to the bathroom when you feel the need to urinate. Emptying the bladder regularly is important in preventing a UTI. By holding urine in the bladder, this gives bacteria more chance to multiply and cause a urinary tract infection. (18) By staying hydrated and urinating when needed you will help to keep your system healthy and flushed.
A UTI is an infection in your urinary system and there are many contributing factors that may cause a person to be more prone to getting a urinary tract infection. However, there are many things you can address and change to help your efforts of preventing a urinary tract infection in the first place. Preventing infection is key to keeping your urinary system and your entire body healthy. Infection can also cause fatigue, delirium and in the worst cases, sepsis and death.
Please remember, if you are experiencing any concerning symptoms seek medical treatment immediately. While supplements may help prevent a UTI, it is imperative to get treatment for an active UTI immediately. As you saw in my previous post, even if you use antibiotics to treat a UTI, any UTI or an antibiotic-resistant UTI can quickly spread to your kidneys and develop into sepsis. A UTI can cause permanent kidney damage, sepsis and can even be deadly (causes 40,000 deaths per year in the United States) (10) so early treatment is pertinent to clear up a urinary tract infection and prevent further complications. Do not wait for a UTI to become dangerous or cause permanent bladder or kidney damage before seeking treatment.
Now that you know what a UTI is and what causes it you will be able to better manage changes in your life to help prevent urinary tract infections. Do any of these apply to you and what do you need to do, or have you done to reduce your own urinary tract infections? Please leave comments or questions below about your own experiences and what steps you have taken or will take to promote a healthier urinary system.
*The information in this article is not meant to provide medical information or be a substitute for medical advice. It is also not intended to provide diagnosis or treatment. It is for informational purposes only and all medical decisions should be made with your personal physician. Read more here.