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Urinary Tract Infections: Prevention is Key
If you have pain or burning when you urinate, feel an urgent need to go or go often, have cloudy, bloody or foul-smelling urine, or have pelvic pain, you might have a urinary tract infection. While women have them more often, they can also affect men. And did you know that cranberry juice is not helpful at preventing or curing UTIs? In this podcast, Dr. Scott Burger, Chief Medical Officer of UM Urgent Care, talks about what a UTI is, what to do if you get one, how to prevent them and much more.
Featured Speaker:
Scott Burger, DO
Scott Burger, DO is the Chief Medical Officer at University of Maryland Urgent Care. He is a dedicated leader and experienced clinician who emphasizes providing high-quality care in all his work. Dr. Burger has over 20 years of clinical experience and is Board Certified in Emergency Medicine. He previously served as the Senior Director of Operations and Strategy at the University of Maryland Medical System and has served as Chief Medical Officer at other Urgent Care Centers throughout the country. Transcription:
Urinary Tract Infections: Prevention is Key
Prakash Chandran: Urinary tract infections, more commonly known as UTIs, are an infection in the urinary system. Though they are more common in women, men can get them too. With all this information around UTIs, we're here to set things straight and teach you how to prevent urinary tract infections from occurring in the first place.
Welcome to Live Greater, a Health and Wellness podcast brought to you by the University of Maryland Medical System. We put knowledge and care within reach, so you have everything you need to live your life to the fullest. My name is Prakash Chandran, and our guest today is Dr. Scott Burger. He's the Chief Medical Officer for University of Maryland Urgent Care.
Dr. Burger, thank you so much for joining us today. We truly appreciate your time. I wanted to get started with the basics. What exactly is a urinary tract infection?
Dr Scott Burger: Sure, and thanks for having me. So, a urinary tract infection in general refers to a bacterial infection of the bladder for the kidneys. There are some others that are outside the scope of this conversation. But for in general, as we're referring to UTIs, we're talking about infections of the bladder or the kidneys.
Prakash Chandran: Okay. Understood. So, when you have a UTI, what exactly are the symptoms? What does someone experience?
Dr Scott Burger: So, the most common symptoms that people experience will be discomfort when they urinate. They're urinating more often than usual. They're rushing. When they have to go, they got to go really fast. Sometimes, there's not as much that comes out, so they go and then they feel like they need to go 10 minutes later. Occasionally, they'll see some blood in the urine. And if the infection is more significant and it's gotten into the kidney, they may develop one-sided middle back pain, fever, nausea, vomiting. That's a more significant type of urinary tract infection if it's extended up into the kidney.
Prakash Chandran: And a more broad question, I know we mentioned up at the top that anyone can get a UTI, but statistically, women are more likely to get them. Why is that and what causes them in the first place?
Dr Scott Burger: Sure. Yeah. Like you said, everybody can get a urinary tract infection, but because of anatomy, women get them much more frequently. Essentially, it's a function of the urethra, which is the tube that goes from the bladder to the outside world, is shorter in a woman and it's not as protected as it is with a man. So, bacteria are able to get into that urethra and migrate up into the bladder triggering a bladder infection.
Prakash Chandran: Okay. But men get them as well. So what exactly are the causes there?
Dr Scott Burger: For men, it generally is a function of age that, as men get older, the prostate, which is an organ that wraps around the urethra, enlarges, and as it does it obstructs the outflow of urine and can lead to some bacterial contamination and backup, and men will get a urinary tract infection.
Prakash Chandran: You covered some of the main symptoms of when someone has a UTI. But what are the symptoms that a UTI has actually gotten more serious, like when you have a kidney infection?
Dr Scott Burger: Yeah. So, those are people who all of a sudden might develop a fever. They feel like they're experiencing pain on one side of their back, kind of in the lower mid of their back. They're getting nauseous, they're having a fever. Those are signs that the infection has migrated from the bladder into the kidney. And often, then they develop some degree of a bloodstream infection. And so they definitely need to be seen and we absolutely want to see these people before they develop those symptoms.
So, it's so important that when somebody develops symptoms, those earlier symptoms of a UTI like burning with urination, more frequent urination, rushing, those sorts of things, that they don't try to treat it themselves by saying, "Well, I'll just drink more fluids," or "I'll take cranberry pills or drink cranberry juice and it'll just go away." Those things do not make a urinary tract infection go away. You need antibiotics for it. So, it's so important to come in with the first sign of having a urinary tract infection.
Prakash Chandran: Okay. So, let's expand on that a little bit more. I was just going to ask you, at what point should someone seek medical attention? But it sounds like as soon as they see or feel that burning sensation or they're urinating more frequently, they should come in. Is that correct?
Dr Scott Burger: Yeah. You don't have to go in in the middle of the night if this sort of thing happens, where you're starting to have those more mild symptoms. But definitely, you want to be seen the next day either through your primary care doctor, a telemedicine visit, an urgent care clinic like University, Maryland Urgent Care that's open seven days a week. You know, all those different venues are capable of doing diagnostic testing and/or sending in treatments that people need.
Prakash Chandran: So, you mentioned antibiotics. Is this the primary way that UTIs are treated?
Dr Scott Burger: Yes, that is the primary mechanism because it's primarily a bacterial infection. So, we absolutely need to treat it with an antibiotic.
Prakash Chandran: Okay. And you also touched upon what I think is a myth here, but a lot of people, including my wife, think that cranberry juice can help with a UTI or even prevent one. And you're saying that there is no truth to that. Is that correct?
Dr Scott Burger: That's right. There was some thought that, by drinking cranberry juice, you change the pH or the acid-base balance of the urine and could prevent a urinary tract infection. That's actually been disproven now definitively. So not only will cranberry juice not prevent somebody from getting a UTI, and it certainly won't cure somebody who has one already. So, you've got to get those antibiotics on board.
Prakash Chandran: Now, with regards to antibiotics, I know this is something that my wife went through. Sometimes when you use an antibiotic to treat a UTI, it's almost like your body kind of adjusts to having that antibiotic for treating it, which then in turn can make you more susceptible to getting a UTI and it feels like this vicious cycle. Is that something that you've heard before? And if so, how do you go about addressing that?
Dr Scott Burger: Oh, yeah. It's so important that your clinician is getting a detailed history from you about any recent history or remote history of urinary tract infections. And in scenarios like that, there's a number of different antibiotics that we can use that have different properties and different ways that they attack the bacteria, so we can use different ones than say somebody was on recently. We also can send off what's called a urine culture, and that's a test that goes to a laboratory and it takes about two or three days to come back where they attempt to grow the bacteria and they check to see what antibiotics are effective in killing the bacteria.
So often, what we'll do is we'll pick an antibiotic, we'll get the person started on, we'll send off the culture. We'll get those results in a couple of days. And we'll confirm that the antibiotic we're using is appropriate. And if not, we'll call the patient back and we'll send in a prescription for an updated antibiotic.
Prakash Chandran: Yeah. So the takeaway there is if you go in with a UTI, it is critical to share your history around having UTIs with your primary care physician or whoever you're talking to. Is that correct?
Dr Scott Burger: A hundred percent. Yeah. It's always so important. You can never share too much with your doctor about your health history. We want to know as much as possible from you about what's happened in the past.
Prakash Chandran: Okay. So, you know, one of the things we're talking about today is prevention. How do you go about preventing a UTI in the first place?
Dr Scott Burger: So, there's a couple of different things. When you consider that women get them much more frequently than men, many of the things that we talk about that are preventative are most useful for women. One of the things is after intercourse, it's important to urinate, that any bacteria that were able to migrate into the urethra, we want to flush those out.
Another thing is not to hold your urine during the day. So, I know a lot of people work very hard at their jobs and they don't drink enough water during the day. Maybe they're so busy and distracted that they hold their urine for many, many hours, and that's just a recipe for getting a urinary tract infection. So, making sure that you pause to go to the bathroom, making sure that you drink plenty of fluids.
And something that girls are taught at a young age is the direction of wiping to clean themselves when they go to the bathroom, which is front to back. They always want to go front to back. Those are probably the most important preventative things that people can do to try to prevent getting a urinary tract infection.
Prakash Chandran: Okay. So beyond those measures, are there any last tips that you can share with our listeners before we close here?
Dr Scott Burger: I think the most critical thing is when you recognize a symptom that is abnormal to make sure you're getting that treatment right away. Because what we really want to do is we want to make sure that we're addressing it when it is a simple infection, before it becomes a kidney infection, which becomes much more complicated. People feel much sicker with that. They often require hospitalization, and we really just want to cut this off at the past and make sure we treat it quickly and efficiently. So, making sure people get treated, that's the most important thing.
Prakash Chandran: Well, that is wonderful advice. Thank you so much for your time and for joining us today, Dr. Burger.
Dr Scott Burger: Appreciate it.
Prakash Chandran: That was Dr. Scott Burger, Chief Medical Officer for University of Maryland Urgent Care. You can find shows just like this one at umms.org/podcast. Thank you for listening to Live Greater, a Health and Wellness podcast, brought to you by the University of Maryland Medical System. We look forward to you joining us again.
Urinary Tract Infections: Prevention is Key
Prakash Chandran: Urinary tract infections, more commonly known as UTIs, are an infection in the urinary system. Though they are more common in women, men can get them too. With all this information around UTIs, we're here to set things straight and teach you how to prevent urinary tract infections from occurring in the first place.
Welcome to Live Greater, a Health and Wellness podcast brought to you by the University of Maryland Medical System. We put knowledge and care within reach, so you have everything you need to live your life to the fullest. My name is Prakash Chandran, and our guest today is Dr. Scott Burger. He's the Chief Medical Officer for University of Maryland Urgent Care.
Dr. Burger, thank you so much for joining us today. We truly appreciate your time. I wanted to get started with the basics. What exactly is a urinary tract infection?
Dr Scott Burger: Sure, and thanks for having me. So, a urinary tract infection in general refers to a bacterial infection of the bladder for the kidneys. There are some others that are outside the scope of this conversation. But for in general, as we're referring to UTIs, we're talking about infections of the bladder or the kidneys.
Prakash Chandran: Okay. Understood. So, when you have a UTI, what exactly are the symptoms? What does someone experience?
Dr Scott Burger: So, the most common symptoms that people experience will be discomfort when they urinate. They're urinating more often than usual. They're rushing. When they have to go, they got to go really fast. Sometimes, there's not as much that comes out, so they go and then they feel like they need to go 10 minutes later. Occasionally, they'll see some blood in the urine. And if the infection is more significant and it's gotten into the kidney, they may develop one-sided middle back pain, fever, nausea, vomiting. That's a more significant type of urinary tract infection if it's extended up into the kidney.
Prakash Chandran: And a more broad question, I know we mentioned up at the top that anyone can get a UTI, but statistically, women are more likely to get them. Why is that and what causes them in the first place?
Dr Scott Burger: Sure. Yeah. Like you said, everybody can get a urinary tract infection, but because of anatomy, women get them much more frequently. Essentially, it's a function of the urethra, which is the tube that goes from the bladder to the outside world, is shorter in a woman and it's not as protected as it is with a man. So, bacteria are able to get into that urethra and migrate up into the bladder triggering a bladder infection.
Prakash Chandran: Okay. But men get them as well. So what exactly are the causes there?
Dr Scott Burger: For men, it generally is a function of age that, as men get older, the prostate, which is an organ that wraps around the urethra, enlarges, and as it does it obstructs the outflow of urine and can lead to some bacterial contamination and backup, and men will get a urinary tract infection.
Prakash Chandran: You covered some of the main symptoms of when someone has a UTI. But what are the symptoms that a UTI has actually gotten more serious, like when you have a kidney infection?
Dr Scott Burger: Yeah. So, those are people who all of a sudden might develop a fever. They feel like they're experiencing pain on one side of their back, kind of in the lower mid of their back. They're getting nauseous, they're having a fever. Those are signs that the infection has migrated from the bladder into the kidney. And often, then they develop some degree of a bloodstream infection. And so they definitely need to be seen and we absolutely want to see these people before they develop those symptoms.
So, it's so important that when somebody develops symptoms, those earlier symptoms of a UTI like burning with urination, more frequent urination, rushing, those sorts of things, that they don't try to treat it themselves by saying, "Well, I'll just drink more fluids," or "I'll take cranberry pills or drink cranberry juice and it'll just go away." Those things do not make a urinary tract infection go away. You need antibiotics for it. So, it's so important to come in with the first sign of having a urinary tract infection.
Prakash Chandran: Okay. So, let's expand on that a little bit more. I was just going to ask you, at what point should someone seek medical attention? But it sounds like as soon as they see or feel that burning sensation or they're urinating more frequently, they should come in. Is that correct?
Dr Scott Burger: Yeah. You don't have to go in in the middle of the night if this sort of thing happens, where you're starting to have those more mild symptoms. But definitely, you want to be seen the next day either through your primary care doctor, a telemedicine visit, an urgent care clinic like University, Maryland Urgent Care that's open seven days a week. You know, all those different venues are capable of doing diagnostic testing and/or sending in treatments that people need.
Prakash Chandran: So, you mentioned antibiotics. Is this the primary way that UTIs are treated?
Dr Scott Burger: Yes, that is the primary mechanism because it's primarily a bacterial infection. So, we absolutely need to treat it with an antibiotic.
Prakash Chandran: Okay. And you also touched upon what I think is a myth here, but a lot of people, including my wife, think that cranberry juice can help with a UTI or even prevent one. And you're saying that there is no truth to that. Is that correct?
Dr Scott Burger: That's right. There was some thought that, by drinking cranberry juice, you change the pH or the acid-base balance of the urine and could prevent a urinary tract infection. That's actually been disproven now definitively. So not only will cranberry juice not prevent somebody from getting a UTI, and it certainly won't cure somebody who has one already. So, you've got to get those antibiotics on board.
Prakash Chandran: Now, with regards to antibiotics, I know this is something that my wife went through. Sometimes when you use an antibiotic to treat a UTI, it's almost like your body kind of adjusts to having that antibiotic for treating it, which then in turn can make you more susceptible to getting a UTI and it feels like this vicious cycle. Is that something that you've heard before? And if so, how do you go about addressing that?
Dr Scott Burger: Oh, yeah. It's so important that your clinician is getting a detailed history from you about any recent history or remote history of urinary tract infections. And in scenarios like that, there's a number of different antibiotics that we can use that have different properties and different ways that they attack the bacteria, so we can use different ones than say somebody was on recently. We also can send off what's called a urine culture, and that's a test that goes to a laboratory and it takes about two or three days to come back where they attempt to grow the bacteria and they check to see what antibiotics are effective in killing the bacteria.
So often, what we'll do is we'll pick an antibiotic, we'll get the person started on, we'll send off the culture. We'll get those results in a couple of days. And we'll confirm that the antibiotic we're using is appropriate. And if not, we'll call the patient back and we'll send in a prescription for an updated antibiotic.
Prakash Chandran: Yeah. So the takeaway there is if you go in with a UTI, it is critical to share your history around having UTIs with your primary care physician or whoever you're talking to. Is that correct?
Dr Scott Burger: A hundred percent. Yeah. It's always so important. You can never share too much with your doctor about your health history. We want to know as much as possible from you about what's happened in the past.
Prakash Chandran: Okay. So, you know, one of the things we're talking about today is prevention. How do you go about preventing a UTI in the first place?
Dr Scott Burger: So, there's a couple of different things. When you consider that women get them much more frequently than men, many of the things that we talk about that are preventative are most useful for women. One of the things is after intercourse, it's important to urinate, that any bacteria that were able to migrate into the urethra, we want to flush those out.
Another thing is not to hold your urine during the day. So, I know a lot of people work very hard at their jobs and they don't drink enough water during the day. Maybe they're so busy and distracted that they hold their urine for many, many hours, and that's just a recipe for getting a urinary tract infection. So, making sure that you pause to go to the bathroom, making sure that you drink plenty of fluids.
And something that girls are taught at a young age is the direction of wiping to clean themselves when they go to the bathroom, which is front to back. They always want to go front to back. Those are probably the most important preventative things that people can do to try to prevent getting a urinary tract infection.
Prakash Chandran: Okay. So beyond those measures, are there any last tips that you can share with our listeners before we close here?
Dr Scott Burger: I think the most critical thing is when you recognize a symptom that is abnormal to make sure you're getting that treatment right away. Because what we really want to do is we want to make sure that we're addressing it when it is a simple infection, before it becomes a kidney infection, which becomes much more complicated. People feel much sicker with that. They often require hospitalization, and we really just want to cut this off at the past and make sure we treat it quickly and efficiently. So, making sure people get treated, that's the most important thing.
Prakash Chandran: Well, that is wonderful advice. Thank you so much for your time and for joining us today, Dr. Burger.
Dr Scott Burger: Appreciate it.
Prakash Chandran: That was Dr. Scott Burger, Chief Medical Officer for University of Maryland Urgent Care. You can find shows just like this one at umms.org/podcast. Thank you for listening to Live Greater, a Health and Wellness podcast, brought to you by the University of Maryland Medical System. We look forward to you joining us again.