Bacteria in the urinary tract is usually what causes a UTI (urinary tract infection). UTIs typically occur due to an imbalance in the microbiota of the genital region, leading to an overgrowth of bacteria. Symptoms of a UTI include pain and burning with urination, cloudy urine, and increased urgency and frequency of urination while only voiding in small amounts.

The microbiota refers to the range of microorganisms that are naturally present on the body. An imbalance in these microorganisms can occur from simple factors like improper hygiene, holding your bladder for too long, or not drinking enough water during the day.

A UTI that does not have any symptoms may clear up on its own, however UTIs causing symptoms like pain and burning with urination, for example, usually need to be treated with antibiotics. It is important to see a doctor or your primary care provider if you think you might have symptoms of a UTI.

Main causes

Th most common causes of a UTI include:

1. Waiting too long to urinate

Urinating helps to clean the walls of the bladder and the urethra, which is the tube that connects the bladder to the outside of the body. Holding your pee for too long prevents this natural cleaning process from happening and can result in an overgrowth of microorganisms that can spread higher up in the urinary tract, causing infection.

When a large amount of urine accumulates in the bladder, the bladder becomes distended and is unable to contract as well, meaning that you may not be able to empty your bladder completely when you finally do use the bathroom. When this happens, a small amount of urine remains in the bladder, increasing the risk for bacterial growth and subsequent infection.

What to do: avoid holding your bladder by going to the bathroom whenever you feel the urge to urinate.

2. Using improper hygiene techniques

Improper hygiene practices can cause bacteria from the rectum to spread to the genital region, increasing the risk for UTIs.

While this is one of the main risk factors for UTIs in women, it can also happen in men as well, especially during bathing if the buttocks are cleaned before the penis.

What to do: when cleaning the genital region it is important to wipe from front to back to help prevent spreading bacteria from the rectum to the genital area. It is ideal to wash the genital region instead of wiping whenever possible.

3. Not drinking enough water

Drinking too little water during the day results in the body making too little urine, allowing the microorganisms that are usually eliminated with urination to continue to grow and ascend into the bladder.

What to do: the recommendation is to drink at least 2 liters (eight to ten 8 oz glasses) of water per day in order to maintain a healthy urinary system. Eating foods with a high water content can also help increase fluid intake and, consequently, the amount of urine produced during the day.

4. Waiting too long to change a pad or tampon

Tampons and pads are a great way to maintain good hygiene during your period, however waiting too long to change a tampon or pad can result in bacterial growth that could potentially spread to the urinary tract, causing a UTI.

What to do: to avoid this problem, make sure to change your pad or tampon frequently, ideally every 4 hours or sooner if it is full. It is also important to wash the genital area when changing out a pad or tampon.

5. Kidney stones

Kidney stones can cause an obstruction in the urinary tract, blocking the normal flow of urine and preventing it from being properly eliminated. When this occurs, bacteria in the urine can remain in the urinary tract, with more time to grow and develop into an infection.

In addition to the typical symptoms of UTI, such as bladder heaviness, pain and burning with urination, and peeing in small amounts, kidney stones can also present with lower back or side pain. See kidney stone symptoms.

What to do: it is important to consult a urologist or your primary care provider if you think you might have a kidney stone. Treatment is aimed at eliminating the stone and relieving symptoms, which may be done using medications in the case of small stones or surgery for stones that are very large or are blocking the flow of urine.

6. Untreated candidiasis (yeast infection)

An untreated yeast infection can lead to recurrent UTIs, as the fungus causing the infection is not being properly eliminated and remains in the genital area. Signs and symptoms of a yeast infection include intense itching in the genital area as well as thick, white vaginal discharge.

What to do: it is important to see a doctor or your primary care provider in order to confirm the diagnosis of a yeast infection and be started on appropriate treatment, which usually involves the use of antifungal pills or creams.

7. Diabetes

Having diabetes can increase the risk for a UTI, as higher blood sugar levels promote the growth of bacteria, leading to infection.

Uncontrolled diabetes can also cause nerve damage in the urinary tract, which can interfere with the sensation of needing to go to the bathroom. This can lead to urinary retention and bacterial growth in the bladder.

What to do: if you have diabetes, it is important to follow a treatment plan as indicated by your doctor, including taking medications to regulate your blood sugar as well as maintaining a healthy diet and regular physical activity.

8. Pregnancy

UTIs are more common in pregnant people due to normal changes in the body during pregnancy. This includes hormone changes as well as the growing uterus, which can cause urine to accumulate in the bladder and increase the risk for bacterial growth in the urinary tract.

What to do: a UTI in pregnancy should be treated as directed by your OBGYN or midwife in order to prevent complications like premature birth. Treatment usually involves antibiotics prescribed by your provider for a period of 7-14 days. It is also important to drink water, avoid holding your bladder, and make sure to empty your bladder completely each time you urinate.

9. Prolapsed bladder

A prolapsed bladder (or cystocele) is a condition in which the pelvic floor muscles are too weak to hold the bladder in its correct position, allowing the bladder to drop down and bulge into the vagina. This can interfere with the storage and elimination of urine, in which the bladder is unable to empty completely. In this situation, an overgrowth of bacteria can occur, leading to a UTI.

In addition to increased urinary frequency caused by a UTI, other symptoms of a prolapsed bladder may include urinary incontinence, pelvic pain or discomfort, and a heavy sensation in the bladder.

What to do: treatment for a prolapsed bladder is done by a urogynecologist and will depend on the degree of prolapse. Physical therapy may be recommended for minor cases, whereas surgery may be needed in cases of more severe prolapse.

10. Enlarged prostate

An enlarged prostate can press on the bladder and block the flow of urinate, preventing the bladder from emptying completely and increasing the risk for bacterial growth and infection of the urinary tract. An enlarged prostate can also cause symptoms like bladder fullness, a weak stream, and urination that starts and stops.

What to do: in this case, it is recommended to consult a urologist or your primary care provider who can perform a prostate exam and prescribe the best treatment, which will vary depending on the size of the prostate and a person's age. In general, a doctor may prescribe medications to decrease the size of the prostate and/or help facilitate urination. Surgery may be indicated in some cases.

11. Constipation

Constipation can also increase the risk for a UTI. This may be because stool that remains too long in the rectum allows gut bacteria to grow and flourish. This bacteria, mainly E. coli, can then spread to the urinary tract, resulting in infection.

What to do: it is important to adopt strategies to help keep your bowel movements regular, such as staying active, drinking enough water, and including high-fiber foods in your diet.