UTI or Kidney Infection? Symptoms, Differences & When to Worry

In this episode of GynoInfo, I break down urinary tract infections (UTIs) in plain, everyday language.

We’ll talk about the difference between a bladder infection (lower UTI) and a kidney infection (upper UTI) — because the symptoms and urgency are very different.

I cover:

• Burning with urination and frequent peeing
• Pubic bone pressure and cloudy urine
• When you can try fluids, ibuprofen, or cranberry juice
• When antibiotics are necessary
• Warning signs of a kidney infection (fever, mid-back pain, chills)
• Why not all burning is a UTI (yeast, STDs, urethritis)
• What a clean-catch urine sample actually means

If you’ve ever wondered, “Is this a UTI?” or “Do I need antibiotics?” — this episode will help you think it through calmly and clearly.

You can write to us at Questions@GynoInfo.net

And follow us on Instagram @gynoinfo

Transcript

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Welcome to Gyno Info, Frank Talk with Dr. Burkey, the podcast dedicated to teaching everyday women what they need to know about their body and how it works to successfully deal with the healthcare system and communicate with their doctors. Each week, I'll provide you with new information and practical tips about gynecology and women's health care. I want to prepare you for your doctor's appointments by teaching you what to expect, what information your doctor will need to know from you, and what questions you will need and should ask her so you can be confident and make the most out of every visit. GynoInfo will give you the knowledge you need to take charge of your health and do this in a clear and frank way that you can understand without having a medical degree. One episode at a time. So now let's begin. Hello. Welcome back to GynoInfo, the podcast about women's health in normal, everyday language that normal, everyday people can understand. No special medical words, no doctor speak. A special welcome to those who just discovered us and are listening for the first time. Please take a moment now to subscribe to DynoInfo so you can get back to this episode in case you have to interrupt in the middle and would like to finish the episode later on. The same episode might not show up in your feed anytime soon. And so if you subscribe, you can get back to it anytime you want. Today I'm going to talk about urinary tract infections, UTI, as many people call them. And before I go any further, please make sure you watch this episode on YouTube rather than just listening to it on some other platform, because I'm going to put a lot of slides in it. Urine is produced in the kidneys as a way of washing out waste products from the blood. These waste products are called water-soluble. An example of a water-soluble substance is sugar. That is why people with diabetes who have too much sugar in their blood because their body cannot break down sugar the right way will have a lot of sugar in their urine. In the olden days, before we had a lot of fancy tests to measure sugar in urine, doctors needed to taste their patient's urine to see if it tasted sweet. I am so glad I was born after that time. Another way for the body to get rid of waste, of things it cannot use or has used up is through the liver in the form of bile. This is the way the body gets rid of oily things that do not mix with water. These substances are called lipid-soluble, things that can be mixed with lipids, with oil, with fat. One example for an oily substance that the body needs to get rid of through the liver are certain vitamins. You guessed it, the so-called lipid-soluble vitamins, the fat-soluble vitamins, such as vitamin D, vitamin E, vitamin A, and vitamin K. Because these vitamins cannot simply be washed out through the kidneys, like vitamin C, for instance, which is water soluble, but they have to be processed in the liver and then put out in the bile. And because of that, too many of these vitamins can actually poison the liver and cause liver damage. And then there are things you eat that the body cannot digest and use as food. They are left in the bowel, such as the fibers in vegetables and fruit, the hard, stringy things in your diet. This is what forms the poop, together with some fat and bacteria, and mostly water. 75% of normal poop is actually water, a little bit less if you're constipated. The bile from the liver is what makes the poop brown. But back to urine. It is basically water that is colored yellowish by the water-soluble waste products that the kidneys mix into this water. On this slide, you can see a picture of the whole urinary tract where the urine travels from the two kidneys where it is made, one on the left side and one on the right side, through the two ureters to the bladder, where it is stored for a while, and from where it is then put through the urethra to the outside. This is called the urinary tract, the tract the urine runs through. An infection anywhere in the urinary tract is called a urinary tract infection, the UTI. A lower UTI is limited to the bladder and often called an uncomplicated UTI. An upper UTI involves the kidneys and is much more serious. Most kidney infections start out as bladder infections, start out as a lower UTI and travel up from the bladder to the kidneys. I will tell you about them later. The most important signs that you have a bladder infection are, of course, pain when you pee, and especially at the end of peeing as the bladder empties. And often a dull, constant pain inside behind your pubic bone. The bladder is a hollow muscle, kind of like a balloon. When it empties, it does that by contracting, tightening the bladder wall muscles, which then dials up the pain from dull to excruciating at the end of peeing. And even though it hurts emptying the bladder, an infected and inflamed bladder prefers to be empty. The stretching of the muscle and the bladder lining when the bladder fills again with urine irritates the bladder wall and causes pain. That is why a major symptom of bladder infections is a feeling that you have to pee constantly, all the time, even to the point where you have a hard time holding your urine, and even when there are only a few drops that then come out. Doctors call that frequent urination. That is an important term to use when communicating with office nurses and doctors. Painful urinating and frequent urinating in small amounts. But you can also just say, I have to pee all the time, and not much comes out, and it hurts peeing. Lower UTIs, bladder infections, are actually relatively harmless. Though painful, they often cure themselves without antibiotics. A lot of the bacteria causing the bladder infections are flushed out when you pee. The body's immune system can then fight the ones that are left over and kill them off. This is why you should drink a lot whenever you suspect that you have a bladder infection or are about to have one. This is what people have done for centuries. It is actually all they could do before we had antibiotics for thousands of years. It is also the current recommendation, the first line recommended treatment for uncomplicated bladder infections. Lots of fluids, plus anti-inflammatory pain medications, medications that heal inflammation such as ibuprofen. You can also drink teas that help with the inflammation, such as chamomile, ginger, turmeric, hibiscus, pennil, and many others. Willow bark tea was an ancient remedy for inflammation. One of the most important things that these bladder teas and other herbal remedies do is flushing the urinary tract and washing out the bacteria. But these natural remedies can also create an environment that the bacteria causing the infection don't like. Then they cannot grow and multiply and are easier to be flushed out. The same holds for cranberry juice and other juices that are high in vitamin C. The bacteria that often cause bladder infections don't like an acid sour environment. This is why these natural remedies with lots of vitamin C work most often quite well. Cranberry juice, especially, is not just rich in vitamin C, but it also contains a special substance that keeps the bacteria from being able to stick to the bladder wall. And if they cannot stick to the wall, they're more easily flushed out. But note, here I'm not talking about the red sugar water that goes for cranberry juice in some supermarkets, but real organic, sour cranberry juice, the one that puckers your mouth when you try to drink it. I personally can only get it down if I mix it with a more agreeable fruit juice, such as pineapple juice. Antibiotic treatment is only necessary if the symptoms don't get better after a couple days of drinking lots and lots of fluid, lots of teas, lots of juices. And also when you are peeing blood, which is a sign of particularly aggressive and nasty bacteria. That's when antibiotics come in. Or when you develop signs of a kidney infection, then you have to act. This now brings us to the upper UTIs or complicated UTIs or kidney infections, pylonephritis in Dr. Speak. These are completely different from simple, uncomplicated bladder infections from lower UTIs. They need a visit to the healthcare provider right now, today. If you cannot get an appointment with your regular family doctor or your clinic right away, you need to go to an urgent care center or even an emergency room, an ER. Untreated kidney infections destroy the kidneys over time. You need kidneys to live and clean out your blood from waste products that get toxic and damage your body if they are not cleared out by the kidneys. Kidney failure is deadly. That's why people who have no longer kidneys that function get put on kidney dialysis. Otherwise, they die. Typical symptoms of a kidney infection, in addition to the bladder infection symptoms that we have already discussed, are one or both sided mid-back pain. That's where the kidneys are located. Especially if someone knocks on the part of your back over the kidneys, as the doctor examining you is going to be most likely doing. Also, fever with or without chills, headaches, and generally feeling quite ill. Words you will need to use when communicating with the receptionist to get an appointment or later talking to your healthcare provider are pain with peeing, having to pee often, blood in the urine if you have it, and then back pain, one or both sides, fever, headache, feeling ill. When you do go to the doctor's office or clinic, it is important that you give them a clean catch urine sample. Clean catch means that it is only urine from the bladder without any mixed-in vaginal juices or other contaminations. You will need to first wipe the crotch with the wipes that they're most likely going to give you, then pee a little bit in the toilet to flush things, and then pee a small amount in the cup that they give you, and then the rest can go in the toilet again. That's how you do a clean catch. Here are a couple more things that matter on the topic of UTIs, urinary tract infections. First, not every time it hurts to pee, it is a bladder infection, especially if the pain is mostly on the outside. If it stinks on the outside, as soon as the urine comes into contact with your crotch, your outer genitals, your vulva, it is more likely to be a vaginal or vulva infection than an actual bladder infection. Urine is usually a bit salty or a bit sour. And when it comes in contact with an open herpesore or the skin on your vulva, your crotch that is irritated and red and inflamed by a major yeast infection or by some other vaginal discharge that damages the skin on your crotch, it burns, it stings, it hurts. It may even give you a feeling of having to go all the time. And you might think that you have a bladder infection, but you do not. That is why it is so important to consider where it hurts when you pee. Deep inside, behind your pubic bone for a bladder infection, stinging on the outside for herpes, yeast, or other vaginal infections, or STDs sexually transmitted diseases. And now that I mentioned STDs, sexually transmitted diseases, let's also say a few words about urethritis. The urethra is a tube from the bladder to the outside. Urathritis is an infection and an inflammation of the urethra. But again, it is more a feeling of pain on the outside, not deep behind your pubic bone like a bladder infection. The word urethritis is generally only used in connection with STDs caused by bacteria like chlamydia. Most often, a urethritis is a combined infection of other parts of a woman's genitals and even her throat, if there was oral sex. That is why it is also very important that you tell your health care provider if there is any chance that you also have a STD. If you have a new partner or more than one partner, or suspect that at least one of them also has other partners, and especially if you're not using condoms all the time, please speak up. Because you could have both a urinary tract infection and an STD, and that would need to be considered in the choice of your treatment. And of course, STDs need to be tested for, so your partner and partners can also be treated, or else you'll be back in the doctor's office in a couple weeks with the same symptoms. This brings us to the end of this episode. I hope you found that this podcast gave you some new information that is useful to you and you will share it with as many other women as you can. Remember that if you have any further questions about this or any other topic having to do with women's health or gynecology, please don't hesitate to send them to me at questions at gynoinfo.net. Again, that's questions at gynoinfo.net. And please also make sure you click the subscribe button wherever you listen to or watch gynoinfo. So you can get back to this episode easily, whenever and wherever you want. And the more people subscribe, the easier it will be for others to find us, and helps Josh and me to keep this podcast going. Thank you. Until next time. Thank you for listening. And remember that you and your health are super important and deserve your full attention. Don't ever put off contacting your doctor because you're scared or embarrassed when something feels wrong about your body. Doctors are here to help you, not to judge you. And also, regular Well-woman visits are always a good idea that you should make time for. You deserve it, and you owe it to yourself, and you owe it to your body and your health. This podcast is part of Pride House Media, hosted by me, Dr. Burke, produced and edited by Josh Rosenzweig. Original music composed by Nell Balaban. If you enjoyed this episode, please subscribe wherever you listen to podcasts. And while you're there, leave us a rating and a review. It really helps others discover the show. Stay connected and join the conversation by following me on Instagram and Facebook at GynoInfo and on LinkedIn at gynoinfopodcast.