Estimated reading time: 5 minutes
Medically reviewed and verified by Kate Burke, MD, MHA
Ulcerative colitis (UC) is a type of inflammatory bowel disease that primarily affects the colon and rectum. It causes inflammation and ulcers in the digestive tract, leading to symptoms like abdominal pain, diarrhea, and rectal bleeding. While UC mostly impacts the gastrointestinal tract, it can also have effects beyond the digestive system. Did you know having UC increases your risk factors of developing a urinary tract infection? If you are wondering how this could happen, look no farther! Here, PatientsLikeMe will explore the connection between UC and UTIs.
What Are UTIs?
Urinary tract infections (UTIs) are infections that happen in any part of the urinary system. This includes the kidneys, ureters, bladder, and urethra. Most UTIs involve the lower urinary tract — the bladder and the urethra. They are usually caused by bacteria, although viruses and fungi can also lead to a UTI. When bacteria enter the urinary tract and multiply, they can cause a UTI. Some people may be at higher risk of infections when their urinary flow is blocked or when the urine flows back up from the bladder to the kidneys.
Common Types
- Cystitis: Infection of the bladder.
- Urethritis: Infection of the urethra.
- Pyelonephritis: Infection of the kidneys, which can be more serious.
Symptoms
- A strong, persistent urge to urinate
- A burning sensation when urinating
- Passing frequent, small amounts of urine
- Cloudy, dark, bloody, or strange-smelling urine
- Pelvic pain (in women)
- Rectal pain (in men)
UTIs are common, especially in women. About one in two women and one in twenty men will get a UTI in their lifetime. They account for about one million emergency room visits in the United States each year.
The Link Between UC and UTIs
While UC primarily affects the GI tract, its inflammatory nature and the treatments used to manage it can impact other parts of the body, including the urinary system. UC is characterized by chronic inflammation. This inflammation can extend beyond the GI tract and affect the urinary system. The body's immune response in UC can also be dysregulated. This makes it harder for the body to fight off infections, including UTIs.
Some UC patients develop complications that can directly affect the urinary tract. For instance, inflammation and scarring in the pelvic region can lead to anatomical changes that predispose people to UTIs. Fistulas, which are abnormal connections between the bowel and other organs, can also develop and cause infections. Essentially if you have UC, you have more risk factors that can lead to a UTI. You are not at a higher risk of developing a UTI compared to someone without the disease.
UC Medications and UTIs
Immunosuppressants and Corticosteroids
Drugs like azathioprine, methotrexate, and cyclosporine suppress the immune system to control inflammation. While effective at managing UC, these medications also lower the body's ability to fight infections. This immunosuppression can make UC patients more vulnerable to bacterial infections, including those in the urinary tract. Corticosteroids, such as prednisone, are also commonly used to treat UC flares. The long-term use of corticosteroids can lead to a higher risk of infections, including UTIs. The risk is particularly significant when these medications are used continuously or in high doses.
Biologics
Biologics, such as infliximab and adalimumab, target specific components of the immune system to control inflammation. While these drugs are effective in managing UC, they also increase the risk of infections, including UTIs. Biologics work by blocking tumor necrosis factor (TNF), a protein that plays a key role in the body's immune response. By inhibiting TNF, biologics reduce inflammation but also weaken the immune system's ability to fight off infections.
Preventing and Managing UTIs in UC Patients
Given the increased risk of UTIs, you should take preventive steps and manage infections quickly if they come up.
- Stay Hydrated: Drinking plenty of fluids helps flush bacteria from the urinary tract.
- Maintain Good Hygiene: Wipe from front to back to prevent bacteria from the anal region from entering the urinary tract.
- Empty the Bladder Regularly: Don't hold in urine and try to empty the bladder completely when urinating.
- Post-Sex Hygiene: Urinating after sex helps flush out bacteria that may have entered the urethra.
- Manage UC: Keeping UC under control with proper medication and lifestyle adjustments can reduce the overall risk of infections.
Managing UTIs
If a UTI does happen, it is important to get medical treatment right away. UTIs are typically treated with antibiotics, and symptoms usually improve within a few days of starting treatment. However, if UTIs keep coming back, work with both a primary care physician and a gastroenterologist to figure out the underlying cause. You may also need to adjust your UC treatment if necessary. This could mean lowering the dose of immunosuppressants or corticosteroids or changing the treatment schedule. Always work with healthcare providers before making any changes to medication regimens.
Ulcerative colitis is a complex condition. The chronic inflammation and impact on the immune system, combined with the medications used to treat it, can result in a urinary tract infections. By understanding this connection and taking preventive steps, you can reduce your risk of UTIs and manage them effectively if they happen!
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