UTI - Urinary Tract Infection

WHAT ARE THE CAUSES OF UTI - Urinary Tract Infection?

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Normal urine is sterile. It contains fluids, salts, and waste products, but it is free of bacteria, viruses, and fungi. An infection occurs when microorganisms, usually bacteria from the digestive tract or vaginal area in women, cling to the opening of the urethra and begin to multiply. Most infections arise from one type of bacteria. The most common bacteria is called Escherichia coli (E. coli), which normally lives in the colon.

In most cases, bacteria first begin growing in the urethra. An infection limited to the urethra is called urethritis. From there bacteria often move on to the bladder, causing a bladder infection (cystitis). If the infection is not treated promptly, bacteria may then go up the ureters to infect the kidneys (pyelonephritis).

The urinary system is structured in a way that helps ward off infection. The ureters and bladder normally prevent urine from backing up toward the kidneys, and the flow of urine from the bladder helps wash bacteria out of the body. In men, the prostate gland produces secretions that slow bacterial growth. In both sexes, immune defenses also prevent infection. But despite these safeguards, infections still occur.

WHO IS AT RISK FOR UTI - Urinary Tract Infection?

Some people are more prone to getting a UTI than others.

• Any abnormality of the urinary tract that obstructs the flow of urine (a kidney stone, for example) sets the stage for an infection. An enlarged prostate gland also can slow the flow of urine, thus increasing the risk of infection.
• A common source of infection is catheters, or tubes, placed in the bladder. A person who cannot void or who is unconscious or critically ill often needs a catheter that stays in place for a long time. Some people, especially the elderly or those with nervous system disorders who lose bladder control, may need a catheter for life. Bacteria on the catheter can infect the bladder. In these patients it is best to change the catheter frequently and use intermittent catherization whenever possible.
• People with diabetes have a higher risk of a UTI because of changes in their immune system. Any disorder that suppresses the immune system increases the likelihood of a urinary infection.
• In women, the rate of UTIs gradually increases with age and women are more likely to have them than men. One factor may be that a woman’s urethra is shorter, allowing bacteria quick access to the bladder. Also, a woman’s urethral opening is near sources of bacteria from the anus and vagina. For many women, sexual intercourse seems to trigger an infection.

WHAT ARE THE SYMPTOMS OF UTI?

Not everyone with a UTI has symptoms, but most people get at least some. These may include:

• Frequent urge to urinate and a painful, burning feeling in the area of the bladder or urethra during urination.
• It is not unusual to feel bad all over–tired, shaky, washed out–and to feel pain even when not urinating.
• Often women feel an uncomfortable pressure above the pubic bone, and some men experience a fullness in the rectum.
• It is common for a person with a urinary infection to complain that, despite the urge to urinate only a small amount of urine is passed.
• The urine itself may look milky or cloudy, even reddish if blood is present.
• A fever may mean that the infection has reached the kidneys. Other symptoms of a kidney infection include pain in the back or side below the ribs, nausea, or vomiting.

COMPLICATED UTI INFECTIONS

Curing infections that stem from a urinary obstruction or from a nervous system disorder depends on finding and correcting the underlying problem, sometimes with surgery. If the root cause goes untreated, this group of patients is at risk for kidney damage. Also, such infections tend to arise from a wider range of bacteria, and sometimes from more than one type of bacteria at a time.

RECURRENT UTI INFECTIONS IN WOMEN

Women who experience multiple or recurrent urinary tract infections with a short period of time need to be evaluated by a urolgist. One of the following treatment options may be advisable in certain instances:

• Take a low doses of an antibiotic such as TMP/SMZ or nitrofurantoin daily for several months. If taken at bedtime, the drug remains in the bladder longer and may be more effective without causing serious side effects.
• Take a single dose of an antibiotic after sexual intercourse.
• Take a short course (1 or 2 days) of an antibiotic when symptoms appear.

Other additional steps that one can take on their own to avoid an infection:

• Drink plenty of water every day.
• Urinate when you feel the need; don’t resist the urge to urinate.
• Women should wipe from front to back to prevent bacteria around the anus from entering the vagina or urethra.
• Take showers instead of baths.
• Cleanse the genital area before sexual intercourse.
• Avoid using feminine hygiene sprays and scented douches, which may irritate the urethra.

UTI INFECTIONS IN MEN

UTIs in men usually stem from an obstruction possible a urinary stone, enlarged prostate or from a foreign body such as a catheter. The first step is to identify the infecting organism treat with antibiotics to which the bacteria is sensitive and relieve the obstruction and/or foreign body.

WAYS TO PREVENT A URINARY TRACT INFECTION

• Try not to use colored toilet paper, bubble bath, perfumed soaps, douches, feminine hygiene deodorants, and deodorant tampons and napkins.
• Wear cotton underwear. Avoid wearing tight clothing, such as bodysuits, tight pants and nylon panty hose without cotton liners.
• Avoid using strong soaps and bleaches when washing underclothes.
• Avoid prolonged activities that can aggravate bladder infections, such as bicycling, horseback riding, and motorcycling.
• Drink plenty of water or other fluids daily.
• Urinate when you feel the urge - do not hold urine for long periods of time.
• Urinate before and after having intercourse.
• During your period, if you wear pads, change them at least twice a day.

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