“I've had recurring UTIs for the past two years,” wrote a member of the support community at ExperienceProject.com. “I'm prescribed antibiotics that only work for about ten days. My symptoms are almost constant burning, urgency to urinate, painful urination, and sometimes even back pain.”
Urinary tract infection (UTI) is an infection that affects any part of the urinary tract. The urinary tract is the system that makes urine and carries it out of the body. It includes the kidneys, ureters, bladder, and urethra. Bladder infection or cystitis is the most common type of UTI. If the infection affects the kidney, it is called pyelonephritis which is a more serious infection, according an article at HPB.gov.sg.
UTIs are more common in boys during the first six months of life because more males are born with structural abnormalities of the urinary tract. In older children and adults, UTIs are more common in females.
Women are especially prone to UTI due to the shortness of the female urethra. According to the HPB article, about 40 percent of women develop a UTI at some point in their life. In Singapore, about 4 percent of young adult females are affected. The incidence rises with age to 7 percent at 50 years. Serious consequences can occur if a UTI affects the kidneys. Infections of the urinary tract are usually treated with antibiotics.
Causes
UTIs are caused by germs, usually bacteria that enter the urethra and then the bladder, according to an article at MedlinePlus. This can lead to infection, most commonly in the bladder, which can spread to the kidneys. In most cases, the body is able to get rid of the bacteria by itself, but certain conditions increase the risk of having UTIs.
Conditions that increase the chances of developing a UTI include:
- Diabetes
- Advanced
age (especially people in nursing homes)
- Problems
emptying bladder completely (urinary retention)
- A tube called
a urinary catheter inserted into urinary tract
- Bowel
incontinence
- Enlarged
prostate, narrowed urethra, or anything that blocks the flow of urine
- Kidney
stones
- Staying
still (immobile) for a long period of time (for example, while recovering
from a hip fracture)
- Pregnancy
Signs and Symptoms
Some symptoms associated with UTI mentioned in the HPB article include:
- Painful
urination (burning sensation)
- Hot and
foul smelling urine
- Blood in
urine, milky/cloudy urine
- Fever
(sometimes with chills)
- Painful
lower abdomen
- Increased
frequency of wanting to pass urine
- Urgency to
pass urine
- Nausea
and/or vomiting
- Back pain
(pyelonephritis or kidney infection)
Other symptoms that may be associated with this disease:
- Painful
sexual intercourse
- Penile pain
- Flank pain
- Fatigue
- Vomiting
- Mental changes or confusion (often the only sign of a possible UTI for elderly person)
Screening and Diagnosis
A urine sample analysis is usually recommended by the doctor if a person has symptoms of UTI. This is in order the urine can be examined for the presence of nitrites and white blood cells, as mentioned in the HPB article. In addition, a urine culture to identify the bacteria is needed to confirm the diagnosis.
Special methods of investigation may sometimes be required for certain groups like young children and adult men.
Treatment
Mild cases of acute bladder infection (cystitis) may disappear spontaneously without treatment. However, because of the risk of the infection spreading to the kidneys (pyelonephritis), treatment is usually advised. Prompt treatment is important especially for the elderly.
Antibiotics may be used to control the bacterial infection. The drug of choice and length of treatment, however, depend on the patient's history and the urine test that identify the offending bacteria. Commonly prescribed antibiotics for UTI include:
- Nitrofurantoin
- Sulfa drugs
(sulfonamides)
- Amoxicillin
- Cephalosporins
- Trimethoprim-sulfamethoxazole
- Doxycycline
Stronger antibiotics may be given intravenously for infection that spread to the kidneys. Chronic or recurrent UTI should be treated thoroughly because of the chance of kidney infection. In chronic UTI, antibiotics may need to be given for long periods (as long as 6 months to 2 years). Follow-up measures may include urine cultures to ensure the bacteria are no longer present in the bladder.
Prevention
Preventive measures may reduce symptoms and prevent recurrence of UTI infection. Appropriate hygiene and cleanliness of the genital area may help reduce the chances of introducing bacteria through the urethra.
Some preventive measures mentioned in the HPB article include:
- Drink plenty of water daily
- Drink cranberry juice (or take vitamin C supplement) to acidify urine
- Urinate immediately when there is an urge; do not resist urge for long periods
- Wipe from front to back after defecation (to prevent bringing contamination from anus)
- Cleanse genital area after intercourse.
- Avoid fluids that irritate the bladder, such as alcohol, citrus juices, and caffeine.
- Avoid scented douches
by Medicana Life
For professional help with UTI, please consult a doctor or urologist.
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