Urinary Tract Infection: Facts, Prevention and Treatment

“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

Understanding Urinary Tract Infections

by Medicana Life

For professional help with UTI, please consult a doctor or urologist.

Infections: What You Need to Know

“I caught [the] flu while in Singapore two years ago which then managed to become a viral infection giving the symptoms of a heart attack,” wrote a forum member at ExperienceProject.com, sharing his experience of viral infection. “Despite several hospital visits, doctors found no sign of heart disease and eventually, despite having occasional BP readings of 240/130, dismissed my symptoms as ‘being nothing wrong'.”

“I discussed the continuing decline in my health with my GP and the possibilities of a viral infection,” the forum member continued. “His advice was that he could not treat a virus and blood pressure pills would control the spikes, which they did not. Faced with increasing weakness and chest pains usually randomly around the chest and at any time of the day or night, I turned to alternative treatment.”

According to an article by Christian Nordqvist at MedicalNewsToday.com, many of us develop a wide range of infections but fight them off rapidly. Some people however develop persistent, long-term chronic infections. The majority is due to viruses such as hepatitis or herpes. Chronic bacterial infections are more likely to affect patients with diabetes as well as those with weakened immune systems.

Among the most common causes of infections mentioned in the MedicalNewsToday.com article are viral, bacterial and fungal infections. The following information is an adapted excerpt from the article.

Viral infections

Viruses are tiny organisms, much smaller than bacteria or fungi. The virus invades its host or the person with the virus and attaches to a cell, entering it and releasing genetic material (DNA or RNA). This genetic material helps the virus multiply and takes over control of the cell, making it replicate the virus. A cell that has this genetic material inserted into it cannot function properly and soon dies. When it does, it releases new viruses which infect new cells.

A person can get infected by:

• Inhaling the virus (breathing it in)
• Being bitten by infected insects or parasites
• Through sexual contact

Respiratory infections of the upper airways, nose and throat are the most common forms of viral infections. Some antiviral medications may help by either undermining the virus' ability to reproduce or by boosting the patient's immune system.

Bacterial infections

Bacteria are tiny single-cell microorganisms belonging to a group all by themselves, usually a few micrometers in length that normally exist together in millions. A gram of soil typically contains about 40 million bacterial cells. A milliliter of fresh water usually holds about one million bacterial cells.

Bacteria can live in virtually any kind of environment, from extremely hot to cold, some even in radioactive waste. A number of bacteria live in our bodies, on our skin, airway, mouth, digestive and urinary tracts—most of the time without causing any harm to the host.

A relatively small number of bacteria cause diseases in humans. Some of the most deadly diseases and devastating epidemics in human history have been caused by bacteria, including:

• Cholera
• Diphtheria
• Dysentery
• Plague
• Pneumonia
• Tuberculosis
• Typhoid
• Typhus

Bacterial infections typically show up with localized redness and heat, inflammation (swelling) and pain. Even with a throat infection, a bacterial infection will usually have more severe pain on one side of the throat. If there is pain in just one ear, it is likely to be a bacterial infection.

Fungal Infections

Fungal infection or mycosis is caused by the presence of parasite fungi in or on a part of the body. Some fungi reproduce through very small airborne spores which people either inhale or pick up on their skin.

Patients on long-term strong antibiotics are at higher-than-normal risk of developing a fungal infection. Strong antibiotics can eventually reduce the population of good bacteria which help maintain the balance of microorganisms in the intestines, mouth, vagina and other parts of the body. If enough of these good bacteria are destroyed, the fungi have an opportunity to grow and cause health problems for the host.

Patients with weakened immune systems, such as those with HIV/AIDS and individuals receiving chemotherapy have a higher risk of developing a fungal infection. Diabetes patients, especially those who do not have good disease control are also more susceptible.

Useful Information on Treatments for Infection (by NetDoctor.co.uk)

• Treatments for Viral Infections
• Treatments for Bacterial Infections
• Treatments for Fungal Infections

What You Need to Know about Infectious Disease

by The National Academies

For professional help with infections, please consult a family doctor or GP.

ENT: Hearing Imbalances

“I started out with ringing in my left ear,” said Debbie, sharing her experience of Meniere’s disease at Menieres-Disease.ca. “I went to three doctors when I developed the ringing because it was so loud that it interfered with my daily living. I even had a hard time sleeping at night.”

“The doctor told me that I had an inner ear infection and gave some antibiotics along with … [medicine] for the nausea and sent me home,” Debbie continued. “I noticed that my ear felt like someone had filled it full of water.”

What is Ménière’s Disease?

Ménière’s disease is a disorder of the inner ear that causes severe dizziness (vertigo), ringing in the ears (tinnitus), hearing loss, and a feeling of fullness or congestion in the ear. This is according to an article at the website of National Institute on Deafness and other Communication Disorders (NIDCD). Ménière’s disease usually affects only one ear and can develop at any age, but it is more likely to happen to adults between 40 and 60 years.

Attacks of dizziness may come on suddenly or after a short period of tinnitus or muffled hearing. Some people will have single attacks of dizziness separated by long periods of time. Others may experience many attacks closer together over a number of days. Some people with Ménière’s disease have vertigo so extreme that they lose their balance and fall, according to the article at NIDCD.

Cause and Diagnosis

The cause of Ménière’s disease is unknown, but predisposing factors include ear infection, allergy, head injury and positive family history. This is according to an article on inner ear fluid imbalance by Loyola Medicine at Stritch.luc.edu. An inner ear fluid imbalance is diagnosed by performing a history, physical examination, and hearing test. Sometimes other tests may also be necessary, such as auditory brainstem response (ABR) test, balance test, or a magnetic resonance imaging (MRI) scan.

Treatment

Ménière’s disease does not have a cure yet, but the doctor may recommend certain treatments to help patients cope with the condition. Some of the treatments mentioned in the NIDCD article include:

Medications. Prescribed drugs can help relieve dizziness and shorten the attack.

Salt restriction. Limiting dietary salt and taking water pills can help some people control dizziness by reducing the amount of fluid the body retains and lowering fluid volume and pressure in the inner ear.

Other dietary and behavioral changes. Some people claim that caffeine, chocolate, and alcohol make their symptoms worse. Avoid or limit such foods and drinks in the diet. Not smoking may also help lessen the symptoms.

Cognitive therapy. Cognitive therapy is a type of talk therapy that helps people focus on how they interpret and react to life experiences. Some people find cognitive therapy helps them cope better with the unexpected nature of attacks and reduces anxiety about future attacks.

Injections. Injecting antibiotic into the middle ear helps control vertigo but significantly raises the risk of hearing loss because it can damage the microscopic hair cells in the inner ear that help us hear.

Surgery. Surgery may be recommended when all other treatments have failed to relieve dizziness.

Alternative medicine. Although scientists have studied the use of some alternative medical therapies in Ménière’s disease treatment, there is no evidence to show the effectiveness of therapies such as acupuncture or acupressure, or herbal supplements such as gingko biloba, or ginger root. If using alternative therapies, patients are advised to inform the doctor as such therapies may sometimes impact the effectiveness or safety of conventional medicines.

Ménière's Disease: What Is It & How Is It Treated?

by The Dr Bob Show

For professional help with ear imbalance or Ménière’s disease, please consult a doctor or an otolaryngologist.