URINARY TRACT INFECTION
Urinary tract infection (UTI) is the second to respiratory infection and it is the most
common type of infection in the body.UTIs is a bacterial infection involving the kidneys, ureters, bladder, or urethra. These are the structures that urine passes through before it being eliminated from the body.
The upper urinary tract is composed of the kidneys and ureters where the lower urinary tract composed of the bladder and the urethra.
URINARY TRACT INFECTION
TYPES OF URINARY TRACT INFECTIONS:
An infection affects the lower urinary tract (urethra or bladder), it may be called as
Urethritis or also called Cystitis, if it only affects the bladder. If bacteria migrates to
upper urinary tract i. e. Ureters or kidney and affects the upper urinary tract then is called as Urethritis and if it affects just the kidneys then it is called as Pyelonephritis. Urinary tract infections are very common in case of adults compared to children, but about 1%-2% of children do get urinary tract infections. Urinary tract infections in children next to bedwetting are more likely to be serious condition than those in adults and should not be ignored particularly in younger children. These infections are more common in girls and women than in boys and men younger than 50 years of age. The lifetime risk of a woman having a UTI is about 50%. They are especially more prone to UTIs due to anatomical reasons; a woman’s urethra is shorter than in a man’s, and it is situated very closer to the anus thus, making it quicker for bacteria to enter in to the bladder. Nearly about 40% of women and 12% of men have a urinary tract infection at some time in their life time. When the kidneys are involved, UTIs can be life threatening condition.
CAUSES OF UTIs:
More than 90% of UTI is caused by a type of bacteria called as Escherichia coli, (E. coli). E coli bacteria normally live in the bowel and also around the anus. E. coli bacteria are fairly settle in its natural environment of the bowel. However, when it introduced to urine’s acidic state the bacteria will thrive. Urinary tract infections normally occur when E.coli bacteria get into the urine and begin
to grow. The infection usually starts at the opening of the urethra where the urine
eliminated from the body and moves upward into the urinary tract then to the bladder. If the infection is not treated at this staring stage , it will continue on and quickly leads to the infection of kidneys. Some bacteria like E. Coli can easily move from the area of anus along the perineum till the opening of the urethra. The movement either due to improper wiping or the sexual intercourse , especially women are more prone to this infection, as they have very
shorter urethras, which helps for easier path to infect bladder. In the normal urination process, urine sweeps out the bacteria through the urethra. However, if too many bacteria multiply in large mass, in normal urinating process is not
sufficient to stop them from speeding. In this urinary tract infection, severe and rapid spreading is the major issue. If the infection reaches the kidney, then it causes serious complications like kidney infection called Pyelonephritis, which can become a very serious and also even life threatening condition of infection is not treated immediately.
SYMPTOMS OF UTIs:
Urinary tract infections always do not cause or show signs and symptoms, but when they cause the symptoms may include,
• Strong persistent urge to urinate
• While urinating people may feel a burning sensation
• Passing frequent and small amounts of urine
• Urine that appears cloudy
• Urine may appear as bright pink, red or cola coloured is a sign of blood in the urine
• Strong urine smell
• Pelvic pain, in women
• Rectal pain, in men
Acute Pyelonephritis (kidney infection)
• Upper back and side pain
• High fever
• Nausea
• Vomiting
• Chills and shivering
Cystitis (bladder infection)
• Pelvic pain
• Discomfort of lower abdomen
• Frequent and painful urination
• Blood in urine
Urethritis ( infection of urethra)
• Burning sensation when urinating
RISK FACTORS FOR UTIs:
Any factors that reduce emptying of the bladder or those which irritate the urinary tract can cause UTIs.
• Obstructions: Any blockages that make difficult to emptying the bladder can able to cause the UTIs. Conditions such as enlargement prostate, kidney stones and even certain forms of cancer are able to cause obstructions.
• Sexual activity: Pressure on the urinary tract during sexual intercourse helps the bacteria to move from colon into the bladder. Generally after the episode of sexual intercourse most of the bacteria enter the bladder and be the part of the urine. However, in this case these pathogens are removed out of the body within 24 hours. But still some bowl bacteria will have the property to stick to the bladder.
• Bathroom hygiene: The motion of the wiping anal region from back to front will
lead to movement of bacteria towards the urine region. These will often lead to
UTIs.
• Spermicides: spermicides will cause irritation in some women which increases the risk of UTIs by increasing chances of bacteria entering the bladder.
• Condoms: Especially latex present in condoms increases friction during intercourse which leads to irrigation of the skin, this increases the risk of UTI but still condoms are predominant factor which helps in minimizing risk of STDs.
• Diaphragm: Diaphragms reduce the extent of bladder emptying as they exert
pressure on the urethra. Some studies have proven the increased chances of UTI in women with diaphragms.
• Diabetes: The diabetic patients with suppressed immune activity are more prone to UTIs, the increased urine sugar level will facilitate easier bacterial growth.
• Loss of estrogen: The normal bacterial flora inside the vagina is altered once a
woman riches a menopause. This is influenced by loss of estrogen level in the body which leads to increased risk of UTIs.
• Prolonged use of bladder catheters: Catheters are thin flexible tubes which are inserted inside the bladder when a person cannot urinate normally. This leads to easy draining of urine into the attached container. The long term use of such
catheters will lead to increased risk of UTIs.
• Weakened immune system: Some medical conditions like diabetes, HIV and serious kidney infections impair the immune system. Some types of medications can be used to prevent rejection of transplanted organs and also suppress the activity of the immune system.
DIAGNOSIS OF UTIs:
The procedures which are used to diagnose urinary tract infections includes,
• Analysing a urine sample: This will help to detect the amount if white blood cells,
red blood cells or bacteria present patients in urine
• Growing urinary tract bacteria in lab: A urine culture is produce and further used
for lab analysis of the urine. This analysis includes test that uses patient urine for
growing the bacteria in lab. This test will provide information regarding bacteria
which cause infection and thus helps in selection of effective medication.
• Creating images of urinary tract: The images of urinary tract is produce by the help of intravenous pylerogram (IVP), a computerized tomography (OT) scan, by use of X rays with contrast dye or an ultrasound. These images provide information about any abnormality in urinary tract.
• Cystoscopy: A long thin tube with a lens called cystoscope is used to view the inner urethra and bladder. This scope provides important information about frequent causes of infection.
UTIs TREATMENT:
Antibiotics are generally used for the treatment of urinary tract infections. Specific
antibiotics and the duration of treatment depend on health condition and the type of bacterium set up in urine.
• Simple infection
Medicines generally recommended for simple UTIs include,
Sulfamethoxazole- trimethoprim
Amoxicillin Nitrofurantoin
Ampicillin
Ciprofloxacin
Levofloxacin
Generally, symptoms clear up within a many days of treatment. But may need to
continue antibiotics for a week or further in order to help medicine resistance and
to insure that the infection is fully annihilate. For an uncomplicated UTI that occurs when case is else healthy, may bear a shorter course of treatment, similar as taking an antibiotic for one to three days. And depends on particular symptoms and medical history. Pain drug( analgesic) may recommended, that numbs bladder and urethra to relieve burning while urinating. One common side effect of urinary tract analgesics is discoloured urine changes into orange or red.
• Frequent infections
If person experience frequent UTIs, often require certain treatment recommendations, such as: Longer course of antibiotic treatment or a program with short courses of antibiotics at the start of urinary symptoms. A single dose of antibiotic after sexual intercourse if infections are related to sexual activity.
Vaginal estrogen therapy if postmenopausal, to minimize chance of recurrent UTIs.
• Severe infections
For a severe UTI, may need treatment with intravenous antibiotics in a hospital.
PREVENTION OF UTIs: It is not possible to prevent all forms of UTIs but some preventive measure can be taken to minimize risk of development of the infection.
• Drink plenty of water after sexual intercourse
• Proper cleaning of vaginal and rectal areas
• Using the shower method should be preferred than using bathing tubs
• Increased fluid intake such as water, which helps in flushing of urinary system
• Use restrooms frequently rather than holding up for a long period of time
• Proper wiping is necessary i.e, from front to back to prevent bacteria entering
urethra, especially in girls and women
• Urinate immediately after a sexual activity to sweep out bacteria, which may have entered urethra during sex
• Use loose fitting comfortable cloth wear to keep area dry. Avoid cloth which holds moisture content, such as nylon as it helps bacteria grow
• Reduce use of unlubricated condom or spermicidal condoms as they cause irritation will, facilitate bacterial growth
• Avoid contraceptives including diaphragm or spermicide
• Use natural urinary antiseptics such as vitamin c rich fruits or cranberry juice