Urinary Tract Infections: Causes and treatment

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Urinary Tract Infections

Since the urinary tract is responsible for moving waste material out of the body, it is perhaps not surprising that urinary tract infections (UTIs) are among the most common of human infections. UTIs tend to be more common in women than men, with almost all females suffering from them at least once in their lifetime. In the United States, UTIs are responsible for more than ten million patient visits to health care providers or hospitals. In fact, they are second only to respiratory illnesses. Therefore, it is important for medical professionals to know the causes and treatment.

What are Urinary Tract Infections?

The urinary tract includes the kidneys, bladder, ureters, and urethra, all of which are structures that involve the passing of urine through and out of the body. Any part of the system can become infected, but upper infections of the kidneys and ureters are more serious than lower urinary infections. Symptoms of upper urinary tract infections include:

  • Chills
  • Vomiting and nausea
  • Tenderness and pain in the upper back, sides or flank area, or genital area
  • Fever
  • Burning with urination
  • Frequent urination with decreased quantity of urine
  • Urine characteristics are different than usual (color, odor, blood or pus in urine)
  • Discharge from genitals that is different from usual discharge in appearance, texture, and odor

Lower urinary tract Infections involve:

  • Pelvic or rectal pain
  • Urge to urinate but the inability to pass much urine
  • Painful, burning urination
  • Urine that is dark in color, cloudy, and has a strong odor

What Causes Urinary Tract Infections?

Urinary tract infections are usually caused by bacteria but can also be caused by fungi, and, rarely, viruses. Any part of the urinary tract can become infected but lower infections of the urethra and bladder are more common. A "clean catch" urine sample-- which is collected mid-stream-- is the most common diagnostic tool. Urine samples show:

  • Whether there is a large white blood count which indicates the body is fighting an infection.
  • If bacteria or fungi are present.

If an upper tract urinary tract infection is suspected, doctors might also order a complete blood count and blood culture to see if the infection has moved to the bloodstream. If a person has recurrent urinary tract infections, other tests such as an ultrasound, CT scan, camera cystoscopy or intravenous pyelogram might be done to determine whether there are obstructions or abnormalities causing the problem.

Risk Factors for Urinary Tract Infections

Any factor irritating the urinary tract or reducing the full emptying of the bladder can create conditions which favor the development of urinary tract infections. Common risk factors include:

  • Age – older people are more susceptible
  • Gender – women get UTIs eight times more often than men
  • Sedentary lifestyle or reduced mobility after medical care
  • Previous UTI
  • Urinary tract obstructions like enlarged prostate, some types of cancer, and kidney stones
  • Use of urinary catheter, especially for a prolonged period
  • Poorly controlled diabetes
  • People with spinal cord injuries
  • Men with an enlarged prostate, which can obstruct the urethra
  • Individuals with suppressed immune systems or who are taking immunosuppressant medications

Additionally, some forms of contraception (such as diaphragms, spermicides and non-lubricated latex condoms) can cause some women to develop UTIs by causing friction, skin irritation and increasing movement of bacteria into the bladder area.

Treatment of Urinary Tract Infections

Treatment of UTIs depends on the cause. If, as is most common, the urinary tract infection is caused by bacteria, antibiotics are the standard treatment. Since 90% of urinary tract infections are uncomplicated and caused by E. coli that live in the bowel and anus, they are generally easily treated with antibiotics and symptoms are often better in 2 to 48 hours. Most often, health providers suggest a 3 to 7-day course of treatment. For alleviation of pain during urination, phenazopyridine may be used for one or two days.

Oral antibiotics are usually used for lower tract infections but upper tract infections might require intravenous antibiotics. Viral UTIs are often treated with antivirals like cidofovir, while fungal UTIs may be treated with antifungal medicine.

Symptom Treatment

Until antibiotics take effect, symptoms can be eased by:

  • Using a hot-water bottle to ease the pain
  • Drinking plenty of water to ease the flow of urine
  • Avoiding spicy foods, alcohol, and coffee which can all irritate the bladder
  • Drinking cranberry juice

Prevention of Urinary Tract Infections

While treating urinary tract infections is relatively simple and straightforward, some patients have trouble with frequent recurrence. Several preventative steps can help reduce or prevent UTIs for these individuals:

  • Not holding urine for long periods
  • For women – cleansing themselves from front to back after urination.
  • Drinking 6-8 glasses of water every day
  • Women might benefit from vaginal probiotics or topical estrogen
  • Older adults can benefit from preventative antibiotics
  • Using cranberry supplements daily
  • Urination after intercourse can help women get rid of bacteria in the urinary tract

Since urinary tract infections are common and frequently reoccur, health care professionals should be prepared to not only diagnose and treat current infections, but also be aware of suggestions for individuals to ease symptoms and practice preventative care.

The views and opinions expressed in this blog are solely those of the author, and do not represent the views of IncontinenceSource, Kestrel Health Information, Inc., its affiliates, or subsidiary companies.

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