Urinary Tract Infections (UTI): Definition, Causes, Risk Factors, Symptoms, Diagnosis, Treatment, Home Remedies And Preventions.

Urinary Tract Infections (UTI): Definition, Causes, Risk Factors, Symptoms, Diagnosis, Treatment, Home Remedies And Preventions.

What are Urinary Tract Infections?

Urinary Tract Infections can be defined as an infection that usually affects the kidneys, ureters, bladder or urethra. These are the structures that urine passes through before being eliminated from the body.

What are kidneys?

Kidneys are pair of organs that lie on the either side of spine at about waist level. They have several functions in the body which includes removing of excess water and waste from the blood and eliminating them as urine. These function make them important in the regulation of blood pressure. Kidneys are also very sensitive to changes in blood pressure and blood sugar and electrolytes balance. Both hypertension and diabetes mellitus can cause damage to kidneys.

What are ureters?

These are two narrow tubes that connects the kidneys and bladder. They are about 10 inches long, drain urine from each kidney in to bladder.

What is urinary bladder?

The bladder is a small sack like organ that collects and store urine. When the urine reaches the certain level in the bladder, we experienced the sensation that we have to void, then the muscle lining the bladder can be voluntarily contracted to expel the urine.

What is urethra?

Urethra is small tube connecting the bladder with the outside of the body. A muscle called the urinary sphincter, located at the junction of the bladder and the urethra, must relax at the same time the bladder contract to expel urine.

Any part of urinary system can become infected. As a rule, the farther up the urinary infection is located, the more serious it is.

Upper urinary system is composed of the kidney and the ureters. Infections in the upper urinary tract can affect the kidney, this infection is called pyelonephritis, which can cause fever, nausea, chills, vomiting and other severe symptoms.

The lower urinary system consist of bladder and the urethra. Infections in the lower urinary tract can affect bladder (cystitis), urethra (urethritis).

UTI are more common among adults than in children , but about 1%-2% of children do get UTI. UTI in children are more likely to be serious than those in adults, especially in younger children.

UTI is the most common urinary tract problem in children besides Bedwetting.

UTI is second only to respiratory tract infection as the most common infection.

These are the most common type in girls and women than in boys and men below 50 years. The reason for this is not fully understood, but anatomic difference between the genders i.e shorter urethra in women may be partially responsible.

What causes UTI?

Urinary Tract Infections occurs when the pathogenic microorganisms (like bacteria) get in the urine and start grow. The bacterial infections usually starts at the opening of the urethra where the urine leaves the body and moves upward in to the urinary tract.

The problems in at least 90% of uncomplicated infections is a type of bacteria called Escherichia coli (E. Coli). These bacteria normally live in the colon and around the anus.

These bacteria can move from the area around the anus to the opening of the urethra. The two most common cause are improper wiping and sexual intercourse.

Usually the act of emptying the bladder flushes the bacteria out of the urethra. If there are many bacteria, urinating may not stop the spread.

The bacteria can travel up to the urethra to bladder, where it can grow and cause infection.

The infection can spread further as the bacteria move up from the bladder through the urethra.

If bacteria reached the kidney, it can cause kidney infection called Pyelonephritis, which can become serious condition if care are not taken.

What are the risk factors of UTI?

The following people are at increased risk of UTI:

People with condition that blocks urinary tract e.g kidney stones.

Women in menopause: Decreased circulating estrogen makes the urinary tract more vulnerable to a UTI.

People with medical conditions that cause incomplete bladder emptying such as spinal cord injury.

Women who use a diaphragm for birth control.

People with suppressed immune system e.g HIV/AIDS, diabetes mellitus. People who take immunosuppressant medications such as chemotherapy for cancer are also at risk.

Men with enlarged prostate (BPH): Prostatitis or blockage of urethra by an enlarged prostate can lead to bladder incomplete emptying, thus increasing the risk of infection. This is more common in old age.

Women who are sexually active: Sexual intercourse introduce more numbers of bacteria in to the bladder. Urinating after sexual intercourse seems to decreased likelihood of developing a urinary tract infections.

The following groups may be at increased risk of UTI:

Hospitalized patients who have been catheterized for long periods.

Children of all ages with vesicoureteral reflux.

Young children who can not properly wiping or wash their hands after using toilet.

Very young infants as bacteria can gain entry to blood stream from the other sites in the the body.

Patients who required to be catheterized before emptying the bladder also are at risk of UTI.

What are the symptoms of UTI?

The symptoms of UTI are classified as those that are found in lower urinary tract infections and those for upper urinary tract infections.

Lower urinary tract infections symptoms

Hematuria (bloody urine), cloudy, or bad smelling in urine.

Lower abdominal pain.

Dysuria (pain sensation in passing urine)

Frequent urination.

Cystitis (inflammation of the bladder).

Upper urinary tract infections symptoms

Symptoms in upper urinary tract infections  develop rapidly and may or may not include the symptoms in lower urinary tract infections.

Symptoms in upper urinary tract infections are:

Infants: there are vomiting, fever, poor feeding, diarrhoea and not growing up.

Newborn: jaundice, fever or low body temperature.

In adults, there are:

Fairly high fever

Vomiting

Nausea

Flank pain: pain in the side or back, usually on only one side at about waist level.

Children: poor feeding, irritability, unexplained fever that doesn't go away, loose stools, loose bowel control, and change in urination pattern.

Elderly: lethargy, change in mental status, low body temperature or fever and poor appetite.

Pregnant women are at increased risk of an UTI. Typically, they don't have a unique or unusual symptoms. If a woman is pregnant, urine test should be done during Ante-natal Care visits because an unrecognized infection can cause pregnancy health complications.

Although some people have symptoms with UTI. Some don't.

The symptoms of UTI can resemble of sexually transmitted infections.

How to diagnose UTI?

The diagnosis of urinary tract infections is based on the information some one gives on his or her symptoms, surgical and medical history, habits and lifestyle. Physical examination and laboratory investigation complete the evaluation.

A medical practitioner may perform a urine dipstick test in the office. Only a few minutes are needed to obtain the result. A sample of your urine may send to lab for urine culture. These results can take a few days to come back.

This tells the medical practitioner the exact bacteria causing the infection and to which antibiotics these bacteria have resistance or sensitivity. The culture is usually sent for special populations, including men, because they are less likely to have UTI. It is not necessary to send a culture for everyone because the majority of UTI are caused by the same bacteria.

The most important laboratory test is urinalysis. A urine culture will be tested for signs of infection, such as the presence of white blood cells and bacteria.

Blood test is usually not required unless the a complicated condition, such as Pyelonephritis or renal failure is suspected.

Ultrasound examination can evaluate kidney and bladder problems.

Rarely, an imaging test may be indicated to detect any underlying problem in the urinary tract that could cause infection. This is only need in repeat infection or special circumstances (unusual bacteria, suspected anatomic abnormality).

A fluoroscopic study can show any problems that predispose children to UTI.

Cystoscopy: this involves the insertion of a thin, flexible tube with a tiny camera on the end through the urethra in to bladder.

This allows detection of abnormalities that might contribute to infections.

Intravenous Pyelogram (IVP): is a special series of of x-rays that uses a contrast dye to highlight abnormalities in the urinary tract.

How Urinary Tract Infections are Treated?

The usual treatment for simple and complicated UTI is antibiotics. The type of antibiotics and and duration of treatment depends on the circumstances. Examples of antibiotics used to treat UTI are:

Ciprofloaxacin

Amoxicillin

Cotrimoxazole

Augmentin, etc.

Your doctor will choose the appropriate antibiotics for your condition and causative agent.

Lower urinary tract infections (bladder infections)

In a healthy person, three day course of antibiotics is usually enough. Some health professionals prefer seven day course of medication. 

In men with prostatitis, four weeks course of antibiotics or more may be required.

In women with potential for or or early involvement of the kidney, diabetes, urinary tract abnormalities are usually given five- to -seven day course of antibiotics.

Children with uncomplicated cystitis are given ten day course of antibiotics.

To alleviate burning pain during urination, Pyridium (phenazopyridine) or a similar drug, can be used in addition to antibiotics for 1-2 days.

Upper urinary tract infections

If someone is very ill, dehydrated or unable to keep anything in his or her stomach because of vomiting, an IV fluids be inserted into the arm. Thi is going to be done after admission in the hospital until the patient can tolerate oral medication.

A complicated, acute infection may require a treatment for several weeks.

Healthy patients with symptoms of Pyelonephritis can be treated as outpatients. They may receive IV fluids and antibiotics or an injection of antibiotics in the emergency department, followed by ten day course of oral antibiotics. They should follow up with their health care professional in one to two days to monitor improvement.

A person with symptoms of Pyelonephritis and other symptoms such as pregnant women, appear very ill, have not got improvement with oral medications may be hospitalized.

Home remedies for UTI

There are many home remedies for UTI as follows:

Drink plenty of water

Use a hot-water bottle to ease pain

Avoid alcohol, coffee and spicy food as they all irritates the bladder

Cranberry may be of help.

Because of the symptoms of UTI mimic those of other conditions, someone should see a doctor if an UTI is suspected. A urine test is needed to confirm an infection. Self care is recommeded.

How to prevent urinary tract infections?

UTI may be prevented by applying the following measures:

Drink plenty water

Empty the bladder completely and regularly, especially after sexual intercourse.

Women should empty the bladder soon after sexual intercourse.

Cranberry juice, especially, has been shown to help prevent UTI

Women and girls should wipe from front to back, not from back to front after bowel movements. As this helps prevent bacteria from the anus entering the urethra.

Sources:

www.medicinenet.com