Urinary Area Infections

Overview

Urinary tract infections lead to eight to ten million doctors’ workplace visits every year within the us, and a minimum of fifty p.c of girls can have a minimum of one urinary tract infection at some purpose in their lives.

Luckily, most tract infections don’t seem to be serious and may be simply treated with antibiotic medications. The symptoms of a tract infection will be stubborn and may persist once treatment. Sometimes AN infection recurs a number of weeks once treatment. Nearly twenty p.c of girls United Nations agency have a tract infection can have another, and thirty p.c of these United Nations agency have had 2 can have a 3rd. About eighty p.c of these United Nations agency have had 3 can have a fourth. If left untreated, tract infections will result in different additional sophisticated health issues so that they shouldn’t be unnoticed.

How the Urinary Tract Works

Your urinary tract includes two kidneys, two ureters, the bladder and the urethra. Your kidneys remove waste and water from your blood to produce urine. Urine travels through muscular tubes, called the ureters, to the bladder. The bladder is a balloon-like organ composed of muscle, connective tissue and nerves that swells as it fills with urine. Urine is stored in the bladder until it is released from the body through another tube, called the urethra. Two muscle groups, the pelvic floor muscles and the urinary sphincters, control the activity of the urethra and bladder neck. These muscles must work together to hold urine in the bladder most of the time and allow the bladder to empty when appropriate.

Cause of Urinary Tract Infection: Bacteria

Most urinary tract infections are caused by a variety of bacteria, including Escherichia coli (E. coli), found in feces. Because the openings of the bowel, vagina and urethra are very close together, it’s easy for the bacteria to spread to the urethra and travel up the urinary tract into the bladder and sometimes up to the kidneys.

Untreated Urinary Tract Infections: Bladder & Kidney Infections

Infection occurs when the bacteria cling to the opening of the urethra and multiply, producing an infection of the urethra, called urethritis. The bacteria often spread up to the bladder, causing a bladder infection, called cystitis. Untreated, the infection can continue spreading up the urinary tract, causing infection in the kidneys, calledpyelonephritis. Pyelonephritis can also occur without a preceding bladder infection.

A kidney infection that is not treated can result in the bacteria entering the bloodstream (this is known as urosepsis), which can be a life-threatening infection requiring hospitalization and intravenous antibiotics.

The first sign of a bladder infection may be a strong urge to urinate or a painful burning sensation when you urinate. You may feel the urge to go frequently, with little urine eliminated each time. At times, the urge to urinate may be hard to control and you may have urinary leakage. You may also have soreness in your lower abdomen, in your back or in the sides of your body. Your urine may look cloudy or have a reddish tinge from blood. It may smell foul or strong. You also may feel tired, shaky and washed out.

If the infection has spread to the kidneys, you may have fever, chills, nausea, vomiting and back pain, in addition to the frequent urge to urinate and painful urination.

Common Causes of UTIs

Some girls square measure additional vulnerable to tract infections than others as a result of the cells in their duct square measureas and in their urethras are additional simply invaded by microorganism. Women with mothers or sisters who have recurring urinary tract infections also tend to be more susceptible. Your risk of tract infection is also bigger if you are pastmenopause. Thinning of the tissues of the epithelial duct, bladder and urethra, as well as change in the vaginal environment after menopause, may make these areas less resistant to bacteria and cause more frequent urinary tract infections.

Irritation or injury to the epithelial duct or canal caused by sexual issues, douching, tampons or female deodorants will provide microorganism an opportunity to invade. Using adiaphragm can cause irritation and can interfere with the bladder’s ability to empty, giving bacteria a place to grow.

Any abnormality of the tract that blocks the flow of piss, such as a kidney stone or significant prolapse of the uterus or vagina, also can lead to an infection or recurrent infections. Illnesses that have an effect on the system, like polygenic disease, AIDS and chronic urinary organ diseases, increase the risk of urinary tract infections. A weak bladder may also build it tough to empty utterly, allowing bacteria to grow. Lengthy use of associate degree inward tubing, a soft tube inserted through the urethra into the bladder to drain urine, is a common source of urinary tract infections. Intermittentcatheterization (where an individual empties the bladder many times every day however the tubing is removed immediately) truly is employed to stop continual infections in some patients.

Because the female internal reproductive organ sits directly on the bladder throughout gestation and might block the voidance of piss from the bladder, UTIs are more common in pregnant women. And once girls develop tract infections throughout gestation, the bacteria are more likely to affect the kidneys. Hormonal changes and positioning of the tract throughout gestation might build it easier for microorganism to invade the kidneys. Such infections in pregnant girls will result in urosepsis, kidney damage, high blood pressure and premature delivery of the baby. All pregnant girls ought to have their piss tested sporadically throughout gestation. Pregnant girls with a history of frequent tract infections ought to have their piss tested typically.

Most antibiotic medications square measure safe to require throughout gestation, however your health care skilled can think about the drug’s effectiveness, however way your gestation has progressed and therefore the potential aspect effects on the fetus when determining which medication is right for you

Diagnosis

Your health care professional will determine whether you have a urinary tract infection based on your symptoms, a physical examination and the result of a laboratory test of your urine. You will be asked to urinate into a small cup. The urine will be examined under a microscope for bacteria and for a large amount of white blood cells, which fight infection. A urine culture may be done in which the bacteria in the urine are encouraged to grow. The bacteria can then be identified and may be tested to see which antibiotic best kills them.

If you are having recurrent symptoms of infections despite treatment, it is important that your urine be cultured before you are placed on antibiotics. Repeated treatment of presumed infections without urine culture should be avoided.

Some bacteria, such as chlamydia, can only be found with special urine cultures. A health care professional may suspect these infections when a woman has urinary tract infection symptoms, but a standard culture doesn’t grow the bacteria.

If you have recurring urinary tract infections, your health care professional may suggest other tests to look for obstructions or other problems that might trap urine in the tract and cause infection:

  • Intravenous pyelogram (IVP) is an X-ray exam of the urinary tract using a dye that is injected into a vein and then enters the kidneys, ureters and bladder. This test is not commonly used alone anymore.
  • A computed tomography scan (CT scan), also known as a CT urography, is a type of X-ray test used to capture images of different structures in the body. The CT scan is usually given with an intravenous dye similar to that used in an IVP (see above). The dye allows your doctor to better see your kidneys, ureters and bladder. Newer CT scanners use much less radiation.
  • Ultrasound uses sound waves to produce images of the urinary tract. No radiation is involved in this test.
  • Cystoscopy is a test using a thin telescope-like instrument that allows your health care professional to see inside the urethra and bladder and examine them for problems.

Treatment

Urinary tract infections are treated with medications that kill the bacteria causing the infection. Your health care professional will determine which medication to prescribe and how you should take it, based on your medical history and condition and the results of the urine tests. Many medications can have side effects, so talk to your health care professional about what to expect. Also, medications can interact with other prescriptions and over-the-counter drugs, so make sure you tell your health care professional what drugs you are taking.

The antibiotics most often used to treat urinary tract infection are pills typically taken for three days. More complicated infections are usually treated with seven to 10 days or more of antibiotics, depending on the bacteria causing the infection, the drug used and your medical history. The most frequently prescribed drugs include:and how long you should take it.

  • ciprofloxacin (Cipro)
  • levofloxacin (Levaquin)
  • nitrofurantoin (Macrobid, Furadantin)
  • norfloxacin (Noroxin)
  • fosfomycin (Monurol)
  • trimethoprim/sulfamethoxazole (Bactrim, Septra)

Note: Fluoroquinolones, which include the antibiotics ciprofloxacin, gatifloxacin, levofloxacin and norfloxacin, have been associated with an increased risk of tendonitis and tendon rupture. If you are prescribed one of these medications for a urinary tract infection, discuss this risk with your health care professional.

Urinary tract infections caused by microorganisms, like chlamydia, could also be treated with the antibiotics azithromycin, antibacterial or antibiotic.

Although your symptoms could also be mitigated during a day or 2 when beginning the medication, you need to take all the medication your health care skilled prescribes. Otherwise, you run the risk of a recurrence. That is, some microorganism could survive and cause your infection to come or cause reinfection with a replacement or totally different organism.

To help ease your discomfort till the antibiotics kick in, you’ll take a prescription medication known as anodyne (Pyridium). A similar medication, known as Uristat, is available over the counter. However, detain mind that these medications solely ease symptoms; they are doing not treat the infection. They additionally amendment the colour of your excreta, will interfere with laboratory testing and should not be taken for quite forty eight hours unless told otherwise by your health care supplier.

If you’re biological time, {you could|you’ll|you will} expertise a lot of frequent tract infections as a result of cutting of the tissues of the canal and channel following change of life may create these areas less proof against microorganism. Hormone replacement (either systemic or vaginal) may help. Vaginal steroid hormone has fewer health risks than general steroid hormone (such as in contraception pill and patches) as a result of solely atiny low quantity is absorbed into the blood. Vaginal steroid hormone is on the market as a cream (Estrace), a pill (Vagifem, Premarin) and a flexible plastic ring (Estring). Femring is another epithelial duct steroid hormone product, however it’s higher doses of steroid hormone and is primarily suggested for warm flashes; ladies with a womb United Nations agency use Femring ought to take progestin to minimize their risk of uterine cancer.

Discuss these treatment options and the latest research about their risks and benefits with your health care professional, keeping your personal health history and needs in mind. If you choose to require secretion replacement medical care, you should take the lowest dose that helps for the shortest time possible. You and your doctor ought to additionally value each six months whether or not or not you ought to be taking hormones.

Severe urinary organ infections could need hospitalization and treatment with endovenous antibiotics, particularly if nausea, vomiting and fever increase the risk of dehydration and prevent the ability to swallow pills. Kidney infections typically need period of antibiotic medical care, though treatment could extend as long as six weeks (this extended course typically is prescribed for men whose infections area unit due to prostatitis, however).

In addition to taking your medication, your health care skilled could suggest drinking many fluid (the equivalent of six to eight 8-ounce glasses a day) to assist flush the urinary tract and avoiding foods and beverages which will irritate the tract, such as coffee and alcohol. A heater could facilitate to quickly relieve pain.

After you’ve got completed your course of medication, your health care skilled could counsel a follow-up excreta check to form certain the infection is gone.

Prevention

There are several simple, do-it-yourself techniques that may prevent a urinary tract infection. Some may work some of the time or only in some women. But, because they carry no side effects, they certainly are worth trying to prevent the often painful and bothersome symptoms the infection can bring:

  • Drink plenty of fluid––the equivalent of six to eight 8-ounce glasses––every day to flush bacteria out of your urinary system. Water is the ideal fluid because it is readily available, inexpensive and noncaloric, but other beverages also count toward your fluid intake, including juices, milk and herbal teas. Even alcoholic beverages such as beer and wine and caffeinated beverages such as coffee and colas help replenish your fluids, but don’t rely heavily on them because they have diuretic properties. Additionally, alcohol and caffeine, as well as spicy foods, are among the substances that may irritate the bladder and, thus, should be avoided.
  • Make sure you’re getting vitamin C in your diet, either through diet or supplements. Vitamin C, or ascorbic acid, makes your urine acidic, which discourages the growth of bacteria. Drinking cranberry juice may also produce the same effect. Cranberry supplements are a more concentrated form of cranberry juice without the sugar content.
  • Urinate frequently and when you feel the urge; don’t hold it in. Keeping urine in your bladder for long periods gives bacteria a place to grow.
  • Avoid using feminine hygiene sprays and scented douches. They may irritate the urethra.
  • If you wear a pad for urinary leakage, you should change it often. Wet pads provide an environment for bacteria to grow.

If you suffer from urinary tract infections more than three times a year, your health care professional may suggest one of the following therapies to try to prevent another recurrence:

  • a low dosage of an antibiotic medication such as trimethoprim/sulfamethoxazole or nitrofurantoin, taken daily for six months or longer
  • a single dose of an antibiotic medication taken after sexual intercourse if it is determined that your UTIs are related to sex
  • a short, one- or two-day course of antibiotic medication taken when symptoms appear
  • Use of preventive medications that change the bladder environment, such as methanamine.

If you experience recurring UTIs, home urine tests, which involve dipping a test stick into a urine sample, may be helpful.

Some research suggests that a woman’s blood type may play a role in her risk of recurrent UTIs. Bacteria may be able to attach to cells in the urinary tract more easily in those with certain blood factors. Additional research will determine if such an association exists and whether it could be useful in identifying people at risk of developing recurrent UTIs.

Vaccines are being developed to help patients build up their own natural infection-fighting powers. Vaccines that are prepared using dead bacteria do not spread like an infection; instead, they prompt the body to produce antibodies that can later fight live organisms. Researchers are currently looking into vaccines that can be administered orally, by way of a vaginal suppository and through the nose.

Facts to Know

  1. Urinary tract infections result in eight to 10 million doctors’ office visits each year in the United States, and at least 50 percent of women will have at least one urinary tract infection at some point in their lives.
  2. Nearly 20 percent of women who have one urinary tract infection will have another, and 30 percent of those who have had two will have a third. About 80 percent of those who have had three will have a fourth. Four out of five such women get another infection within 18 months of the last one.
  3. Some women are more prone to the infection than others. Women at higher risk include those who are past menopause, who have diabetes or who use a diaphragm. If your mother or sister had frequent urinary tract infections, you are more likely to have one. Recently, researchers found that women who use spermicides as contraception—particularly if they use them with diaphragms—are also at a greater risk for recurrent UTIs.
  4. About 2 percent to 7 percent of pregnant women develop a urinary tract infection. Pregnant women are more likely to have UTIs and the infection is more likely to spread to the kidneys. UTIs during pregnancy need prompt attention by a health care professional to avoid a premature birth. Pregnant women may have no symptoms associated with an infection so regular urine tests are important.
  5. One type of bacteria––Escherichia coli (E. coli), which lives in the digestive system and spreads to the urinary tract––causes most urinary tract infections.
  6. Urinaryurgency, urge incontinence and pain with urination can be early symptoms of urinary tract infection. Urinary urgency is characterized by frequent overwhelming urges to urinate. Urgency incontinence is urine leakage resulting from not getting to a toilet in time.
  7. Urinary tract infections usually are not serious and are easily treated by taking antibiotics. Kidney infection is the most common complication and can produce fever, chills, nausea, vomiting and back pain.
  8. Although urinary tract infections do occur in men, women are at greater risk because of their anatomy. The female urethra is short, and the rectum, vagina and urethra are located closely together in women, making it easy to spread bacteria that live in the digestive tract to the urinary tract.
  9. Women who have more than three urinary tract infections in a year may benefit from preventive antibiotic therapy. Such therapy may involve taking a low dose of medication every day for six months or longer, taking a single dose after having sex or taking a dose for one or two days when symptoms begin to appear. If you experience recurring UTIs, home urine tests, which involve dipping a test stick into a urine sample, may be helpful.
  10. When being treated for a urinary tract infection, take all the antibiotic medication you have been given, even if your symptoms are gone before you finish your prescription. If you fail to complete the treatment, the infection may still be present, and your symptoms will return or another infection may arise in a short time.

Key Q&A

  1. How do you get a urinary tract infection?The infection is most often caused by bacteria from the digestive tract being spread to the urethra and then traveling up the urinary tract to the bladder and sometimes the kidneys. It can also be caused by bacteria and microorganisms transmitted during sexual intercourse.
  2. Isn’t it true that once you have a urinary tract infection, you’ll never have another one?No. In fact, once you have a urinary tract infection, you are more likely to have another. Nearly 20 percent of women who have a urinary tract infection will have another, and 30 percent of those who have had two will have a third. About 80 percent of those who have had three will have a fourth. Four out of five such women get another infection within 18 months of the last one.
  3. How can I tell if I have a urinary tract infection?Symptoms of urinary tract infections may include frequent, urgent needs to urinate, but not making it to the toilet in time; a painful, burning sensation when urination occurs; cloudy or reddish-colored urine; urine that smells foul or strong; and soreness in the back, side or lower abdomen. If fever, chills, nausea, vomiting and/or back pain accompany the symptoms, you may have a kidney infection. See your health care professional promptly if you have any signs of a urinary tract infection.
  4. My urinary tract infection seems to be gone. Do I still need to take the rest of my antibiotic medication?Yes, absolutely. Although your symptoms may disappear in one or two days after taking antibiotic medication, you must take all the medication to destroy the germs causing the infection. If you don’t, your symptoms may return, or you may have another urinary tract infection in a short time.
  5. Will a urinary tract infection harm my baby or me when I’m pregnant?If the infection is caught and treated early, generally not. However, pregnant women are more likely to have a urinary tract infection spread to their kidneys, which can cause kidney damage, high blood pressure and increased risk of premature delivery. If you’re pregnant and suspect you have a urinary tract infection, see your health care professional right away.
  6. Isn’t drinking cranberry juice to prevent urinary tract infection an old wives’ tale?Not necessarily. Cranberry juice and vitamin C make the urine more acidic, which makes it more difficult for bacteria that can cause urinary tract infections to grow. Cranberry juice also has another unique factor that helps prevent bacteria from adhering to the urinary tract walls.
  7. Why do I keep getting urinary tract infections?Some women are more prone to urinary tract infections than others because the cells in their vaginal areas and in their urethras are more easily invaded by bacteria. Your risk of developing a urinary tract infection is also greater if you’re past menopause because changes in your tissues after menopause may make the area less resistant to bacteria.Irritation or injury to the vagina or urethra caused by sexual intercourse, douching, tampons or feminine deodorants can give bacteria a chance to invade. Using a diaphragm can cause irritation and can interfere with the bladder’s ability to empty, giving bacteria a place to grow.Any abnormality of the urinary tract that blocks the flow of urine, such as a kidney stone, also can lead to an infection. Illnesses that affect the immune system also increase the risk of urinary tract infections.Practicing good personal hygiene habits, including washing the areas around the bowel, vagina and urethra daily and wiping from front to back, can help prevent spreading bacteria to the urinary tract. Drinking plenty of water daily, urinating when you feel the need (rather than waiting) and urinating after sexual intercourse can help flush the system of bacteria.
  8. Are there any medications that can prevent my recurring infections?If you have urinary tract infections three times a year or more, ask your health care professional about preventive antibiotic therapy. Taking a low dosage of antibiotics over an extended time or a single dose after sexual intercourse is often prescribed to head off infections. Or, you may take antibiotics for one or two days when you first notice signs of a urinary tract infection. Talk with your health care professional about which treatment may be best for you.