Urinary Tract Infections
What is urinary system?
The body takes nutrients from the eaten food where waste products are left behind in the bowel and in the blood. The urinary system filters blood, separates the unwanted toxins from the nutrients and creates liquid waste containing excessive water, salt, toxins and other waste products. This liquid waste is stored for sometime and then removed from the body as urine. Urinary system also helps to balance water, potassium and sodium in the body. The urinary system is like a drainage system and helps the rest of the body to work properly. All organs in the urinary system should work together and in correct order for normal urination functionality.
The urinary system includes two kidneys, two ureters, a bladder and a urethra.
Kidneys: These two fist-sized and bean-shaped organs are located each side just below the rib cage and on the back of the body. Kidneys filter blood, separate the unwanted toxins from the nutrients and create liquid waste containing excessive water, salt, toxins and other waste products as urine. Every day, kidneys filter about 120 quarts of blood and produce about 1 to 2 quarts of urine.
Ureters: These two thin tubes of muscle connect both kidneys with bladder. These tubes carry urine from the kidneys to the bladder.
Bladder: This sac-like, balloon-shaped and self-expandable organ is located in the pelvis between hip bones. It is a container that stores urine before it leaves the body by the urination process. A normal bladder can hold 500 ml of urine in women and 700 ml of urine in men. Normally people feel the need to pee when the bladder holds 200 to 350 ml of urine in it.
Urethra: This tube-shaped organ is located at the bottom of the bladder that allows urine to leave the bladder to exit the body during urination. For male, urethra passes through the prostate and into the penis. For females, urethra is much shorter and runs from the bladder to open in front of the vagina.
What are urinary tract infections (UTIs)?
Urinary tract infections (UTI) are among the most common infections in any part of the urinary system which includes two kidneys, two ureters, a bladder and a urethra. Typically, the urine doesn’t contain any bacteria. However, microbes can get into any part of the urinary system from outside of the body and cause infections. Most UTIs involve the urethra and bladder in the lower tract than the ureters and kidneys in the upper tract. Generally UTIs are more common in women than men.
Types and symptoms of urinary tract infections (UTIs)
Type of urinary tract infections (UTIs) are related to affected organs. Each type has a different name and symptoms depending on the affected organ.
Cystitis: Cystitis is inflammation of the bladder which is caused by a bladder infection. This infection is more common in women than men. This infection is mainly caused by bacterial infection, although it sometimes happens when the bladder is irritated or damaged for another reason such as certain medications, radiation therapy, complication of another illness etc. Oftenly mild symptoms will go away by themselves within a few days where severe symptoms will need proper treatment of antibiotics medications. If this infection shows severe symptoms and is left untreated, it may spread to kidneys and develop kidneys infection. Usual symptoms of this infection are:
Pain or burning when peeing
Strong urge to pee
Frequent urination
A feeling of urgentness for pee
A feeling of pressure in the abdomen
Dark, cloudy or strong smelling urine
Pelvic discomfort
Pyelonephritis: Pyelonephritis is inflammation of the kidneys which is caused by a kidney infection. This infection is mainly caused by Escherichia Coli (E Coli) bacterial infection, scientists believe that most kidney infections start as a bladder infection that moves upstream to infect one or both of the kidneys. Usual symptoms of this infection are:
Fever
Chills
Nausea or vomiting
Pain in upper back or side or groin
Urethritis: Urethritis is inflammation of the urethra which is caused by a urethra infection. This sexually transmitted infection is mainly caused by bacterial or viral infection, although it sometimes happens for another reason such as some physical injury, sensitivity to certain chemicals in spermicides, contraceptive foams and jellies. Usual symptoms of this infection are:
Pain or burning when peeing
Pain during sexual intercourse
Penile discharge with pus or blood
Itchiness at the tip of the urethra
Pelvic pain
Causes of urinary tract infections (UTIs)
Urinary tract infections (UTI) are among the most common infections in any part of the urinary system which includes two kidneys, two ureters, a bladder and a urethra. Microbes can get into any part of the urinary system from outside of the body and cause infections and inflammation. Most UTIs involve the urethra and bladder in the lower tract than the ureters and kidneys in the upper tract. Generally UTIs are more common in women than men. The most common causes and factors regarding this condition are listed below:
When the bladder is irritated or damaged for another reason such as certain medications, radiation therapy, complication of another illness etc.
Escherichia Coli (E Coli) bacteria generally live in the large intestine and can sometimes get out of the anus and into the urethra. Bacteria can travel up to the bladder to cause bladder infections. If this infection isn't treated, bacteria can move upstream to infect the kidneys. More than 90% of bladder infections (cystitis) are caused by E. coli.
Sensitivity to certain chemicals in spermicides, contraceptive foams and jellies.
Sexual intercourse can transfer bacteria into the partner’s urinary system.
Aging persons are more likely to get UTIs.
Urine flow affecting conditions such as kidney stones, enlarged prostate, a stroke, a spinal cord injury etc.
A Weakened immune system due to diabetes can raise the risk of UTIs.
Pregnancy.
Prolonged use of urinary catheters.
Prolonged bed rest or reduced mobility after illness.
How are urinary tract infections (UTIs) diagnosed?
Doctors may diagnose by gathering more information about a person's medical condition by examining and knowing the following things:
By knowing about the person's symptoms & possible triggers.
By knowing about the medical history of the person.
By doing a physical examination of the person to diagnose the affected body organ.
There are various tests to diagnose urinary tract infections (UTIs). These tests are as below:
Physical exam: A healthcare provider diagnoses a bacterial infection by listening to symptoms, listening to heart and lungs, feeling to abdomen and looking at skin.
Urine Tests: A healthcare provider or laboratory takes urine samples. These tests confirm whether a person has a bacterial or fungi infection and the bacteria that causes the infection. It helps to decide the line of treatment. Viral infection is rare but a person with weakened immune system or had an organ transplant are at risk of viral infection so doctors may conduct other special tests to diagnose viral infections.
Blood Tests: A healthcare provider or laboratory takes blood samples. Blood tests are helpful to identify White Blood Cells count and Red Blood Cells count. These counts are typically changed during bacterial infections so a healthcare provider can confirm the bacterial infection.
Imaging Tests: If a healthcare provider thinks that a person has recurring UTIs or obstructions in the urinary tract or bacterial infection in lungs, brain or other internal organs, imaging tests such as X-rays, Ultrasound or CT Scan are helpful to identify affected urinary tract organs and severity of infection.
Cystoscopy: For recurrent UTIs, a healthcare provider may perform a cystoscopy. This test is performed using a long thin tube with light and lens which is called a cystoscope. The cystoscope is inserted in the urethra and passed through to the bladder to see inside the urethra and bladder. During this test, a doctor may remove a small piece of bladder tissue and test it to rule out bladder inflammation or cancer.
Treatment of urinary tract infections (UTIs)
Urinary tract infections need medical treatment, diet and lifestyle management to reduce symptoms and to treat infections. Healthcare providers use antibiotics depending on the type of bacteria, organs affected in the body and severity of the symptoms. Sometimes, certain antibiotics do not work on some patients as per expected or they have allergies of certain antibiotics. So it is very crucial for healthcare providers to prescribe certain antibiotics based on a person's symptoms and medical history. Similarly it is important for a person to take only prescribed medications after proper diagnosis by a healthcare provider. Antibiotic resistance is a growing problem so antibiotics may be prescribed only for severe bacterial infections.
Medications: Antibiotics are the most common treatment that either kill harmful bacteria or stop them multiplying, and help the body’s immune system to fight the harmful bacteria. Viral UTIs are treated with antiviral medications where fungal UTIs are treated with antifungal medications. Fever and pain relievers are supportive medications to manage fever and pain during infection.
Sulfamethoxazole-Trimethoprim ( Bactrim, Bactrim DS )
Fosfomycin ( Monurol )
Nitrofurantoin ( Macrodantin, Macrobid, Furadantin )
Aspirin (fever-pain relievers)
Ibuprofen ( Advil, Motrin IB ) (fever-pain relievers)
Acetaminophen (fever-pain relievers)
Lifestyle management: Follow these lifestyle related changes before infection, during treatment or after getting rid of infection to avoid getting repeated infection.
Water: Drink plenty of water everyday because it can help flush away the bacteria that's causing infection.
Good hygiene: Practicing good hygiene is one of the best ways to prevent infections especially for women. Good hygiene includes washing the hands and body properly and frequently, keeping all personal items clean, not sharing personal items with others, wearing clean and dry loose-fitting cotton clothes, changing pads from time to time during menstrual cycle, not using feminine deodorants etc.
Private parts cleaning: Wipe properly from front to back after using the toilet. Don’t hold urine for a longer period and empty the bladder completely during urination. Pee after sex to flush out any bacteria that may have entered the urethra.
Safe sex Using a condom during sexual intercourse as well as washing and cleaning private parts of both men and women before and after sexual activity will prevent or reduce infections.
Birth control methods: Birth control methods such as diaphragm, unlubricated condoms or spermicidal jelly may increase the risk of UTIs. Diaphragms can increase bacteria growth, while unlubricated condoms and spermicides can irritate the urinary tract.
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