A urinary tract infection (UTI) is a bacterial infection affecting the urinary tract. Generally, human urine is bacteria-free. An infection happens only when bacteria mix with the urine and overcome bodily defenses inside the urinary tract. The bacterium commonly responsible for the infection is Escherichia coli, which usually lives around the anus and in the bowel. Other bacteria such as mycoplasma and chlamydia could cause a urethra infection but they don’t hurt the bladder.

The urinary system comprises the kidneys, bladder, two ureters and a urethra. A UTI could affect the kidneys, urethra, bladder, or two or more of these organs simultaneously. Based on the specific part affected, the infection may have different names. A bladder infection is called cystitis; urethritis is the name for a urethra infection; and pyelonephritis for a kidney infection.

Vulnerable People

Image credit: Flickr
Image credit: Flickr

Serious UTI complications are rare and may lead to blood poisoning or kidney failure. The following people are likely to get UTI:

  • Women are more susceptible than men since their urethra is just 4 cm in length, which is a short distance the bacterium needs to travel to reach the bladder’s internals.
  • Some women have genetic UTI issues. Others could have urinary system structural abnormalities, which could make them more vulnerable to the infection.
  • Diabetic women are at a higher risk due to their weakened immune system, which makes them less capable of fighting away UTI-like infections.
  • Sexually active women, as sexual intercourse could bring in larger quantities of bacteria inside the bladder. But even sexually non-active women have risks, due to their anatomy.
  • Women using diaphragm as a birth control measure.
  • Pregnant women and individuals with other medical conditions such as diabetes, stroke, kidney stones and spinal cord injury. UTI-affected pregnant ladies could end up delivering premature or low birth weight infants.
  • Men with prostatitis or an enlarged prostate, since urethra obstruction by a dilated prostate could lead to partial bladder emptying, thereby increasing infection risks. The condition is more prevalent in older men.
  • Though rare, kids may also get UTI. About a percent or two could get UTIs, primarily due to poor hygiene. Most kids don’t wash their hand properly post a bowel movement, thereby increasing infection probabilities.
  • Nursing home residents or hospitalized patients who have urinary catheterizations for extended time periods are vulnerable to urinary tract infection. These individuals have a thin tube, called catheter, placed within their urethra to drain the urine out from the bladder.

Generally, a healthy person with a UTI problem could be cured in a few days of treatment. The condition gets complicated when the person is already weakened by other health conditions, such as a heart transplant or pregnancy, prostate enlargement or kidney stone issues. The treatment for such people could extend to two weeks.

Symptoms

  • Frequent urge to urinate and a burning sensation or pain when urinating
  • Bloody, dark, or strange-smelling urine
  • Lower abdomen or back pain
  • Chills or fever
  • Fatigue or shaky feelings

Kids, elderly people, newborns and infants may not get these symptoms. In others, the symptoms should likely disappear in a few days. But if they last for close to a week, seeing the GP is imperative.

Diagnosis

Treatment plans typically begin at a urologist – a doctor specializing in urinary issues. Before treatment, a nurse or doctor would put the patient through a urine test, to confirm presence of bacteria, red blood cells, white blood cells, nitrites, and other chemicals. Urine culture could also be performed for determining the bacteria type. Confirming the bacteria variant helps ascertain the best antibiotic for treating the infection.

Patients are asked to provide a midstream, clean-catch urine specimen or collect the sample after having urinated into the toilet first. This is avoiding urine that flows out first, which is often contaminated. Women are usually asked to gently clean the area surrounding the urethral opening with soap and water or a sterile wipe before sample collection.

Further tests, such as an intravenous pyelogram (IVP), could be done for checking the urinary tract. Cystoscopy is another option wherein a bendy, thin tube is used for viewing the bladder’s innards. A blood test is not generally done, unless kidney failure or pyelonephritis is suspected. Other diagnosis options include:

  • Ultrasound (for evaluating bladder and kidney problems)
  • Intravenous pyelogram (for highlighting urinary system abnormalities)
  • CT scan (for a detailed 3D urinary system image that helps check anatomic abnormalities)
  • Urodynamics (to determine the urinary tract’s urine-releasing and storing potential)

Treatment

Antibiotics are often recommended, especially to women who exhibit recurrent UTI symptoms. At times, long-term antibiotic usage can prevent future UTI occurrences. Besides antibiotics, the practitioner could also suggest a patient to drink large quantities of water, to avoid dehydration and relieve symptoms. An alternative treatment, methenamine hippurate is recommended for women who can’t take antibiotics. For UTI pain, paracetamol could be prescribed. Heating pad for the abdomen or back also helps.

Prevention

  • Emptying the bladder completely every time the need arises.
  • Drinking lots of water, which would avoid constipation.
  • Avoiding bladder-irritating fluids such as caffeine and alcohol.
  • Wiping the bottom after a bowel movement (in case of women) from front to rear, and not the other way round.
  • Not using scented bath products and hygiene sprays as they’ll only add to the irritation.
  • Cleaning the genital part prior to sex.
  • Using menstrual cups or sanitary pads instead of tampons.
  • Urinating post sex to get rid of bacteria that could have entered the urethra.
  • Breastfeeding can decrease UTI risks in children.
  • Unlubricated condoms, diaphragms, or other birth control measures should not be used. A diaphragm increases bacteria growth; spermicides and unlubricated condoms cause irritation – these may cause UTI.
  • Keeping the genital region dry and moisture-free, so that there’s no bacteria growth. Loose-fitting clothes and cotton underwear are recommended. Nylon underwear and tight jeans are not advisable.
  • Cranberry extracts can help with preventing UTI development, but won’t treat existing UTIs.

Preventive measures for women with recurrent UTIs could entail an antibiotic dose after sexual intercourse; a daily, single antibiotic dose for six months minimum post treatment; or a 2-3-day short antibiotic course if symptoms reappear.