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Urinary Tract Infections
• Urinary Tract Infections: Definition
|What Is A Urinary Tract Infection?
A urinary tract infection (UTI) is an infection which occurs in one or more parts of the urinary tract (image). The urinary tract is the route urine takes as it is excreted from the body, starting at the kidneys, traveling down the ureter to the bladder (where it is stored - see diagrams of bladder and kidneys) and then finally moving down the short urethra and out of the body. Men, women and children are vulnerable to UTIs but women are mainly affected because of their anatomy. 95 percent of female UTIs are caused by bacteria and occur in the lower urinary tract (urethra and bladder). This is also known as cystitis or a bladder infection, the terms are used interchangeably. In a few cases, a UTI can infect the upper tract area (ureters and kidneys). This is a more serious condition called pyelonephritis, commonly referred to as a kidney infection or a silent kidney infection. It is estimated that about 6 to 7 million Americans experience UTI symptoms every year. The real figure may however be a lot higher as many patients do not report symptoms because they either stop spontaneously or they rely on over the counter medications for treatment.
Lower Urinary Tract Infection (Cystitis/Bladder Infections)
1. The need to urinate frequently although there is little urine to come out.
Upper Urinary Tract Infection (Kidney Infection)
With a kidney infection symptoms tend to affect the whole body, not just the pelvic area. About 30 percent of UTIs turn out to be kidney infections. As well as the usual bladder infection symptoms (such as painful or frequent urination) a kidney infection can also cause:
1. UTI symptoms which continue longer than 7 days.
This type of infection requires immediate attention.
1. Men, women and children are prone to developing UTIs. However, for the purpose of this article, we will focus on women who are the most likely to develop it. The female anatomy predisposes women to a UTI because of the shortness of their urethra. A woman's urethra is about 2.5cm long, compared to a man's which on average is 15cm. A shorter urethra means a shorter distance for the bacteria to travel to infect the bladder. The urethra starts at the bladder and ends at the vaginal opening. As the end is located very close to the anus, this is a common source of bacteria.
Most uncomplicated UTIs (that is cystitis/bladder infections which do not have more serious symptoms like fever or vomiting) are caused by bacterial infections. In particular by the bacteria E.coli which is naturally present in the intestines. If it spreads to the vaginal opening (usually after love making or by wiping from back to front after a bowel movement) it can invade the bladder and colonize. In a few cases (5 to 15 percent), particularly in perimenopausal or menopausal women, other bacteria may cause infection (such as Staphylococcus saprophyticus, proteus mirabilis, klebsiella and enterococci bacteria).
UTIs of the upper urinary tract (kidney infections) tend to be caused by the same bacteria that cause cystitis, but evidence indicates that the bacteria may be of a more virulent nature. This means it can spread faster and cause more illness.
The vast majority of women with painful urination complaints turn out to have a lower urinary tract infection. For a urinary tract infection diagnosis the doctor will ask the patient to provide a clean urine sample in a container. He then carries out a urinalysis (or urine dipstick) test to check for white blood cells (pus). If the sample is positive, a urine culture is done in a laboratory to identify the type of bacteria present. This is important for identifying the correct form of treatment. Although urine cultures are still performed regularly, recent studies indicate that nearly 50 percent of all women with cystitis do not have enough bacteria to yield a positive result. If no bacteria are found the doctor may investigate other potential causes of painful urination including STDs, yeast infections or vaginitis.
In many cases, where symptoms are straightforward and previous infections have occurred, the doctor may simply prescribe antibiotics (even over the phone). If severe symptoms occur and a kidney infection is suspected a urine culture will be ordered. Currently there is no test which differentiates between cystitis and kidney infections.
Urinary tract infections treatment: Oral antibiotic medications cure 94 percent of straight forward (uncomplicated) urinary tract infections, although the rate of recurrence is high. For years UTIs were treated with a course of antibiotics lasting 7 to 14 days, but recent studies show that a 3 day course, occasionally a 5 day course, is just as effective. A shorter treatment had the added benefit of reducing the risks of yeast infections, diarrhea and rash associated with antibiotics. Symptoms usually disappear within 48 hours of treatment, but the full prescribed course should still be taken. If the treatment does not succeed, a relapse may occur within 3 weeks. This is usually treated with the same antibiotic but taken for a longer period (7 to 14 days).
Occasionally women with chronic recurrent urinary tract infections develop resistance to standard antibiotics. In such a case stronger alternatives such as norfloxacin or ciprofloxacin may be prescribed. In all instances treatment involves drinking 6 to 8 glasses of water a day to help flush out bacteria. See also: Natural treatment for urinary tract infections as well as how to treat cystitis.
Some tips which may help prevent UTIs include:
1. Emptying the bladder directly before and after love making can help prevent UTIs by flushing out bacteria. Diaphragms, spermicides and condoms can irritate the lining of the urethra, so it may be worth considering another birth control method. Ask your doctor for advice.
Interstitial cystitis (IC) (image) is not considered a urinary tract infection. IC, unlike cystitis, is not caused by a bacterial infection nor does it respond to antibiotics. IC usually involves discomfort or pain in the bladder and to the surrounding pelvic area due to inflammation. It can also cause an urgent need to urinate frequently. Symptoms may become worse during menstruation and pain can be experienced during sexual intercourse. As the symptoms of IC vary so much and in severity many researchers now believe that it is not one condition, but many. For this reason, more recently it is being referred to as bladder pain syndrome (BPS) or painful bladder syndrome (PBS). Many women with IC have other conditions such as fibromyalgia and irritable bowel syndrome. IC may be the local manifestation (in the bladder) of a more general condition which causes inflammation in the whole body.
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WOMENS HEALTH ADVICE: ABOUT URINARY TRACT INFECTIONS