URINARY TRACT INFECTIONS
Easy Guide To: UTI Infection In Women

UTI Guide pictures of cystitis


Diagram of Urinary Tract

For more diagrams:
Urinary System Explained

Urinary Tract Infections

Contents

Urinary Tract Infections: Definition
What Are The Symptoms of UTI's?
Who Develops a UTI?
What Causes UTIs?
How Are They Diagnosed?
How Are They Treated?
Any Prevention Tips?

What Is Interstitial Cystitis?


UTI Index

Diagnosis
Treatment
Natural Treatments
Recurrent Infections
Interstitial Cystitis
Elderly Women

Related Topics

Vaginitis
Yeast Infections
Fibromyalgia Guide
Books on Urinary Tract Infections

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.

What Are The Symptoms Of A Urinary Tract Infection?

Lower Urinary Tract Infection (Cystitis/Bladder Infections)

1. The need to urinate frequently although there is little urine to come out.
2. Painful, burning sensation when urine is passed.
3. Urine may have a cloudy appearance and have a strong smell. Occasionally there may be a little blood in the urine.
4. Tenderness in the area just above the pubic bone.
5. Pain in the pelvis and lower back.
6. Tummy feels bloated.

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.
2. Increased need to urinate at night.
3. Severe back pain.
4. Vomiting and nausea.
5. Fever & chills.

This type of infection requires immediate attention.

Who Develops Urinary Tract Infections?

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.
2. Having sexual intercourse for the first time is a common trigger or after a period of abstinence. UTIs of this origin are usually labeled 'honeymoon cystitis'. Traditional missionary position with the man on top may increase infection risks as the act involves directing the penis along the floor of the urethra and bladder. This can irritate the lining and push bacteria from the entrance of the vagina back up towards the bladder. Postmenopause women (aged 55 to 75) are also prone to honeymoon cystitis, particularly if their partner is taking the drug Viagra. Vaginal dryness is also a factor.
3. Colds and flu’s lower the immune system and make women more prone to UTIs. Those in hospital are also at risk. Nearly 80 percent of all hospital contracted UTIs occur where a urinary catheter is in place.
4
. Withholding urination has been suggested as a cause, but this has not been proven.
5. Pregnant women are prone to cystitis because the fetus can press on the bladder which prevents it being completely emptied.
6. Contraceptives, in particular contraceptive diaphragms can irritate the lining of the urethra. In fact experts believe that diaphragms tend to be made too large. Spermicides and condoms can also increase susceptibility, as well as increase risks of vaginitis infections.
7. Perimenopause and postmenopausal women are prone to UTIs. As estrogen levels fall the tissues of the vagina thin (vaginal atrophy), making them more prone to tearing and infection. Estrogen loss also reduces the vagina's natural immune ability which helps to block E.coli bacteria from adhering to the vaginal cells. See: Urinary tract infections in older women.
8. Antibiotic use often upsets the delicate balance of bacteria in the vagina leading to the overgrowth of 'bad' bacteria.
9. Women who have skin allergies to beauty products like bubble bath and soap may find the genital area reacts to their use, making them more prone to UTIs. Any small rashes or skin 'injuries' can provide an opening to bacteria.

What Causes Urinary Tract Infections?

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.

How Are Urinary Tract Infection's Diagnosed?

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.

How Are Urinary Tract Infection's Treated?

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.

Can Urinary Tract Infection's Be Prevented?

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.
2. Drink plenty of water as this helps to keep bacteria flushed out of the urinary system.
3. Drinking 10 ounces of cranberry juice a day (unsweetened version) may help prevent bacteria attacking the bladder lining. A cranberry supplement is another alternative.
4. Change sanitary napkins/towels regularly.
5. After a bowel movement wipe from front to back to prevent bacteria from entering the vagina (image).
6. Avoid chlorinated swimming pools, bubble baths, scented douches and feminine hygiene sprays. No direct link has been proven, but anecdotally some women report improvements.
7. Women with recurring infections may be prescribed prophylactic (preventative) dosages of antibiotics to be taken every day or after sexual intercourse.

What Is Interstitial Cystitis?

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
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