Urinary Tract Infection

What Is a Urinary Tract Infection?
About half of women will get a urinary tract infection or UTI at some point in life. It happens when germs infect the system that carries urine out of your body -- the kidneys, bladder, and the tubes that connect them. Bladder infections are common and usually not serious if treated promptly. But if the infection spreads to the kidneys, it can cause more serious illness.

UTI Symptoms: Bladder Infection
Most UTIs are bladder infections. Symptoms include:
Pain or burning during urination
The urge to urinate often
Pain in the lower abdomen
Urine that is cloudy or foul-smelling
Some people may have no symptoms

UTI Symptoms: Kidney Infection
An untreated bladder infection can spread to the kidneys. Signs of this include:
Pain on either side of the lower back
Fever and chills
Nausea and vomiting

When to See Your Doctor
See your doctor right away if you have signs of a urinary tract infection. A bladder infection is generally not a medical emergency – but some people have a higher risk for complications. This includes pregnant women, the elderly, and men, as well as people with diabetes, kidney problems, or a weakened immune system.

UTI or Something Else?
Although burning during urination is a telltale sign of a UTI, it can  also be a symptom of certain sexually transmitted diseases (STDs.) These  include chlamydia, gonorrhea, and trichomoniasis. Simple lab tests are  available to distinguish a UTI from an STD.

Honeymoon Cystitis
Few things can ruin a honeymoon like a UTI. But this is so common, it has its own name – "honeymoon cystitis." The reason is that sexual activity can push bacteria into the urethra. Of course, the problem is not confined to honeymoons. Some women get a bladder infection almost every time they have sex. Women who use a diaphragm for birth control are especially vulnerable.

Stealth UTI
Occasionally, UTIs occur without the classic symptoms. A person may have no symptoms at all. Yet, a urine test shows the presence of bacteria. This is known as asymptomatic bacteriuria. In many cases, no treatment is needed. But pregnant women, some children, and recipients of kidney transplants should be treated to avoid a kidney infection.

UTI Complications
The main danger associated with untreated UTIs is that the infection may  spread from the bladder to one or both kidneys. When bacteria attack the  kidneys, they can cause damage that will permanently reduce kidney function. In  people who already have kidney problems, this can raise the risk of kidney  failure. There’s also a small chance that the infection may enter the  bloodstream and spread to other organs.

How Do UTIs Begin?
Many types of bacteria live in the intestines and the genital area, but this is not true of the urinary system. In fact, urine is sterile. So when errant bacteria, such as the E. coli shown here, is accidentally introduced into the urinary system, it can start a UTI. Typically, bacteria travel up the urethra to the bladder, where an infection can take hold. Women are more susceptible than men, probably because they have shorter urethras.

What Boosts Your Risk?
UTIs are most common in sexually active women. Other factors that may increase your risk include:
Not drinking enough fluids
Taking frequent baths
Holding your urine
Kidney stones

Urinary Tract Infections in Men
Men are much less likely than women to get UTIs. When it does happen, it's often related to another underlying medical condition, such as a kidney stone or an enlarged prostate.

Diagnosing UTIs
The first step in diagnosing a UTI is usually a simple urine test called a urinalysis. It looks for bacteria, as well as abnormal counts of white and red blood cells. The dipstick test provides quick results. Your doctor may also send your urine to a lab for culture to confirm the type of bacteria. At-home test kits can help detect a UTI, but are not 100% accurate. Be sure to go over the results and your symptoms with your doctor.

Treating UTIs
Prescription antibiotics will almost always cure a UTI. Your health care provider may recommend drinking lots of fluids and emptying your bladder frequently to help flush out the bacteria. Kidney infections can often be treated with oral antibiotics, too. But severe kidney infections may require hospital care, including a course of intravenous antibiotics.

Treating Recurrent UTIs
Some women are prone to getting UTIs over and over again. If you have three or more a year, talk to your doctor about how to prevent or minimize these infections. Your options may include:
Taking a low dose of antibiotics long-term
Taking a single antibiotic dose after sex
Taking antibiotics promptly as self-treatment when symptoms appear

UTIs and Diabetes
People with diabetes are more vulnerable to UTIs for several reasons. First, their immune systems tend to be weaker. Second, high blood sugar can spill into the urine and encourage the growth of bacteria. Also, nerve damage related to diabetes can prevent the bladder from fully emptying. People with diabetes should talk with their doctor at the first sign of a UTI.

UTIs and Pregnancy
During pregnancy, there are several factors that boost the risk of UTIs, especially a kidney infection. Hormones cause changes in the urinary tract, and the uterus may put pressure on the ureters or bladder or both -- making it more difficult for urine to pass from the kidneys to the bladder and out.  Untreated UTIs can contribute to preterm labor, so be sure to alert your doctor if you suspect you have an infection.

UTIs and Menopause
Estrogen has a protective effect in the urinary tract, but levels of this hormone drop off significantly during menopause. Low estrogen levels can make it easier for bacteria to thrive in the vagina or urethra. For this reason, women may be more susceptible to UTIs after menopause.

UTIs and Hospital Stays
A hospital stay can put you at risk for a UTI, particularly if you need to use a catheter. This is a thin tube that's inserted through the urethra to carry urine out of the body. Bacteria can enter through the catheter and reach the bladder. This is more often a problem for older adults who require prolonged hospital stays or who live in long-term care facilities.

UTIs in the Elderly
UTIs are among the most common infections in the elderly. But the symptoms may not follow the classic pattern. Agitation, delirium, or other behavioral changes may be the only sign of a UTI in elderly men and women. This age group is also more likely to develop serious complications as a result of UTIs.

UTIs in Infants
Babies occasionally develop UTIs, but they can’t tell you what they feel. Here are some signs to watch for:
An unexplained fever
Strange-smelling urine
Poor appetite or vomiting
Fussy behavior
 It’s vital to treat a baby’s UTI quickly to prevent kidney damage. Promptly changing a dirty diaper can help prevent bladder infections. And of course, wipe from front to back whenever changing a baby's diaper.

UTIs in Children
About 1% of boys and 3% of girls develop UTIs by age 11. This includes some children who repeatedly delay a bathroom trip. Their muscles may not relax enough later to fully empty the bladder and flush away any bacteria. More regular bathroom trips and drinking plenty of liquids may help. A small number of children have a structural problem that obstructs urine flow or lets urine flow back from the bladder to the kidneys, triggering chronic kidney infections. This can lead to kidney damage.

UTI or Potty Training Problem?
Accidents are par for the course during toilet training. Even kids who have mastered the art of the potty may sometimes have a relapse. Other children may scream or cry when taken to the potty, as a way of rebelling against the process. These are generally not signs of a UTI.

Preventing UTIs
Here are several strategies to reduce your risk of UTIs:
Drink plenty of water.
Visit the toilet before and after sex.
Wipe from front to back.
Avoid feminine hygiene sprays.
Take showers instead of baths.

The Cranberry Connection
Maybe Mom told you that cranberry juice cures a UTI. She’s close. Some studies suggest it can prevent, but not treat an infection, and is more effective in young and middle-aged women. Cranberries contain a substance that prevents E. coli bacteria from sticking to the walls of the bladder. If you don’t like the taste of cranberry juice, capsules or tablets may work, too. People with a history of kidney stones should check with a doctor, first.

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