UTI's

Today’s health and beauty buzz is on urinary tract infections (UTI’s).  I have yet to meet a woman who has not felt the pain and discomfort of a UTI. UTI’s are the second most common infection of the body and in the U.S. account for 8.1 million visits per year to health care providers.                                 

The bladder, the kidneys and the tubes connecting them are all part of the urinary tract system. The urinary tract system makes urine and carries it out of the body. The urine travels from the kidneys down 2 narrow tubes and is stored in the bladder. It is then emptied out through a tube at the bottom of the bladder. This tube is called the urethra.

What is a UTI?

Any part of the urinary tract system can become infected. Most UTI’s occur in the bladder and are not serious if treated right away. If they are not treated correctly the infection can spread to the kidneys. This is serious and can cause permanent damage.

Causes of UTI’s

1. Most UTI’s are caused by e coli. This is a bacteria that lives in the bowel. E coli are 80% responsible for causing UTI’s. There are many other bacteria along with fungi and parasites which also cause UTI’s but occurrence from these are much less frequent.  The bacteria from your stool gets inside the urethra, travels up to the bladder and causes infection. Bladder infections are also known as cystitis.
2. Sexually transmitted diseases can cause infection of the urethra but generally not of the bladder.
3. Lack of estrogen in menopausal women. Levels of estrogen which helps prevent recurrent UTI’s as well as levels of “good bacteria” found in the vagina which prevents the growth of bad bacteria, drop during and after menopause.
4. Catheters- Prolonged use of catheters are a common source of bacterial infections.
5. Sex may move bacteria into the urinary tract especially in women.
6.  Bacteria in the blood or lymph system can cause bladder and kidney infections.
7.  Kidney stones and enlarged prostrate can cause UTI’s in men.
8.  Birth control spermicidal foams and diaphragms.
9.  Diabetes or suppressed immune systems.

Who is affected by UTI’S?

Men, women, children, the elderly and even infants can be affected by UTI’s.

Women are at much higher risk than men for contracting a UTI.  UTI’s are most common in young to middle aged women because:-

1. The rectum is closer to the urethra in women than in men and so bacteria from the stool can easily be introduced.
2. The urethra is shorter in women and this allows bacteria to reach the bladder more easily.
3. Sex can push bacteria into the urethra.
4. The fluid produced by a man’s prostate gland helps to kill bacteria in his urinary tract.

Symptoms and Diagnosis of a UTI 

1. Pain whilst urinating and a strong urge to urinate whilst only passing small amounts.                                                                                 
2. Cloudy, bad or strong smelling urine or blood in urine.
3. Pelvic and abdominal pain in women and rectal pain in men.

Kidney infection symptoms include fever, chills and shaking, pain in the back and side, nausea and vomiting.

Many people go undiagnosed as UTI’s don’t necessarily cause symptoms. Go immediately to your doctor if you have any symptoms of a UTI.

 A urine specimen will be sent to the lab to see if there is any pus, red blood cells or bacteria present. This is usually the first course of action.

 A urine culture is sometimes done to determine what kind of bacteria is causing the infection. The lab uses the urine sample to grow bacteria to see which medications are best for treatment.

A cystoscopy may be called for if recurrent infections occur. This is a thin tube with a scope and is placed into the urethra in order to see into the bladder.

A CT scan may be done if an abnormality of the urinary tract is suspected.

Another test involves a dye being injected into the vein in your arm. X-rays are then taken of the urinary tract. The dye highlights the bladder so abnormalities can be detected.

Treatment of a UTI

•  Antibiotics are the most common method of treatment. Type and duration will depend on the type and severity of infection. Usually the infection clears in a few days but it is vitally important to complete the entire course of antibiotics.
• For menopausal women, a vaginal estrogen cream maybe prescribed.
• Pain killers.
• Sometimes a single dose antibiotic/antimicrobial pill is recommended to be taken immediately after intercourse.
• Drink lots of fluid to flush the kidneys.

Prevention of UTI’s

• Drink lots of water and cranberry juice. Cranberry is thought to line the walls of the bladder to prevent harmful bacteria growth. Drinking water dilutes the urine so that you will urinate more frequently thus flushing the bacteria.
• Urinate as soon as you feel the urge.
• Probiotics are thought to be helpful in promoting the formation of good bacteria.
• 1000mg a day of a cranberry supplement.
• Wipe from front to back after both urination and a bowel movement. This will help prevent the bacteria from the rectum being introduced into the urethra and into the vagina.
• A recent study has shown that the introduction of a probiotic vaginal suppository “Lactin-V” from “Osel Inc” has proved beneficial in decreasing recurrent UTI’s by 50%. Phase 1 of the study showed minimal side effects.
• Avoid the use of feminine products such as douches and deodorants. This can upset the pH balance and cause irritation.
• Vitamin C may increase the acidity in the urine making it more difficult for bacteria to thrive. Take up to 1000mg per day.
• Urinating as well as washing prior to sex and immediately afterwards may decrease the risk of UTI’s. Your partner should also practice good personal hygiene. Women who's partners are circumcised seem to suffer less from UTI's.
• Wear panties with a cotton crotch to allow skin to breathe and moisture to escape. Avoid thongs.

Tips for collecting a mid stream urine sample

  Often you are requested to produce a urine sample and are   not given specific instructions. Poor specimens can alter test results.                                                     

1.   Wash your hands well. Write your name on container if it is not pre labeled. Open the container and place the lid down with the inner surface facing up.

2.   Wipe the entire vaginal/rectum area well with medicated wipes. These should be provided in your doctor’s bathroom. Wipe from front to back.

3.   Hold the vagina apart and begin to urinate. After a few seconds, place the container in the stream without stopping the flow. Do not allow the container to touch the genitals. Collect about 60 ml or 2 fl oz. Finish urinating into the toilet. This is a mid stream sample and most accurate for testing.

4.   Don’t get toilet paper, menstrual blood or feces into the sample. If you are menstruating, make sure you let the physician know as this will affect your test results.

5.   Replace the lid and hand sample to the nurse.

                              Stay healthy, happy and safe.

Consult with your physician before taking any medications including supplements/vitamins and do not self diagnose.

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