Everything you need to know about UTIs

KARACHI: If you’ve ever had a Urinary Tract Infection (UTI), you know how annoying and painful it can be. A UTI is an infection in any part of your urinary system — could be your kidneys (a condition called pyelonephritis), ureters, bladder (a condition called cystitis) and the urethra (a condition called urethritis). Most infections involve the lower urinary tract including the bladder and the urethra.

Urinary tract infections are very common, occurring in 1 out of 5 women at some point in their lives. Though UTIs are common in women, they can also happen to men, older adults and children. 1 to 2% of children develop urinary tract infections. Each year, 8 million to 10 million visits to doctors are for urinary tract infections. And today, we’re sharing with you everything you need to know about UTIs.

What causes a UTI?

Have you ever been through a UTI and wondered what’s causing you this much pain – well, you’re not alone in this! UTIs are typically caused by microorganisms — usually bacteria — that enter the urinary tract through the urethra and to the bladder, causing inflammation and infection. Although the urinary system is designed to keep out such microscopic invaders, these defences can sometimes fail. When that happens, bacteria may take hold and grow into a full-blown infection in the urinary tract causing unavoidable discomfort to the patient.

We spoke to Dr Maryam Shoaib who elaborated on the types of UTI:

Infection in the bladder (cystitis) is a type of UTI is caused by Escherichia coli (E. coli), a type of bacteria commonly found in the gastrointestinal (GI) tract. However, sometimes other species of bacteria can also be responsible.

Sexual intercourse may lead to cystitis, but you don’t have to be sexually active to develop it. All women are at risk of cystitis because of their anatomy — specifically, the short distance from the urethra to the anus and the urethral opening to the bladder.

Infection of the urethra (urethritis) is a type of UTI that can occur when GI bacteria spreads from the anus to the urethra. Also, because the female urethra is close to the genitalia, sexually transmitted infections, such as herpes, gonorrhoea, chlamydia and mycoplasma, can cause urethritis.

Symptoms of a UTI

A urinary tract infection causes the lining of the urinary tract to become inflamed, each type of UTI may result in its specific signs and symptoms, depending on which part of your urinary tract is infected. The following are some tell-tale signs of a UTI explained by Dr Munazza Jilani:

• Pain in the side (flank), abdomen or pelvic area.
• Pressure in the lower pelvis.
• Frequent need to urinate (frequency), urgent need to urinate (urgency) and incontinence (urine leakage)
• Painful urination (dysuria) and blood in the urine.
• Abnormal urine colour (cloudy urine), brown coloured urine and strong or foul-smelling urine.
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Other symptoms that may be associated with a urinary tract infection include: Pain during sex,  pain in the male genitalia, flank (side of the body) pain or lower back pain, fatigue,  fever (temperature above 100 degrees Fahrenheit) and chills,  vomiting, and mental changes or confusion

How do doctors diagnose UTIs?

Apart from the tell-tale symptoms that a patient experiences, Dr Jilani recommends the following tests to confirm the diagnosis:

Urinalysis: This test will examine the urine for red blood cells, white blood cells and bacteria. The number of white and red blood cells found in your urine can actually indicate an infection.

Urine culture: A urine culture is used to determine the type of bacteria in your urine. This is an important test because it helps determine the appropriate treatment.

If your infection does not respond to the treatment or if you keep getting infections over and over again, your doctor may prescribe you an ultrasound, a CT scan or a cystoscopy (this test uses a special instrument fitted with a lens and a light source, cystoscope, to see inside the bladder from the urethra.)

People who are at risk of getting UTIs

• Women who use diaphragms for birth control may be at higher risk, as well as women who use spermicidal agents.
• After menopause, a decline in circulating estrogen causes changes in the urinary tract that make you more vulnerable to infection.
• Babies born with urinary tract abnormalities that don’t allow urine to leave the body normally or cause urine to back up in the urethra have an increased risk of UTIs.
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• Kidney stones or an enlarged prostate can trap urine in the bladder and increase the risk of UTIs.
• Diabetes and other diseases that impair the immune system — the body’s defence against germs — can increase the risk of UTIs.
• People who can’t urinate on their own and use a tube (catheter) to urinate have an increased risk of UTIs. This may include people who are hospitalised, people with neurological problems that make it difficult to control their ability to urinate and people who are paralysed.
• Urinary surgery or an exam of your urinary tract that involves medical instruments can both increase your risk of developing a urinary tract infection.

How to prevent UTIs

You can take the following steps to reduce your risk of getting urinary tract infections. Remember these tips are only for preventing the UTIs and should not be taken as a treatment plan if you’re already infected:

• Drink plenty of liquids, especially water. Drinking water helps dilute your urine and ensures that you’ll urinate more frequently — allowing bacteria to be flushed from your urinary tract before an infection can begin.
• Drink cranberry juice. Although studies are not conclusive that cranberry juice prevents UTIs, it won’t hurt you either and is a good change from when you’re bored of having plain water.
• Wipe from front to back. Doing so after urinating and after a bowel movement helps prevent bacteria in the anal region from spreading to the vagina and urethra.
• Empty your bladder soon after intercourse. Also, drink a full glass of water to help flush out the bacteria.
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• Avoid potentially irritating feminine products such as deodorant spray, douches and powders, in the genital area that may irritate the urethra.
• Change your birth control method. Diaphragms, or unlubricated or spermicide-treated condoms, can all contribute to bacterial growth.
• Avoid tight-fitting clothes to help keep you dry, preventing bacteria from growing in the urinary tract.
• Switch to cotton underwear. This will prevent extra moisture from getting trapped around your urethra.
• In some post-menopausal women, your doctor may suggest an estrogen-containing vaginal cream that reduces the risk of developing a UTI by changing the pH of the vagina.

Dr Shoaib assures us that, “UTIs typically respond very well to treatment. A UTI can be uncomfortable before you start treatment, but once your doctor identifies the type of bacteria and prescribes the right antibiotics, your symptoms should improve. But it is important that you keep taking your medication for the entire course of time that your doctor has prescribed it for otherwise, the infection may come back.” So the next time you get a UTI, keep an eye on what may have caused it and try rectifying your habits to avoid it in future after you’ve consulted your doctor!