Urinary tract infection (UTI)

Urinary tract infection (UTI) is the name given to an
infection of any part of the urinary system.

DESCRIPTION

The urinary system is made up of the kidneys, the ureters (the
tubes that carry urine from the kidneys to the bladder), the
bladder, and the urethra (the tube that passes from the bladder
through the penis in men or the vulva in women – which is located
between the vaginal opening and the clitoris) through which we
urinate.

 

A UTI develops when part of the urinary system becomes
infected, usually by bacteria. The normal urinary tract is sterile
(germ free), but can become infected when bacteria enters the
urinary system through the urethra, or more rarely, though the
bloodstream.

 

There are two types of UTI:

1. Lower UTI: this is an infection of the lower part of the
   urinary tract. Examples of lower UTIs include; cystitis which is an
   infection of the bladder, and urethritis which is an infection of
   the urethra.
2. Upper UTI: this is an infection of the upper part of the
   urinary tract that includes the kidneys and the ureters. Upper UTIs
   can result in kidney damage and, for this reason, are potentially
   more serious than lower UTIs.

CAUSE

In the majority of cases UTI is caused by Escherichia coli (E
coli) bacteria that normally lives in the bowel (colon) and around
the anus. The two most common causes of this bacteria moving to the
opening of the urethra are poor toilet hygiene and sexual
intercourse. Usually, urinating flushes the bacteria out of the
urethra. If there are too many bacteria, urinating may not stop the
spread.

 

The bacteria can travel up the urethra to the bladder, causing
an infection. The infection can spread further as the bacteria move
up from the bladder via the ureters. If the bacteria reach the
kidneys a kidney infection (pyelonephritis), may develop which can
become a very serious condition if not treated promptly.

RISK FACTORS

There are a number of factors that increase the risk of UTI.
These include;

• Conditions that block (obstruct) the urinary tract, such as
  kidney stones.
• Medical conditions that cause incomplete bladder emptying (for
  example, spinal cord injury or bladder decompensation after
  menopause).
• Suppressed immune systems e.g in cases of AIDS and diabetes.
  People who take immunosuppressant medications also are at increased
  risk.
• Women who are sexually active. Sexual intercourse can introduce
  larger numbers of bacteria into the bladder. Infection is more
  likely in women who have frequent intercourse. Urinating after
  intercourse seems to decrease the likelihood of developing a
  urinary tract infection.
• Women who use a diaphragm for birth control.
• Prostatitis or obstruction of the urethra by an enlarged
  prostate can lead to incomplete bladder emptying, thus increasing
  the risk of infection. This is most common in older men.
• Infants born with abnormalities of the urinary tract which
  sometimes need to be corrected with surgery.
• Uncircumcised males. This risk is still relatively low, but it
  is higher than in circumcised males.
• Women are more likely to develop UTIs because the female
  urethra is shorter allowing bacteria quick access to the
  bladder.

SIGNS AND SYMPTOMS

The symptoms of a lower urinary tract infection can
include:

• pain, or a burning sensation during urination (dysuria),
• a strong, persistent urge to urinate
• feeling that you are unable to urinate fully,
• blood in the urine or cloudy, strong-smelling urine
• pain in your lower abdomen, and
• mild fever

 

The symptoms of an upper urinary tract infection can
include:

• any of the symptoms of a lower urinary tract infection,
• a high fever
• nausea or vomiting,
• shaking or chills, and
• pain in your lower back or side which is usually only on one
  side.

 

Always consult your Doctor for the diagnosis and treatment of
UTI. It is important that patients suffering UTI seek medical
attention, as untreated UTI can cause permanent damage. The
diagnosis of UTI usually involves the patient providing a urine
sample, which will be analysed in a laboratory to determine the
type of organism (e.g. bacteria) that is causing the infection.
Your Doctor will give you instructions on how to collect this
sample. Your Doctor may prescribe a course of oral antibiotic
medications to treat the infection. More severe upper UTI
infections may require intravenous antibiotics. Your Doctor may
also recommend steps you can take to reduce your risks of
contracting another infection.

 

A pregnant woman who develops a UTI should be treated promptly
to avoid premature delivery of her baby and other risks such as
high blood pressure. Some antibiotics are not safe to take during
pregnancy. Your Doctor will recommend the most suitable type.

DIET HINTS

• Drink plenty of water.
• Avoid coffee, alcohol, and spicy foods, all of which can
  irritate the bladder.

• Garlic is a natural antibiotic, which can improve immune
  function.
• Vitamin C can enhance immune function. It may inhibit the
  growth of some bacteria in the urinary tract.
• Acidophilus is needed to restore ‘friendly’ bacteria,
  especially if antibiotics have been taken Research is currently
  evaluating the potential role of probiotics such as acidophilus in
  the prevention of recurrent UTIs.
• Cranberry is the herb of choice for bladder infections.
  Components in cranberry juice prevent bacteria from adhering to the
  lining of the bladder. If pure cranberry juice is unavailable,
  cranberry capsules may be substituted.
• Marshmallow root may help inhibit bacterial growth by
  increasing the acidity of urine.
• Horsetail herb has a diurecic action and has a long history for
  use in urinary tract infections.

ORGANISATIONS & SUPPORT GROUPS

See the Australian Kidney Foundation topic on the
Healthpoint.

PHARMACIST’S ADVICE

Ask your Pharmacist for advice.

1. After going to the toilet, wipe from the vagina towards the
   anus (front to back) to avoid spreading bacteria.
2. Avoid using strong or highly perfumed soaps, talcum powder or
   deodorants in the vaginal and anal areas.
3. Drink plenty of water (2 litres a day) to dilute the urine
4. Urinate when the need is there and do not put it off.
5. During your period, change tampons and pads regularly.
6. Ask your Pharmacist for a urinary tract alkalising powder which
   will help to make the urine more alkaline. Dissolve a sachet of the
   powder in a glass of water and drink a glass several times a day.
   This will decrease the burning sensation.
7. Quit smoking. Smoking irritates the bladder and increases the
   risk of bladder cancer. 
8. Wear cool cotton underwear, rather than a synthetic material to
   help with ventilation. Avoid wearing pantyhose and tight jeans. Do
   not sit in cold or draughty areas, particularly when you are wet
   e.g. after swimming.
9. If the diet is inadequate consider some supplements. Ask your
   Pharmacist for advice.