Urinary Tract Infections (UTI)

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), urinary tract infections (Read about "Urinary System") or UTI's are nothing to be embarrassed about. They are very common. In fact, according to the National Kidney and Urologic Diseases Information Clearinghouse, respiratory infections (Read about "Respiratory System") are the only infections that are more common than UTI's. UTI's send people to the doctor over nine and a half million times a year. Anyone can get them though women are most at risk because of their anatomy. The American College of Obstetricians and Gynecologists (ACOG) says that one in five women will have a UTI sometime in their life; some will have more than one or even get them often.

The urinary system is made up of four parts:

• Kidneys - fist size organs in the middle of the back
• Ureters - drain the urine from the kidneys
• Bladder - a reservoir to hold the urine until it can be expelled
• Urethra - tube from the bladder to the outside

Urine is normally sterile. That means it doesn't contain living organisms such as bacteria, viruses or fungi. (Read about "Microorganisms") Infections occur when something gets into the system and starts to multiply. NIDDK says most infections come from one type of bacteria, Escherichia coli. You've heard of it as E. coli. When it shows up in water supplies and foods it can make people sick (Read about "E. coli"), even kill those with weak immune systems. (Read about "The Immune System") The E. coli that causes UTI's normally lives in the colon. UTI's can also be caused by sexually transmitted diseases such as chlamydia. (Read about "STD's")

Most of the time the infection begins in the urethra. If it stays there, it's called urethritis. If it spreads up to the bladder, it is called cystitis. Cystitis is an inflammation of the bladder. (Read about a type of cystitis not caused by infection in "Interstitial Cystitis")

If the infection continues to spread, it can reach the kidneys and is called pyelonephritis.

Infections in men

In men, the prostate is also considered part of the urinary tract and can be infected.

According to NIDDK, young men and boys seldom get infections. This is mainly due to the longer urethra. Older men tend to get UTI's from obstructions like kidney stones. (Read about "Kidney Stones")

UTI's in men can also develop as a result of prostate problems. If the prostate does get infected, it can be a stubborn infection. Symptoms can include chills, fever, pain in the lower back and genital area, urinary frequency and urgency often at night, burning or painful urination, and body aches. Prostate infections are very serious and can be deadly. (Read about "Prostate Problems & Prostate Cancer")

Infections in women

As mentioned above, UTI's are much more common in women. A woman's chances of getting a UTI also increase as she gets older, with menopause. (Read about "Menopause") The exact reasons women are more susceptible aren't clear. Suspicions, according to NIDDK, include a woman's shorter urethra and the proximity of the urethra to sources of bacteria such as the vagina and the anus.

It seems that if you have an infection once, you are likely to have one again. Here are the numbers for women, according to the National Kidney and Urologic Diseases Information Clearinghouse: One in five will have one infection in their lives; one in five of them will have a second and 30 percent of those will have a third; eighty percent of the women who have had three will have more.

Infections in children

Urinary tract infections (UTI's) affect about 3 percent of children in the United States every year. Throughout childhood, the risk of a UTI is 2 percent for boys and 8 percent for girls. UTI's account for more than 1 million visits to pediatricians' offices every year.

The symptoms are not always obvious to parents, and younger children are usually unable to describe how they feel. Your child may have a high fever, be irritable or stop eating. The child may have a fever, or the diaper urine may have a funny smell or color. An older child with bladder irritation may complain of pain in the abdomen and pelvic area. Crying or complaining that it hurts to urinate and producing only a few drops of urine at a time are other signs of urinary tract infection. Recognizing and treating urinary tract infections is important. Untreated UTI's can lead to serious kidney problems. (Read about "Kidney Disease")

UTI risk factors

Any time the urinary tract isn't running smooth and clear, the chances of an infection increase. A kidney stone (Read about "Kidney Stones") blocking the flow of urine is a prime example. Catheters are a common source of infections. Extra care needs to be taken that they are clean and sterile. People with diabetes may have a higher risk. (Read about "Diabetes") Any disease that lowers the immune system can increase the risk of UTI's. Intercourse can also increase the risk because bacteria can be forced into the urethra.

Bathroom habits may also play a role. Regular urination that completely empties the bladder helps keep the urinary tract sterile by flushing away bacteria. Therefore, those who frequently delay going to the bathroom are more likely to develop UTI's. In some children a urinary tract infection may be a sign of an abnormal urinary tract that may be prone to repeated problems.

Symptoms and tests

Some people can have an infection and not have any symptoms, but most people do have symptoms. The most common, according to ACOG, is pain on urination but there are others:

• frequent urge to urinate
• tiredness
• feeling shaky
• a burning sensation on urination
• urine that is milky, cloudy, bloody or has a foul odor
• pain in the lower front part of the abdomen or in the mid-back

If you have these symptoms, they can also indicate other problems, so you should see a doctor. ACOG says that tests for UTI's take a urine sample and looks for bacteria and pus. You will usually be asked to give a clean urine sample by washing the genital area and collecting a midstream sample of urine in a sterile container. In the urinalysis test, the urine is examined for white and red blood cells and bacteria. The bacteria can also be tested against different antibiotics to see which drug best destroys the bacteria.

If you or your child get repeated infections, the doctor may order some tests to determine if your system is normal. One of these tests is an intravenous pyelogram, which gives x-ray images of the bladder, kidneys, and ureters. (Read about "X-rays") Your doctor also may recommend an ultrasound exam, which gives pictures from the echo patterns of soundwaves bounced back from internal organs. (Read about "Ultrasound Imaging") Another useful test is cystoscopy. (Read about "Endoscopy") A cystoscope is an instrument made of a hollow tube with several lenses and a light source, which allows the doctor to see inside the bladder from the urethra.

Treatments

UTI's are treated with antibiotics. (Read about "Antibiotics") NIDDK says the exact drug used depends on the history of the patient and the bacteria that is present. Over the counter analgesics (pain relievers) may relieve the pain and discomfort, but they do not treat the infection. That's why it is important to speak carefully with your doctor about the treatment method and understand how long you are to take the drug. Stopping too soon can result in re-infection.

Avoiding infections

You can also ask your doctor about ways to avoid infections in the first place. According to the American Academy of Family Physicians, some of the things that might be suggested are:

• Drink plenty of water.
• Don't delay; urinate whenever you have the urge.
• Wipe from front to back. White toilet paper without added fragrances is best.
• Take showers instead of baths
• Avoid sprays and scented douches

Women should also make sure they urinate soon after intercourse. Although there are no guarantees, taking precautions can at least help reduce your risk.

Related Information:

    Genital Health - Male

    Genital Health - Female

    Polycystic Kidney Disease