What is a urinary tract infection?

Our bodies cope with a lot as it adapts and changes over the course of our lifetimes. As we go through the trials and tribulations of dealing with menstruation, pregnancy and eventual menopause for women, as well as ageing and fatherhood or men, another one of life's maladies you can expect to face are urinary tract infections, or UTIs. 

Urinary tract infections (UTIs) are quite common in adults of all ages. In fact, or women, your odds of getting one are as high as one in two, and unfortunately, you can probably expect to get a few during your lifetime. Men can also get UTIs, but it is less common with the odds dwindling to one in 20 during their lifetime.

Although commonplace in adults, a small percentage of children also get UTIs and these are more likely to be serious — especially in younger children.

As the name suggests, a UTI can present itself anywhere within urinary system which comprises of the kidneys, ureters, bladder and urethra.

Your urinary system is designed so that there is minimal risk of serious infection in the kidneys. This is done by preventing urine from flowing back up into the kidneys from the bladder.

The good news is that while UTIs stay confined to the bladder and urethra, they are easily treatable and not serious or life threatening. It’s when they head towards and make it to the kidneys that a new set of problems must be dealt with.

Types of UTIs

When an infection affects the lower urinary tract (urethra or bladder), it may be called urethritis, or cystitis if it only affects the bladder. When it migrates to and affects the upper urinary tract (ureters or kidneys) it is called ureteritis, or pyelonephritis if it affects just the kidneys.

UTI symptoms

UTI symptoms will differ depending whether it presents in your upper or lower urinary tract. You may have all or only some of these symptoms and you may have both upper and lower UTI symptoms at the same time. The type and severity of UTI symptoms will vary from person to person.

Common UTI symptoms include:

• Burning sensation when passing urine
• Pain in your abdomen, pelvis or back
• General feeling of being unwell
• Passing urine much more frequently than usual
• Feeling an urge to urinate, but being unable to, or only passing a few drops
• Urinary incontinence
• Feeling like the bladder is still full after urination
• Cloudy, bloody or dark, foul smelling urine

A person with an upper urinary tract infection or kidney infection can also experience:

• Chills
• High fever
• Nausea and/or vomiting
• Loin (lower abdominal) pain
• Back pain

UTIs in young children and babies

Although commonplace in adults, a small percentage of children and babies can also get urinary tract infections. You should ensure your child is seen by a doctor as soon as possible as it may indicate a more serious problem. Keep a look out for the following symptoms.

• Irritability
• High fever (38°C or above)
• New ‘wetting’ in a child who has previously been dry
• Feeding problems in babies

Causes of UTIs

The culprit in more than 90% of UTI cases is a type of bacteria called Escherichia coli, (E. coli). These bacteria normally live in the bowel and around the anus. E. coli bacteria are fairly sedate in its natural environment of the bowel. However, the bacteria will thrive when introduced to urine’s acidic state.

Urinary tract infections normally occur when E.coli bacteria get into the urine and begin to grow. The infection usually starts at the opening of the urethra where the urine leaves the body and moves upward into the urinary tract to the bladder. If the infection isn’t treated at this point, it will continue and quickly infect the kidneys.

E. coli bacteria can move quite easily from the area around the anus and the perineum, to the opening of the urethra. The two most common causes of this are improper wiping and sexual intercourse. Women are more prone to UTIs because the urethra in a woman is very close to both the vagina and the anus. This provides the bacteria a quicker pathway to the bladder. 

The normal process of urination flushes the bacteria out through the urethra. However, if the infection has already taken hold and there are too many bacteria, urinating may not stop their spread.

The danger here is the infection spreading further. If it reaches the kidneys, it can cause a kidney infection (pyelonephritis), which can become a very serious and even life-threatening condition if not treated immediately.

Risk factors for developing UTIs

Some people are more at risk of developing UTIs than others including:

• Sexually active women — partly because the female urethra is shorter and therefore easier for bacteria to reach the bladder
• People with urinary catheters — particularly those too ill and those who can’t empty their own bladder
• Diabetics — changes to the immune system make a person with diabetes more vulnerable to infection. Also, a higher sugar level in the urine makes it easier for bacteria to grow
• Men with enlarged prostates — this can cause the bladder to only partially empty
• Babies — especially those born with congenital abnormalities of the urinary system

Additionally, other factors that increase the likelihood of UTIs include:

• Being pregnant
• Having tumours or stones in the urinary tract
• Using a diaphragm as contraception
• Having a medical condition involving the bladder or kidneys
• Anything that obstructs the flow of urine out of the bladder
• A previous UTI

Diagnosing and treating UTI

Whether your symptoms indicate an upper or lower urinary tract infection, you should seek the advice of your doctor as soon as possible. Your doctor may diagnose a UTI based purely on the symptoms, or they might confirm the symptoms with some tests to determine which course of treatment is the most suitable.

UTI prevention

Some helpful some tips for preventing UTIs.

• Drink lots of water.
• Urinate as soon as you feel the need.
• Choose showers over baths.
• Wipe your bottom from front to back to prevent bacteria from around the anus entering the urethra.
• Make sure you have adequate lubrication during sex
• Cleanse your genital area before and after sex.
• Urinate after sex to flush away any bacteria that may have entered your urethra.
• Avoid using feminine hygiene products such as sprays or douches.
• Cranberry juice is said to be a natural urinary antiseptic. 
• Wear cotton underwear and loose-fitting clothes. 

UTI prognosis

If you have a lower urinary tract infection, antibiotic treatment usually clears up the infection. If you leave it too long and the infection spreads to the upper urinary tract, other more serious problems can present themselves including: permanent scarring of the urinary tract (which could lead to further problems), pyelonephritis (kidney infection) and beyond that, infections of the blood.

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