Not again I thought as I went to the toilet for the third time in an hour, the dreaded curse of yet another urinary tract infection (UTI), but I am not alone. Urinary tract infections are the most common type of bacterial infection, with women more likely to be affected, and indeed 1 out of 2 women will have at least 1 episode during their lifetime. Men and children very rarely get a UTI but when they do the symptoms and consequences can be very serious. Pregnant women are at an increased risk and they must be monitored closely for symptoms as infection can have serious implications for both the mother through premature labour and her newborn through a low birth weight.
So what causes a UTI and why are they so common? Basically a UTI is an infection of the urinary system, which comprises the kidneys, ureters, bladder and urethra. Bacteria including E.coli, Staphylococcus and Chlamydia are responsible for the majority of UTIs. Considering E.coli, it normally resides in the gut and causes no problems there as it is an essential component of gut flora, but when it is displaced to the urinary tract it multiplies rapidly and causes infection. There are several factors which put individuals at an increased risk of getting a UTI such as the presence of kidney stones as these block the urinary tract and therefore increase the quantity of toxins and bacteria which cannot be eradicated. Immunocompromised individuals are more prone due to a virus, diabetes, cancer or any drug which directly interferes with their immune system. Sexual activity in females also increases their chances of being inflicted, as does an enlarged prostate in males.
How do you know you have a UTI? Most people get specific symptoms, although these symptoms do differ slightly depending on whether the bacteria affect the lower or upper part of your urinary tract. You may suspect you are suffering from a lower UTI if you experience any of the following unpleasant symptoms; a burning sensation when you urinate, feeling as if you constantly have to go to the toilet and yet when you get there not being able to produce that much urine, a dull ache in your lower abdomen and perhaps a slightly raised temperature. The symptoms of upper tract UTI's are much more serious and sufferers may have a very high temperature accompanied by vomiting, back pain and chills.
When you experience any of these symptoms you should visit your clinician. Visual inspection of your urine will reveal it to be cloudy and perhaps foul smelling. A midstream urine sample should be collected and sent to the microbiology laboratory for proper classification of the causative organism. On identification of the organism antibiotic sensitivity assays should be performed in order to deduce the most suitable antibiotic to kill the bacterium. There is no point in giving someone an antibiotic that their infection is resistant too.
Treatment is based on 2 things firstly taking the appropriate antibiotic and completing the full course, and secondly taking measures to reduce further UTIs. Common antibiotics used are amoxicillin and nitrofuratoin. If symptoms persist another course may be needed. It is virtually impossible to prevent a UTI but there are several things that can be done to prevent or reduce further infection such as drinking at least 2L of water per day to flush out toxins and bacteria, and emptying your bladder fully and when you need to rather than holding it in until a more convenient time. It is also recommended that you wash your genitals regularly including before and after sexual activity. UTI's must be treated as those left untreated can cause serious kidney damage as well as blood poisoning.
