URINARY TRACT INFECTION
Urinary Tract Infection or UTI is referred to any infection related to the urinary system starting with the kidneys to the connecting tubes to the bladder and finally the urethra.
Any surrounding structure infection is also called UTI.
Symptoms:
The most common symptom of UTI is burning sensation on urination, however other symptoms could point to UTI as well, like frequent urination and feeling or irritation, feeling “unfinished” after urination, sometimes the urine is dark with odor and even some blood.
Some people describe a strong urge to void and have to “run” to the toilet, others describe cramps in the low abdomen.
All of these symptoms point out to a local urine infection that is affecting only the urinary tract.
If the infection is left unattended and became complicated, more pronounce symptoms may start appearing telling us that the condition is now complicated affecting the whole body.
Those symptoms of complicated UTI are something like fever, flank pain, nausea and vomiting start to appear in addition to decreased appetite.
Elderly people may start getting confused and dehydrated, and may become lethargic.
Middle age women tend to recognize these symptoms easily and routinely call their doctor asking for antibiotic prescription knowing that they have UTI.
In elderly people, the situation is more tricky, usually elderly people suffer from some kind of urinary problems , like leaking urine, prostate problem , difficulty emptying bladder and what we call it a “neurologic bladder”.
In these cases, the symptoms persist while UTI start evolving without the person paying much attention to it.
Few days after, the symptoms start showing up as generalized weakness, low appetite, dehydration and confusion.
Care givers of elderly people are familiar with those symptoms and can spot a UTI fairly easy.
Men with prostate enlargement, whose condition is controlled on medications, may find out one day that their prostate symptoms’ are out of control. Think UTI.
Many times, UTI causes no symptoms. We call it Asymptomatic UTI.
Occurrences :
In early life, boys tend to get more UTI than girls, but as they advance in age females get ten folds more UTI than males.
Factors that increase the risk of acquiring bladder UTIs in young women include sexual activity, use of spermicidal condoms or diaphragm, and genetic factors such as blood type or maternal history of recurrent bladder UTI.
Factors for older women include Uncontrolled Diabetes, incomplete bladder emptying, vaginal changes following menopause, poor hygiene and finally, elderly women who live in Nursing homes or Assisted Living Facilities tend to get more frequent UTI.
Testing for UTI:
Once UTI is suspected, a simple Urine Analysis is usually enough to establish the diagnosis.
Labs are instructed to send the urine for additional test called “Urine Culture” if the initial test indicates infection.
Urine Cultures gives us the type of bacteria that is causing the infection and the effective antibiotics against it, but takes 48 hours to get the result.
Occasionally we may have to do ultrasound or Ct-scan of the abdomen to identify any blockage or kidney stones.
In pregnant women, we routinely screen for UTI even without any symptoms because it is associated with higher risk of miscarriage.
Prevention :
Studies have shown that certain measures can prevent the occurrence of UTI like,
Cranberry Juice, this prevents the bacteria from sticking to the bladder wall and prevent infection.
Antibiotics, in conditions where bacteria colonized the bladder and causes more than 3 infections in a year, we put the patient on a daily one pill of antibiotics to prevent infection.
Using Lubricated condoms and voiding after sexual intercourse shown to prevent UTI.
Women at the age of menopause will benefit from Hormone Replacement Therapy.
Contrary to popular opinion, no evidence exists for the efficacy of douching, wiping from front to back, or wearing cotton fabric underwear; in preventing bladder UTIs.
Treatment:
Treatment of UTI varies depending on the severity of the infection.
A simple infection can be treated with 3 days course antibiotics, but if it recurs again, the treatment can be extended to 5 or 7 days.
In most cases, the problem will be solved with pills, however in case of complication, the patient is needed to be admitted to the hospital and given IV antibiotics.
Pregnant women with asymptomatic UTI are given 7 days of oral antibiotics.
Conclusion:
Urinary Tract Infection or UTI is a very common condition accounts for many doctor office visits and can be complicated.
Early recognition of the symptoms and proper treatment is essential to avoid any complication.
Elderly people are most vulnerable and special attention should be given.
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