Urinary Tract Infection - Causes, Symptoms And Home Remedies For It's Treatment

A bacterial urinary tract infection (UTI) is the most common kind of infection affecting the urinary tract. Urine, or pee, is the fluid that is filtered out of the bloodstream by the kidneys. Urine contains salts and waste products, but it doesn't normally contain bacteria. When bacteria get into the bladder or kidney and multiply in the urine, a UTI can result.

The two forms of lower urinary tract infection (UTI) are cystitis (infection of the bladder) and urethritis (infection of the urethra). They're nearly 10 times more common in females than in males (except in elderly males) and affect 10% to 20% of all females at least once.

In males, lower UTIs typically are associated with anatomic or physiologic abnormalities and, therefore, need close evaluation. Most UTIs respond readily to treatment but recurrence and resistant bacterial flare-up during therapy are possible.

What causes Urinary incontinence?

Most lower UTIs result from ascending infection by a single gram negative, enteric bacterium, such as Escherichia coli, Klebsiella, Proteus, Enterobacter, Pseudomonas, and Serratia. In a patient with neurogenic bladder, with an indwelling urinary' catheter or a fistula between the intestine and bladder, a lower UTI may result from simultaneous infection with multiple pathogens.

Studies suggest that infection results from a breakdown in local defense mechanisms in the bladder that allows bacteria to invade the bladder mucosa and multiply. These bacteria can't be readily eliminated by normal urination.

Bacterial flare-up during treatment is usually caused by the pathogen's resistance to the prescribed antimicrobial therapy. Even a small number of bacteria (fewer than 10,000/ml) in a midstream urine specimen obtained during treatment casts doubt on the effectiveness of treatment.

In almost all patients, recurrent lower UTIs result from re infection by the same organism or by some new pathogen. In the remaining patients, recurrence reflects persistent infection, usually from renal calculi, chronic bacterial prostatitis, or a structural anomaly that's a source of infection. The high incidence of lower UTI among females probably occurs because natural anatomic features facilitate infection.

If untreated, chronic UTI can seriously damage the urinary tract lining. Infection of adjacent organs and structures (for example, pyelonephritis) may also occur. In this instance, prognosis is poor unless the patient responds to systemic treatment with multiple I. V. antibiotics.

Signs and symptoms of Urinary incontinence

The patient may complain of urinary urgency and frequency, dysooa, bladder cramps or spasms, itching, a feeling of warmth during urination, nocturia, and urethral discharge (in men). Other complaints include low back pain, malaise, nausea, vomiting, pain or tenderness over the bladder, chills, and flank pain. Inflammation of the bladder wall also causes hematuria and fever.

Diagnosis information

Tests used to diagnose lower UTI include:

• Microscopic urinalysis showing red blood cell and white blood cell counts greater than 10 per high-power field suggests lower UTI.
• Clean-catch urinalysis revealing a bacterial count of more than 100,000/ml confirms UTI. Lower counts don't necessarily rule out infection, especially if the patient is urinating frequently, because bacteria require 30 to 45 minutes to reproduce in urine. Clean-catch collection is preferred to catheterization, which can reinfect the bladder with urethral bacteria.
• Sensitivity testing determines the appropriate antimicrobial drug. If the patient history and physical examination warrant, a blood test or a stained smear of urethral discharge can rule out venereal disease.
• Voiding cystoureterography or excretory urography may detect congenital anomalies that predispose the patient to recurrent UTI.

Treatment of Urinary incontinence

Appropriate antimicrobials are the treatment of choice for most initial lower UTIs. A 7- to 10-day course of antibiotics is standard, but studies suggest that a single dose or a 3- to 5 day regimen may be sufficient to render the urine sterile. (Elderly patients may still need 7 to 10 days of antibiotics to fully benefit from treatment.) If a culture shows that urine still isn't sterile after 3 days of antibiotic therapy, bacterial resistance probably has occurred, and a different antibiotic will be prescribed.

A single dose of amoxicillin or cotrimoxazole may be effective for females with acute, uncomplicated UTI. A urine culture taken 1 to 2 weeks later will indicate whether the infection has been eradicated. Recurrent infections from infected renal calculi, chronic prostatitis, or structural abnormalities may necessitate surgery. Prostatitis also requires long-term antibiotic therapy. In patients without these predisposing conditions, long term,low-dose antibiotic therapy is the treatment of choice.

Special considerations and Prevention

• If ordered, administer nitrofurantoin macro crystals with milk or meals to prevent GI distress.
• If sitz baths don't relieve perineal discomfort, apply warm compresses sparingly to the perineum but be careful not to burn the patient. Apply topical antiseptics on the urethral meatus as necessary.
• Collect all urine specimens for culture and sensitivity testing carefully and promptly.
• Monitor the patient for GI disturbances from anti microbial therapy and for other possible adverse reactions.
• Both girls and guys can do to prevent UTIs is to go to the bathroom frequently. Avoid holding urine for long periods of time.
• Assess the patient for complications of UTI.
• Evaluate the patient's voiding pattern and monitor urine output (volume and characteristics).
• Drinking lots of water each day keeps the bladder active and bacteria free.
• Explain the nature and purpose of anti microbial therapy. Emphasize the importance of completing the prescribed course of therapy or, with long-term prophylaxis, of strictly adhering to the ordered dosage.
• Males and females should also keep the genital area clean and dry. Girls should change their tampons and pads regularly during their periods.
• Familiarize the patient with prescribed medications and their possible adverse effects. If antibiotics cause GI distress, explain that taking nitrofurantoin macro crystals with milk or a meal can help prevent such problems. If therapy includes phenazopyridine. warn the patient that this drug turns urine red-orange.
• Explain that an uncontaminated midstream urine specimen is essential for accurate diagnosis. Before collection, teach the female patient to clean the perineum properly and to keep the labia separated during urination.
• Suggest warm sitz baths for relief of perineal discomfort.
• Use enough lubrication during sex. Try using a small amount of lubricant (such as K-Y Jelly) before sex if you're a little dry.