Tuesday, October 4, 2022

Chronic Urinary Tract Infection Symptoms

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Other Virulence Factors Of Uropathogenic E Coli

Urinary Tract Infections

UPEC strains frequently downregulate responding neutrophil activity, hence evading the dominant acute immune response , providing an important advantage for establishing infection. Additionally, UPEC resists phagocytic killing and dampens proÂduction of antibacterial reactive oxygen species by neutrophils. Downregulation is achieved by reduced expression of polymorphonuclear neutroÂphil genes.

The greater the number of organisms delivered to the kidneys, the higher the chance of producing infection. The kidney itself is not uniformly susceptible to infection because few organisms are necessary to infect the medulla, whereas 10,000 times as many are necessary to infect the cortex. The greater susceptibility of the medulla may be caused by the high concentration of ammonia, which may inactivate complement, and by poor chemotaxis of PMNs into an area of high osmolality, low pH, and low blood flow.

It Seems Like Such A Tiny Thing But Its Made Such A Difference Campaigners Say

NHS Digital updated its website to last week to provide information around chronic bladder infections where previously there was none.

Campaigners say this is a huge step forward but there is still a long way to go in improving testing and treatments for the condition.

Chronic UTI sufferer Leah Herridge has been pushing for the change alongside Chronic Urinary Tract Infection Campaign and Bladder Health UK.

Letters were also sent from members of the Embedded/Chronic UTI Support Group and the organisers of a new charity that is being set up to raise money for better testing and treatment for the disease called Chronic UTI Global Support.

The NHS websites Cystitis page has been updated to include mentions of chronic UTI and to acknowledge that current tests may not pick up these infections.

An i investigation previously revealed that outdated testing methods can lead to up to 50 per cent of infections being missed and some women undergo unnecessary, painful invasive treatments after being misdiagnosed with an incurable condition called interstitial cystitis following referral to a urologist.

Interstitial cystitis or bladder pain syndrome is described by the NHS as a poorly understood condition. There are few treatment options and some experts in the field question whether the condition even exists as often patients are later found to have a chronic infection and see improvement following treatment with antibiotics.

Persistent Uti Vs Recurrent Or Frequent Uti: Whats The Difference

A recurrent urinary tract infection is officially defined as three episodes of a UTI in the previous 12 months or two episodes within the previous 6 months.

At the moment, it is generally accepted that recurrent UTIs occur due to either reinfection or a persistent infection.

Reinfection refers to an infection where the pathogen is eradicated by treatment, then the same or a different pathogen ascends the urinary tract to cause a new infection.
Persistence means the pathogen that caused the UTI is not completely cleared from the bladder by treatment, remains detectable in the urine, and after treatment returns to a level that once again causes symptoms of infection. This cycle of persistence can repeat indefinitely, feeling like a new infection each time. A persistent infection is also called a chronic urinary tract infection.

Evidence suggests that many recurrences of UTI may actually be caused by an underlying bladder infection that came about due to ineffective initial treatment.

Frequent UTIs caused by persistent bladder infection are also referred to as chronic cystitis or chronic urinary tract infection.

Note that while terms used for various urinary tract conditions may sound different, they could refer to the same thing.

When we refer to recurrent UTI in this site, we usually mean persistent infections also called chronic urinary tract infections.

Whatever youre doing to treat each occurrence of UTI is probably not working.

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Seek Medical Attention For Utis

It is important to seek medical attention if you think you may have a UTI particularly if you think you may have a bladder or kidney infection, both of which are very serious conditions. Early treatment of urinary infection can help to prevent infection spreading to the bladder or kidneys.

Your doctor will test your urine to check which micro-organism is present. Urinary tract infections usually respond quickly and well to antibiotics.

Treatment For More Severe Utis

cystitis symptoms

Kids with a more severe infection may need treatment in a hospital so they can get antibiotics by injection or IV .

This might happen if:

  • the child has high fever or looks very ill, or a kidney infection is likely
  • the child is younger than 6 months old
  • bacteria from the infected urinary tract may have spread to the blood
  • the child is dehydrated or is vomiting and cannot take any fluids or medicine by mouth

Kids with VUR will be watched closely by the doctor. VUR might be treated with medicines or, less commonly, surgery. Most kids outgrow mild forms of VUR, but some can develop kidney damage or kidney failure later in life.

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Going Beyond Cranberries To The Gut Microbiota

The suggestion to take cranberry extract to help with chronic urinary tract infections is well known and widely prescribed. Cranberry extract has been shown in many studies to be beneficial. But some women have a greater challenge in managing their urinary disorders, more than cranberry extract may be able to help.

Another February 2021 study made these comments on the role of cranberry extract and the importance of the beneficial bacteria of the gut microbiota.

A recent placebo-controlled clinical trial found a 39% reduction in UTI symptoms among recurrent UTI sufferers who consumed a daily cranberry beverage for 24 weeks. Using metagenomic sequencing of stool from a subset of these trial participants, we assessed the impact of cranberry consumption on the gut microbiota, a reservoir for UTI-causing pathogens such as Escherichia coli, which causes more than 80% of UTIs.

The researchers here are examining what role the cranberries had in altering the beneficial bacteria of the gut microbiota. What they found was that the cranberries, while helping with the UTIs, did not positively impact or significantly change the bacterial composition of the gut microbiota.

How Are Utis Treated

UTIs are treated with antibiotics. After several days of antibiotics, your doctor may repeat the urine tests to be sure that the infection is gone. It’s important to make sure of this because an incompletely treated UTI can come back or spread.

If someone has a lot of pain from a UTI, the doctor may recommend a medicine to help relieve the spasm and pain in the bladder. This will turn pee a bright orange color, but it’s harmless and will usually make a person much more comfortable within hours. In the case of a kidney infection, a doctor may prescribe pain medicine.

If you’ve finished all the medicine or if your symptoms aren’t much better after 2 to 3 days of treatment, contact your doctor.

Drink lots of water during and after treatment because each time you pee, the bladder cleanses itself a little bit more. Cranberry juice may also be helpful. Skip drinks that containe caffeine , such as soda and iced tea.

People who get a doctor’s help for a UTI right away should be clear of symptoms within a week. Someone with a more severe infection may need treatment in a hospital so they can get antibiotics by injection or IV .

A doctor may tell people with UTIs to avoid sex for a week or so, which lets the inflammation clear up completely.

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What Are The Signs & Symptoms Of Utis

UTIs can cause such signs as:

  • pain, burning, or a stinging sensation when peeing
  • an increased urge or more frequent need to pee
  • fever
  • waking up at night a lot to go to the bathroom
  • belly pain in the area of the bladder
  • foul-smelling pee that may look cloudy or contain blood

If you have any symptoms of a UTI, you’ll need to go to a doctor right away. The sooner you begin treatment, the less uncomfortable you’ll be. Call your doctor’s office or clinic. If you can’t reach your doctor, you can visit an urgent care center or hospital emergency room. The most important thing is to take action as soon as possible.

Tests For Uti Are Inaccurate And Based On Science That Is Out Of Date

UTI (urinary tract infection): Symptoms, Treatment & Prevent Recurrent

GPs and urologists rely on dipstick tests and urine cultures to diagnose bacterial infections. Recent studies have found that dipstick tests miss more than half of infections and urine cultures miss two-thirds of infections. A misplaced faith in these tests has led to a massive misunderstanding in mainstream medicine.

When dipstick tests and cultures fail to identify an infection, doctors and urologists can dismiss bacterial infection and look for other causes. Patients can then undergo investigations including ultrasound scans to test the kidneys cystoscopies where a camera is inserted into the bladder and urodynamics testing where the patient is catheterised and their bladder filled with liquid to analyse how they pass urine.

These tests are painful, invasive and give little useful information. After they fail to show a physical cause other than signs of inflammation in the bladder, many people with chronic UTI are told that they have interstitial cystitis , painful bladder syndrome , urethral syndrome or an overactive bladder .

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Cranberry Juice And Tablets

Cranberry juice and tablets have been shown to reduce RUTIs as they contain a compound called tannin, or proanthocyanidin, which reduces E. coli vaginal colonisation., Although earlier, smaller studies have shown that consuming cranberry juice or tablets can prevent RUTIs, an updated Cochrane review showed that evidence for its benefit in preventing UTIs is small therefore, cranberry juice cannot be recommended any longer for UTI prevention.,

Causes Of Chronic Urinary Tract

The following are some of the reasons that cause chronic urinary tract infection.

  • Bacteria from the rectum & vagina any bacteria from the rectum and vagina can infect the urinary tract and cause chronic UTI
  • Bladder or kidney stones are- the bladder & kidney stone can harm your kidneys and may also lead to chronic UTI
  • Genetic predisposition- genetic predisposition can also be the reason for the cause of chronic UTI in you. if any family member is suffering from chronic UTI, you are also at risk of chronic UTI increases
  • Urinary tract problems- If you are suffering from any other urinary tract problems then you are at higher risk of chronic urinary tract infection.

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What Is A Urinary Tract Infection

A urinary tract infection is an infection of the urinary system. This type of infection can involve your urethra , kidneys or bladder, .

Your urine typically doesnt contain bacteria . Urine is a byproduct of our filtration systemthe kidneys. When waste products and excess water is removed from your blood by the kidneys, urine is created. Normally, urine moves through your urinary system without any contamination. However, bacteria can get into the urinary system from outside of the body, causing problems like infection and inflammation. This is a urinary tract infection .

What Are Urinary Tract Infections In Cats

Symptoms Of Urinary Tract Infection

Urinary tract infections are not common in cats. Only 1-3% of cats with signs of urinary tract disease will have a urinary tract infection.

Because they can resemble so many other conditions, UTIs need to be distinguished from other conditions, such as crystals in the urine. Fortunately, by running some simple tests, your veterinarian will be able to tell the difference.

In most cases, UTIs in cats are usually caused by bacteria. Bacterial urinary tract infections in cats are generally relatively easy to treat and respond well to medications. Chronic infections, or those that do not respond to regular medication, can require more testing to figure out why your cat is at higher risk for urinary tract infections.

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And It Won’t Hurt To Try These

Like many women, you may have memorized the following age-old advice for preventing UTIs:

  • Wipe from front to back.

  • Urinate before and after sex.

  • Drink lots of water.

  • Avoid tight underpants and jeans.

These suggestions are directed at flushing the bladder and keeping E. coli from spreading into the urinary tract. Although studies have failed to show that they prevent either primary or recurrent UTIs, there’s no harm in trying them, Dr. Gupta says. “They can’t hurt, and if they help, you’re ahead of the game.”

Can I Prevent A Urinary Tract Infection

You can usually prevent a urinary tract infection with lifestyle changes. These tips can include:

In some post-menopausal women, a healthcare provider may suggest an estrogen-containing vaginal cream. This may reduce the risk of developing a UTI by changing the pH of the vagina. Talk to your healthcare provider if you have recurrent UTIs and have already gone through menopause.

Over-the-counter supplements are also available for UTIs. These are sometimes recommended for people who have frequent UTIs as another way to prevent them. Talk to your healthcare provider before starting any supplements and ask if these could be a good choice for you.

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Does Cranberry Juice Prevent A Urinary Tract Infection

Many people say that cranberry juice can help treat, or even prevent, a UTI. Researchers are currently looking into the topic, but havent found a definitive answer yet. Healthcare providers recommend drinking lots of fluids if you have, or have a history of getting, a UTI. Adding a glass of unsweetened cranberry juice to your diet isnt a proven way to prevent a UTI, but it typically wont hurt you either.

When Urinary Tract Infections Keep Coming Back

Recurrent Uncomplicated Urinary Tract Infections in Women: AUA/ CUA/ SUFU Guideline 2019

Image: Thinkstock

If you are prone to recurrent UTIs, you can head them off before they take hold.

Unless you’re in the fortunate minority of women who have never had a urinary tract infection , you know the symptoms well. You might feel a frequent urgency to urinate yet pass little urine when you go. Your urine might be cloudy, blood-tinged, and strong-smelling. For 25% to 30% of women who’ve had a urinary tract infection, the infection returns within six months.

If you have repeated UTIs, you’ve experienced the toll they take on your life. However, you may take some comfort in knowing that they aren’t likely to be the result of anything you’ve done. “Recurrent UTIs aren’t due to poor hygiene or something else that women have brought on themselves. Some women are just prone to UTIs,” says infectious diseases specialist Dr. Kalpana Gupta, a lecturer in medicine at Harvard Medical School.

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It Is Usually More Than Just Recurrent Urinary Tract Infections

As the research above notes, urinary tract infections can be part of a more complex problem for post-menopausal women than estrogen cream can tackle. A previous paper reported observations to this affect and that topically applied estrogen may help.

Estrogen deficit in postmenopausal women causes urogenital atrophy, which is responsible for a wide range of urinary disorders and genital disorders . The efficacy of estrogen therapy on urinary incontinence is not yet demonstrated, but it is widely recognized that the topical use of estrogens lowers the risk of recurrent urinary infections and improves urogenital atrophy.

Things You Can Do Yourself

To help ease pain:

  • takeparacetamolup to 4 times a day to reduce pain and a high temperature for people with a UTI, paracetamol is usually recommended over NSAIDs such as ibuprofen or aspirin
  • you can give childrenliquid paracetamol
  • rest and drink enough fluids so you pass pale urine regularly during the day, especially during hot weather

It’s important to follow the instructions on the packet so you know how much paracetamol you or your child can take, and how often.

It may also help to avoid having sex until you feel better.

You cannot pass a UTI on to your partner, but sex may be uncomfortable.

Taking cystitis sachets or cranberry products has not been shown to help ease symptoms of UTIs.

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Urinary Tract Infections In Men That Just Dont Go Away

Although painful and distressing most are short-lived. But if you keep on getting a UTI or feel like its never really gone away you could have chronic infection.

Chronic UTI often starts when a simple infection is left untreated or fails to get better with standard treatments. Read about how and why chronic UTI develops.

Needing to pee all the time, pain when you pee, passing tiny amounts of urine, bladder and urethral pain, pain in your belly, back and legs, difficulty passing urine, problems with incontinence. The symptoms of chronic UTI are similar to acute infections but they vary from person to person.

Currently theres just not enough research to understand why some people never experience a UTI, why some people have one or two infections and why some people develop chronic infections.

The symptoms of chronic UTI are, frustratingly, not exclusive to the condition they are common to a number of other lower urinary tract health conditions as well. This can often result in other avenues being explored for diagnosis first by your GP, leading to chronic UTIs being diagnosed by exclusion of other conditions, all the while allowing the UTI to develop further.

Other LUTS conditions that are investigated in men include:

  • detrusor muscle weakness or overactivity
  • prostate inflammation
  • neurological disease

I Feel Like I Have A Uti But My Tests Are Negative

Urinary Tract Infection

Sound familiar? Unfortunately the standard tests used to diagnose UTIs dipstick tests and mid-stream urine cultures miss about half of infections. The figure is likely to be even higher for chronic infections.

But some doctors are more likely to rely on test results than on the symptoms their patients are describing and rule out infection as a cause.

No test is perfect, as they all have different sensitivity levels. A relatively low concentration of bacteria may fall below the sensitivity limit of a given test, but still be concentrated enough to have a profound effect on the patient. As a result, UTIs are best diagnosed with a combination of tests, physical examinations and symptom analysis.

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