Causes Of Upper Urinary Tract Infection
The kidneys and the ureters make up the upper urinary tract, but an infection of the upper urinary tract mostly affects the kidneys. Pyelonephritis, kidney infection, may affect only one or both kidneys. Usually, viruses or bacteria, mostly E.Coli, reach the kidneys by ascending the urinary system through the urethra, but in some cases, they might be transported to the kidneys via the bloodstream.7
What Is The Prognosis For A Person With A Urinary Tract Infection
Urinary tract infections typically respond very well to treatment. A UTI can be uncomfortable before you start treatment, but once your healthcare provider identifies the type of bacteria and prescribes the right antibiotic medication, your symptoms should improve quickly. Its important to keep taking your medication for the entire amount of time your healthcare provider prescribed. If you have frequent UTIs or if your symptoms arent improving, your provider may test to see if its an antibiotic-resistant infection. These are more complicated infections to treat and may require intravenous antibiotics or alternative treatments.
Who Gets Urinary Tract Infections
Anyone can get a urinary tract infection, but they are more common in women. This is because the urethra in females is shorter and closer to the anus, where E. coli bacteria are common. Older adults also are at higher risk for developing cystitis. This increased risk may be due to incomplete emptying of the bladder. There are several medical conditions that can be related to this, including an enlarged prostate or a bladder prolapse .
If you get frequent urinary tract infections, your healthcare provider may do tests to check for other health problems such as diabetes or an abnormal urinary systemthat may be contributing to your infections. People with frequent UTIs are occasionally given low-dose antibiotics for a period of time to prevent the infection from coming back. This cautious approach to treating frequent UTIs is because your body can develop a resistance to the antibiotic and you can get other types of infections, such as C. diff colitis. This practice is used very infrequently.
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Why Are Women And Older Adults More At Risk
E. coli or other bacteria cause UTIs, which are infections in your kidneys, bladder, ureters or urethra. Unfortunately, women are more likely to get them mainly because of their anatomy.
A womans urethra is shorter than a mans and closer to the anus. The urethra is also close to the vagina, which can collect bacteria during sex. So bacteria from both the anus and vagina have easy access to a womans urinary tract.
Post-menopausal women are also at higher risk because pH changes in the vagina make it more susceptible to infection.
Both men and women are more likely to get UTIs as they age. Certain medical conditions, such as bladder prolapse in women and enlarged prostate in men, cause incomplete bladder emptying in older adults. Urine that stays in your bladder too long can encourage bacteria to grow.
Some newer diabetic drugs can also promote sugar in the urine and create conditions ideal for a UTI, Dr. Vasavada adds.
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Dr Viney said: “Where the bleeding is associated with pain the causes are usually infection or stones in the urinary tract.
“More worryingly is when there is blood in the urine with no pain. In this instance we need to rule out a cancer of the bladder, prostate or kidney.
“Individuals on blood thinning treatments are a greater risk of seeing blood in the urine but will still need investigating by your doctor.”
If you haven’t got any other symptoms and its the first time it has happened, get in touch with your GP or call 111.
The Evidence: Diagnosis Management And Prevention
We searched Ovid for English-language human studies conducted among adults aged 65 years and older and published in peer-reviewed journals from 1946 to November 20, 2013. We focused on community-dwelling older adults. Search terms included UTI, asymptomatic bacteriuria, risk factors and UTI, community-onset UTI, functional decline and UTI, delirium and UTI, dehydration and UTI, diagnosis and UTI, diet and drug therapy and UTI, prevention and UTI, and urine tests and UTI. We also searched for recently published Cochrane reviews regarding treatment and prevention of UTI in community-dwelling older adults. The recommendations that follow are based on evaluation of the existing evidence.
Types Of Urine Infections
The major types of UTI include:
Cystitis: This refers to the infection of the bladder caused by a type of bacteria called E. coli , which is most commonly found in the gastrointestinal tract of your body. In some cases, other bacteria can also be responsible for causing cystitis.
Urethritis: This refers to the condition wherein bacteria in the gastrointestinal tract spread to the urethra from the anus.
Pyelonephritis: This refers to a kidney infection, wherein the urinary tract infection generally starts from your bladder but eventually heads upwards to one or both of your kidneys. In some cases, kidney infections can lead to grave health risks, however, early intervention and quick treatment can help you circumvent most complications.
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You Eat A Lot Of Sugar
Bacteria that cause UTIs love feeding on sugar, so you run the risk of providing a feast for them whenever your sweet tooth strikes. Kalas V, et al. Structure-based discovery of glycomimetic FmlH ligands as inhibitors of bacterial adhesion during urinary tract infection. DOI: 10.1073/pnas.1720140115
If you eat tons of added sugars and get a real surge in your blood sugar, you may end up with some of that sugar in your urine, says Mary Jane Minkin, MD, a clinical professor of obstetrics and gynecology at the Yale School of Medicine.
Some foods and beverages, like coffee, booze, and chocolate, can also irritate your delicate urinary tract and exacerbate an existing UTI.
Ongoing Management Of Uti
Dr N: So, shes going to come in next week and give a urine sample. Well see if the E coli has been cleared and then try to figure out what the next step will be.
Urine testing should be in response to symptoms as outlined in the . Repeated urine testing as a test of cure is not warranted among older patients. Among patients with recurrent symptomatic UTI , use of chronic suppressive antibiotics for 6 to 12 months are effective at reducing UTI episodes and should be considered. Nitrofurantoin given at 50 mg daily is used in older patients with minimal adverse effects and no growth of nitrofurantoin-resistant fecal flora after 1 year of treatment. Six months of trimethoprim-sulfamethoxazole , trimethoprim , and nitrofurantoin are also effective, but trimethoprim-sulfamethoxazole resistant E coli fecal isolates were more common in patients treated with trimethoprim-based regimens.
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What Causes Utis In Women
A UTI is caused by bacteria from your skin or rectum entering the urinary tract and causing an infection. Women with typically female genitals are more likely than other people to get UTIs. The urethra is the tube that takes urine out of your body from your bladder. In most women, the urethra is shorter and closer to the rectum. Both of these factors mean that bacteria dont have as far to travel, making it easier for an infection to start. Some women may have different types of genitals. Depending on their anatomy, these women may be more or less likely to get UTIs.
What Causes A Urinary Tract Infection
Accounting for over 8 million doctor visits each year, wake forest urinary tract infections are one of the most common types of infections. Caused by viral, fungal, or bacterial microbes, UTIs affect the kidneys, ureters, bladder, and urethra. Women are more susceptible to UTIs than men and studies show that women have over a 50 percent chance of developing a UTI during their lifetime. Given the prevalence of UTIs, people may be curious about what causes the infections as well as any risk factors to consider.
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Can I Become Immune To The Antibiotics Used To Treat A Uti
Your body can actually get used to the antibiotics typically used to treat a urinary tract infection . This happens in people who have very frequent infections. With each UTI and use of antibiotics to treat it, the infection adapts and becomes harder to fight. This is called an antibiotic-resistant infection. Because of this, your healthcare provider may suggest alternative treatments if you have frequent UTIs. These could include:
- Waiting: Your provider may suggest that you watch your symptoms and wait. During this time, you may be encouraged to drink plenty of fluids in an effort to flush out your system.
- Intravenous treatment: In some very complicated cases, where the UTI is resistant to antibiotics or the infection has moved to your kidneys, you may need to be treated in the hospital. The medicine will be given to you directly in your vein . Once youre home, you will be prescribed antibiotics for a period of time to fully get rid of the infection.
Recurrent Urinary Tract Infection In Pregnancy
UTI is the most frequent medical complication of pregnancy. The risk factors of preterm delivery, low infant birth weight and abortions are most commonly associated with symptomatic and asymptomatic bacteriuria during pregnancy. In pregnancy, factors that contribute to UTI risk are ureteric and renal pelvis dilation increased urinary pH decreased muscle tone of the ureters, and glycosuria, which promotes bacterial growth. Treatment of asymptomatic bacteriuria in pregnancy reduces the risk of pyelonephritis. As RUTIs are common in pregnancy, they need prophylactic treatment if they occur. Screening for bacteriuria is recommended in all pregnant women at their first prenatal visit and then in the third trimester., They should subsequently be treated with antibiotics such as nitrofurantoin, sulfisoxazole or cephalexin.,, Antibiotic prophylaxis for RUTI in pregnant women is effective using continuous or post-coital regimens. The causative organisms of UTI in pregnancy are similar to those found in non-pregnant patients, with E. coli accounting for 8090% of infections., Urinary group B streptococcal infections in pregnant women need to be treated and followed by intrapartum prophylaxis.
Role Of Urinary Testing In Diagnosing Symptomatic Utis In Older Adults
The utility of urinary dipstick testing, urinalysis, and urine culture is challenging in the older adult because of the high prevalence of bacteriuria and pyuria that may not be clinically important. As in the case of Mrs M, all urinary studies to evaluate for leukocyte esterase, nitrites, pyuria, and bacteriuria over a 2-year period were positive.
The urinary dipstick, although easy and convenient, has variable test characteristics. Sensitivity and specificity for urinary dipstick testing to evaluate for leukocyte esterase, nitrites, or both vary in older adults by the age of study participants, clinical suspicion of UTI, and laboratory definition for UTI used . The sensitivity and specificity for a positive dipstick test in older patients with was 82% and 71% , respectively. Other studies of elderly patients showed the negative predictive value for dipstick testing ranges from 92% to 100%., Urinary dipstick analysis should be performed in the out-patient setting primarily to rule out and not to establish a diagnosis of UTI. In a patient with a low pretest probability of UTI, if the dipstick is negative for leukocyte esterase and nitrites, it excludes the presence of infection and mitigates the need to obtain urinalysis and urine culture . High false-positive rates limit dipstick testing effectiveness. Further urinary studies are warranted for patients with a high pretest probability of UTI.
What Is The Urinary Tract
The urinary tract makes and stores urine, one of the body’s liquid waste products. The urinary tract includes the following parts:
- Kidneys: These small organs are located on back of your body, just above the hips. They are the filters of your body removing waste and water from your blood. This waste becomes urine.
- Ureters: The ureters are thin tubes that carry urine from the kidneys to your bladder.
- Bladder: A sac-like container, the bladder stores your urine before it leaves the body.
- Urethra: This tube carries the urine from your bladder to the outside of the body.
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How Are Urinary Tract Infections Diagnosed
Your doctor will use the following tests to diagnose a urinary tract infection:
- Urinalysis: This test will examine the urine for red blood cells, white blood cells and bacteria. The number of white and red blood cells found in your urine can actually indicate an infection.
- Urine culture: A urine culture is used to determine the type of bacteria in your urine. This is an important test because it helps determine the appropriate treatment.
If your infection does not respond to treatment or if you keep getting infections over and over again, your doctor may use the following tests to examine your urinary tract for disease or injury:
- Ultrasound: In this test, sound waves create an image of the internal organs. This test is done on top of your skin, is painless and doesnt typically need any preparation.
- Cystoscopy: This test uses a special instrument fitted with a lens and a light source to see inside the bladder from the urethra.
- CT scan: Another imaging test, a CT scan is a type of X-ray that takes cross sections of the body . This test is much more precise than typical X-rays.
Women Of What Age Are Most Affected By Utis
Once you develop a UTI, treating it does not mean that you can sit back and relax because there are chances of it recurring. About 1 in 4 women develops a recurrence of urinary tract infections.20
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Causes Of A Urinary Tract Infection
Urinary tract infections are incredibly common, especially among women. They are also the second most common infection after the common cold and affect over fifty percent of women during their lives. While these infections don’t always cause symptoms, they can cause pain, burning while peeing, and an urgent need to go to the bathroom. UTIs can also spread from the bladder to the kidneys and even the blood, and lead to serious complications if they are left untreated. Once an individual has had a single UTI, they are more likely to get another. Some women even have chronic urinary tract infections. There are many possible causes of a urinary tract infection, but the following are most common.
Other Causes Of Utis In Women And Men
Being constipated makes you susceptible to UTIs as it prevents your bladder from emptying fully.26
Bacteria from your bowels can easily reach your urethra when you suffer from diarrhea, resulting in UTIs.27
People with diabetes are prone to UTIs because of immune system impairments, improper metabolic control, and incomplete bladder emptying.28
4. Kidney Stones
Kidney stones can obstruct the flow of urine due to which it may be difficult for you to empty your bladder fully.29
People with acquired immunodeficiency disease syndrome/human immunodeficiency virus have a high risk of contracting UTIs because their immune system will not be able to fight infections effectively.30
6. Urological Abnormalities
Urological abnormalities are often associated with UTIs that are complicated.31 Treatment of such patients is individualized to minimize complications and risks of future infections.
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Holding In Your Urine
If you have to go, go! Holding our urine for 6 hours or more may make UTIs more common, as bacteria that does get into the bladder has lots of time to overgrow between voids, Dr. Hawes says. While traveling, for example, it may seem like a good idea to hold tight and keep driving until the next rest area, but do yourself a favor and stopthe extra miles arent worth the risk of a UTI.
Check If It’s A Urinary Tract Infection
Symptoms of a UTI may include:
- pain or a burning sensation when peeing
- needing to pee more often than usual during the night
- pee that looks cloudy
- needing to pee suddenly or more urgently than usual
- needing to pee more often than usual
- lower tummy pain or pain in your back, just under the ribs
- a high temperature, or feeling hot and shivery
- a very low temperature below 36C
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Medications Like Birth Control
Birth control is a common trigger of urinary tract infections, although not all contraceptives cause UTIs. Diaphragms, condoms, intrauterine devices , and medications like birth control may make you more prone to a urinary tract infection. An IUD can increase the risk of a UTI for several reasons. One study found twenty-five percent of IUD users had trigone congestion. The bladder trigone is a region of the bladder that is responsive to the expansion of the bladder as it fills and triggers the brain to know you need to urine. Congestion refers to dilation of the vessels supplying blood to this region. IUDs can also form bacterial biofilms in some cases that may trigger an infection. Oral contraceptives have also been linked to an increased risk of a urinary tract infection, so if individuals have recurring urinary tract infections, switching to a different form of birth control may be recommended.