Predisposing Factors For Recurrent Uti
Risk factors for recurrent UTIs in younger women include:
- Sexual intercourse
- Which makes it easier for bacteria to enter the urinary tract
Risk factors for recurrent UTIs in postmenopausal women include:
- Post menopausal changes in the vaginal tissues which make:
- Vaginal and urethral tissues thinner and more fragile
Risk factors for recurrent UTIs in men include:
- Blockage in the urinary tract e.g.:
- Due to benign enlargement of the prostate gland
Chronic Urinary Tract Conditions: Different Names For The Same Family Of Problems
|Hypersensitive Bladder Syndrome
|An umbrella term used in East Asia to cover conditions resulting in symptoms including, bladder pain, discomfort, pressure or other unpleasant sensation, and is associated with disorders such as a frequent need to urinate day and nightand/or an urgent need to urinate. It encompasses Bladder Pain Syndrome. International Painful Bladder Foundation|
If you do a little research, you will quickly find there are also sub-categories within these conditions, with varying symptoms and levels of injury to the urinary tract.
It is not our intention here to imply these chronic urinary tract conditions are the same, or that they affect people in the same ways. But they do have an important thing in common in the majority of cases, no cause has been identified, and the condition is therefore not curable. Treatment focuses on reducing symptoms rather than resolving the underlying issue.
|After about 3.5 years of chronic urinary tract infections, two doctors said they couldnt help me further. A third said maybe you just have irritable bladder or IC. That maybe didnt feel like a diagnosis. Why did my test results tell them nothing?|
So why do we mention these chronic urinary tract conditions?
Let us explain
Can Lower Back Pain Cause Blood In Urine
Blood in the urine that accompanies severe lower back pain may indicate endometriosis, a common health condition that occurs in more than 11% of adolescent and adult females in the United States. Endometriosis occurs when tissue similar to the endometrium the lining of the uterus grows in areas of the body outside of the uterus.
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What Are The Symptoms Of A Urinary Tract Infection
These are the most common symptoms of a UTI:
- Frequent urination
- Pain or burning when passing urine
- Urine looks dark, cloudy, or reddish in color
- Urine smells bad
- Feeling pain even when not urinating
- Pain in the back or side, below the ribs
- Nausea and/or vomiting
- Despite an strong urge to urinate, only a small amount of urine is passed
- Women may feel an uncomfortable pressure above the pubic bone
The symptoms of UTI may look like other conditions or medical problems. Always see a health care provider for a diagnosis.
Reframing A Diagnosis Of Interstitial Cystitis
We shouldnt think of IC as a specific condition, after all, those who have been diagnosed with it experience a vast range of different symptoms. And a cause for the onset of those symptoms has not been identified.
Instead, we should think of the term as a placeholder, while we wait for a specific cause to be identified.
A diagnosis of exclusion leaves a lot of room for misdiagnosis. Some researchers now believe the insensitivity of standard testing methods may have led to large numbers of unnecessary diagnoses of IC.
|“…if the test is negative, the sensitivity is such that there is no justification for claiming you do not have an infection… if the culture is negative it is again wrong to claim this proves an absence of infection the culture is too insensitive. For these reasons, negative tests are unhelpful and a cause of terrible suffering.”|
And this isnt just theoretical. Hundreds of females previously diagnosed with Interstitial Cystitis that is, the absence of infection have been able to receive better testing that has identified an infection.
With an infection identified these individuals have gained long term treatment that relieves their painful symptoms and has often led to complete resolution of the issue.
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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
Its 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.
A Pharmacist Can Help With Utis
You can ask a pharmacist about treatments for a UTI.
A pharmacist can:
- offer advice on things that can help you get better
- suggest the best painkiller to take
- tell you if you need to see a GP about your symptoms
Some pharmacies offer a UTI management service. They may be able to give antibiotics if they’re needed.
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What Are The Types Of Utis
Common types of UTIs include:
- cystitis: this bladder infection is the most common type of UTI. It happens when bacteria move up the urethra and into the bladder.
- urethritis: when bacteria infect the urethra
- pyelonephritis: a kidney infection caused by infected urine flowing backward from the bladder into the kidneys or an infection in the bloodstream reaching the kidneys
Latin America: Progress Towards Regional Guidelines
Close to one-tenth of the worlds population lives in Latin America. Theunique ethnic makeup of patients, alongside local variation in the availabilityof medicines, antibiotic resistance, and health care practices necessitates thecreation of regional guidelines on the treatment of UTI. Prescription ofantibiotics for recurrent UTI without consideration of preventive measures iscommon in many Latin American countries. In a global survey of E.coli susceptibility in 10 countries, the mean sensitivity totrimethoprim/sulfamethoxazole was 71.2% in the sole representative LatinAmerican country, Brazil, it was 54.4%.46
The current Brazilian guidelines were based on systematic review and expertopinion, organized by the Urogynecology Committee of the Brazilian Federation ofGynecology and Obstetrics Associations . Thecommittee included papers that cover genital prolapse, stress urinaryincontinence, overactive bladder, mixed urinary incontinence, painful bladdersyndrome, and recurrent UTI. Guideline sections covering genital prolapse andstress urinary incontinence have been published in the Brazilian Journal ofGynecology and Obstetrics.47,48 The guidelines forrecurrent UTI have yet to be published in a peer-reviewed journal, but areavailable online as a guide for members of FEBRASGO they recommend behavioralmodification, followed by immunomodulatory prophylaxis ,and, finally, by either continuous or postcoital antimicrobial prophylaxis.
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Pathogenesis And Risk Factors
Multiple potential mechanisms unique to diabetes may contribute to the increased risk of UTI in diabetic patients.38 Higher glucose concentrations in urine may promote the growth of pathogenic bacteria.8,39 However, several studies did not find an association between HbA1c level, which serves as a proxy for glycosuria, and risk of UTI among diabetic patients also, sodium glucose cotransporter 2 inhibitors, which increase glycosuria, were not found to increase the rate of UTI.3,40 High renal parenchymal glucose levels create a favorable environment for the growth and multiplication of microorganisms, which might be one of the precipitating factors of pyelonephritis and renal complications such as emphysematous pyelonephritis.30,41 Various impairments in the immune system, including humoral, cellular, and innate immunity may contribute in the pathogenesis of UTI in diabetic patients.5,6,42 Lower urinary interleukin-6 and -8 levels were found in patients with diabetes with ASB, compared to those without diabetes with ASB.41 Autonomic neuropathy involving the genitourinary tract results in dysfunctional voiding and urinary retention, decreasing physical bacterial clearance through micturition, thereby facilitating bacterial growth.9,10,43 Bladder dysfunction occurs in 26%85% of diabetic women, depending on age extent of neuropathy and duration of diabetic disease,44 and thus should be considered in all diabetic patients with UTI.
Eating Diet & Nutrition
Experts dont think eating, diet, and nutrition play a role in preventing or treating bladder infections. If you have any type of UTI, talk with a health care professional about how much to drink each day to help prevent or relieve your infection.
The National Institute of Diabetes and Digestive and Kidney Diseases and other components of the National Institutes of Health conduct and support research into many diseases and conditions.
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What Can You Do If You Keep Getting Utis
If you keep getting UTIs, you must talk to your doctor. After talking with you, your doctor will either recommend treatments for recurring urinary infections or send you to a special doctor called a urologist. A urologist focuses on diseases and problems of the entire urinary system, so he may be able to better pinpoint what is causing your infections and how to treat and prevent them.In addition to the tips mentioned above, you can also take some other simple steps to help prevent UTIs, such as:
- Drink plenty of water.
Why Utis Keep Coming Back
It is estimated that 50% of women who encounter a UTI go on to experience a recurrence of infection within a year3. Some individuals have multiple UTI episodes throughout their life, and a few suffer from chronic UTIs. Factors that may increase the chance of UTI recurrence include:
- Sexual intercourse
- Certain types of birth control, particularly diaphragms and spermicidal agents
- Inherent predisposition: some women have urinary tracts that are more prone to bacterial invasion
- Anatomical abnormalities or blockages in the urinary tract
- Immune suppression caused by diseases such as diabetes
- Post-menopausal changes in the vaginal lining and in the ability of the bladder to contract
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How Are Chronic Utis Treated
If you have recurrent or chronic UTIs, your doctor may send you to a urologist who specializes in diseases of the urinary system. According to the National Institute of Diabetes and Digestive and Kidney Diseases, some of the ways that recurrent UTIs are evaluated and treated include:
- Testing The doctor will want to take a urine sample to test for bacteria and white blood cells. It may be necessary to do special X-ray studies to see if there is an obstruction or stones in the urinary tract. A urologist may look into your bladder by passing a special scope through the opening into your bladder. This exam is called cystoscopy.
- Antibiotics for Treatment Normally, UTIs responds very well to antibiotics, and you may only need to take medication for a few days. For recurrent UTIs, antibiotics may be needed for 10 days or more.
- Surgery In some cases of prostate disease, stones, or other obstruction of the urinary system, surgery may be done to restore normal flow of urine and help clear up infections.
- Antibiotics for Prevention Some strategies to prevent recurrent UTIs with antibiotics include taking low-dose antibiotics for six months or taking antibiotics after sexual intercourse.
- Frequent Urine Testing Women who have recurrent UTIs may benefit from testing their urine frequently with a dipstick that warns of any bacteria in the urine.
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Urinary Tract Infections In Women
UTIs are common, particularly with increasing age. Women are more likely to get a UTI than men. Nearly 1 in 3 women will have a UTI needing treatment before the age of 24.
In women, the urethra is short and straight, making it easier for germs to travel into the bladder. For some women, UTIs relate to changes in their hormonal levels. Some are more likely to get an infection during certain times in their menstrual cycle, such as just before a period or during pregnancy.
In older women, the tissues of the urethra and bladder become thinner and drier with age as well as after menopause or a hysterectomy. This can be linked to increased UTIs.
During pregnancy, the drainage system from the kidney to the bladder widens so urine does not drain as quickly. This makes it easier to get a UTI. Sometimes germs can move from the bladder to the kidney causing a kidney infection. UTIs during pregnancy can result in increased blood pressure, so it is very important to have them treated as soon as possible.
Women are more at risk of repeated UTIs if they:
- use spermicide jelly or diaphragm for contraception
- have had a new sexual partner in the last year
- had their first UTI at or before 15 years of age
- have a family history of repeated UTIs, particularly their mother
- suffer from constipation
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Uti Tests And Diagnosis
If you suspect that you have a urinary tract infection, go to the doctor. You’ll give a urine sample to test for UTI-causing bacteria.
If you get frequent UTIs and your doctor suspects a problem in your urinary tract, they might take a closer look with an ultrasound, a CT scan, or an MRI scan. They might also use a long, flexible tube called a cystoscope to look inside your urethra and bladder.
Can Urinary Tract Infections Be Prevented Or Avoided
There are many lifestyle choices that can help you prevent UTIs. These are some of the things you can do to protect yourself from them:
- Drink plenty of water to flush out bacteria. For some people, drinking cranberry juice may also help prevent urinary tract infections. However, if youre taking warfarin, check with your doctor before using cranberry juice to prevent urinary tract infections. Your doctor may need to adjust your warfarin dose or you may need to have more frequent blood tests.
- Dont hold your urine. Urinate when you feel like you need to. Some children dont go to the bathroom often enough. If your child does this, teach him or her to go to the bathroom several times each day.
- Wipe from front to back after bowel movements. Teach your child to wipe correctly.
- Urinate after having sex to help wash away bacteria.
- Use enough lubrication during sex. Try using a small amount of lubricant before sex if youre a little dry.
- If you get urinary tract infections often, you may want to avoid using a diaphragm as a birth control method. Ask your doctor about other birth control choices.
- Avoid taking or giving your child bubble baths.
- Wear loose-fitting clothing , and dress your child in loose-fitting clothing.
- If you are uncircumcised, wash the foreskin regularly. If you have an uncircumcised boy, teach him how to wash his foreskin.
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Living With Urinary Tract Infections
If you have 3 or more urinary tract infections each year, your doctor may want you to begin a preventive antibiotic program. A small dose of an antibiotic taken every day helps to reduce the number of infections. If sexual intercourse seems to cause infections for you, your doctor many suggest taking the antibiotic after intercourse.
Is It Possible To Have A Uti Without Any Symptoms
Yes. Symptoms of a UTI can vary, and its not entirely uncommon for someone to experience no symptoms of a urinary tract infection. Its estimated that 1 to 5 percent of younger women experience asymptomatic bacteriuria , which is a UTI without the classic symptoms. While its unclear why the bacteria involved with urinary tract infections sometimes dont cause symptoms for these people, we do know that instances of symptom-free UTIs increase with age. Up to 16 percent of women older than 65 have been found to have ASB, and that number grows to almost 20 percent for women over 80. Other factors that increase your chances of an asymptomatic UTI are:
- Urinary catheter use
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How Is A Uti Diagnosed
To find out whether you have a UTI, your doctor or nurse will test a clean sample of your urine. This means you will first wipe your genital area with a special wipe. Then you will collect your urine in midstream in a cup. Your doctor or nurse may then test your urine for bacteria to see whether you have a UTI, which can take a few days.
If you have had a UTI before, your doctor may order more tests to rule out other problems. These tests may include:
- A cystogram. This is a special type of x-ray of your urinary tract. These x-rays can show any problems, including swelling or kidney stones.
- A cystoscopic exam. The cystoscope is a small tube the doctor puts into the urethra to see inside of the urethra and bladder for any problems.
If You Have Diabetes It Is Twice As Likely You Will Develop A Utiwhy
There are many factors that elevate the risk for UTIs for people with diabetes. Common sense would tell us that higher blood sugars increase the risk for all infections.
Well, believe it or not, the jury is still out on that theory for some odd reason. I could not find any recent research anywhere on this theory or for that matter on urinary tract infections in people with diabetes. My hope is more research will be considered since the complications associated with these infections can be life threatening.
According to a study by Nitzan et al Urinary tract infections in patients with type 2 diabetes mellitus: review of prevalence, diagnosis and management, UTIs are most common and severe with complicated outcomes in people with type 2 diabetes. The study presents the reasons people with diabetes are at a greater risk for urinary tract infections which I will outline here:
Likely Causes of Urinary Tract Infections in People with Diabetes:
- Poor metabolic control
- Use of catheters
Poor metabolic control is not completely understood as a cause of utis yet, so this is a great opportunity for researchers. The extra sugar in the urine builds up, causing the growth of extra bacteria which leads to the infection in the bladder.
We have already discussed a few of these, but lets discuss the ones we havent.
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