Understanding Urinary Tract Infections
“Infections in certain special situations like pregnancy, children below the age of ten, elderly people above the age of sixty-five and complicated infections require special attention”
The Extent Of Urinary Infections
One In every three women get at least one urinary Infection by the age of 24, As women grow older, this ratio gradually increases and 50 per cent of the women get a urinary infection at least once in their lifetime.
These statistics are staggering and reveal the tremendous impact of these infections on health, lifestyle, quality of life and finances. Luckily, men are half as likely to get urinary infections, thanks to their gender. However, 25 per cent of the elderly males over the age of 65 do get urinary infections.
The reasons why women are more susceptible to urinary infections are because of shorter female urinary passage tubes (called urethra) prostatic secretions having anti -bacterial properties and the act of sexual intercourse which makes women more susceptible. Also, ‘honeymoon cystitis’ is a type of urinary infection which affects women on their honeymoon, for obvious reasons.
Types Of Urinary Tract Infections
Urinary tract infections or UTI can be divided into two types: upper urinary tract infections (also called pyelonephritis) and lower urinary tract infections. Upper urinary tract infections involve the kidneys and the ureters (tubes that connect the kidneys to the bladder). Lower urinary tract infections involve the bladder and the urethra (and the prostate in men).
Upper urinary tract infections result from bacteria ascending up from the bladder or urethra or via the bloodstream spread from other organs or tissues. Lower urinary tract infections often result from intestinal bacteria that travel to the lower urinary tract. It is vital to differentiate between these two infections because the outcome, treatment and duration of treatment are very different.
Symptoms Of Both The Infections
Symptoms of upper urinary tract infections are fever, shivering and flank pain. Symptoms of lower urinary tract infections is fever and burning while passing urine. On a lighter note, the late legendary boxer, Muhammad Ah who said, “I float like a butterfly and sting like a bee,” when recently released from the hospital after receiving treatment for urinary tract infection, said, “It really stung like a bee” Other common symptoms include lower abdominal tenderness and frequency of urination. Investigations help to distinguish between the two types of infections. These include routine urine examination, urine culture, blood culture and ultrasound or CT scan of the kidneys and urinary tract.
Treatment Of Urinary Infections
This may be pharmacological (with medications) or non-pharmacological.
Pharmacological treatment includes antibiotics based on the culture report which identifies the bacteria responsible as well as the antibiotics which will be most effective. These antibiotics may be given orally or through injections. Remember, infections can be caused by agents other than bacteria, like fungus, virus and tuberculosis.
Treatment needs to be tailored appropriately. Upper tract infections need treatment for at least two to six weeks. Lower tract infections need treatment for three to seven days in women, while a single dose would suffice for men.
Non-Pharmacological treatment includes neutralising the acidity of urine by anti-acids like citralka. Drinking plenty of water causes increased urinary flow that helps flush out the bacteria.
- Preventive Treatment
For those individuals who frequent get urinary infections, preventive treatment can also be tried. This includes giving low-dose antibiotics (one-fourth the normal treatment dose) for a period of three to six months. For certain infections caused by a bacterium called Escherichia coli (which is responsible for over 80 per cent of urine infections), cranberry juice is helpful in prevention.
The recommended dose is two glasses of cranberry juice daily. If cranberry juice is not permitted for some, like diabetics, cranberry juice extract is available in a tablet form. Each tablet contains 300 mg of cranberry extract and the recommended dose is six tablets daily, taken at intervals.
The Kidney And UTI In Special Situations
Infections in certain special situations like pregnancy, children below the age of ten, elderly people above the age of sixty-five and complicated infections require special attention, These special measures are needed, or it can result in kidney damage and even death if they are not tackled properly.
Complicated Infections include those in diabetics, post-transplant patients, patients who are on medicines that cause immunosuppression, those with kidney stones, those with some genetic deformities of the urinary system and those who are infected with unusual bacteria.
These infections should be treated aggressively with hospitalization and injectable antibiotics. Surgery should be performed to correct and for correctable abnormalities like stones, tumours, prostate glands, etc. These patients tend to have frequent infections and need to be closely monitored and treated as and when needed. Furthermore, such patients do not have the usual standard textbook symptoms of urinary infections.
Infections of the kidney and urinary tract are among the commonest of infections worldwide. They are easily treated, if identified early, but can be life-threatening if neglected.