Urinary tract infections

Urinary tract infections (UTIs) affect millions of people each year, particularly women. UTIs are usually not serious if caught and treated early. Left untreated, however, they can lead to permanent kidney damage.


Causes
Many UTIs are caused by E. coli bacteria, which are commonly found in the intestines. Sometimes, through poor bathroom hygiene or other habits, the bacteria enter the urethra, the tube that carries urine out of the bladder. Once inside the urethra, the bacteria may multiply. They may then move on to the bladder, the chamber in the lower abdomen where urine is stored. If the infection is not stopped, the bacteria may continue to spread up narrow tubes called the ureters to the kidneys. In some cases, UTIs are caused by an infection that has migrated to the urinary tract from another part of the body. For men, an infection from the prostate gland is sometimes to blame.
Once the infection reaches the kidneys, it can be life-threatening. The kidneys -- a pair of fist-size organs located in your back, just below the bottom ribs on either side of your spine -- perform several essential jobs in the body. They remove liquid waste from the blood and expel it from your body in the form of urine. They also help regulate the balance of essential chemicals in the body and blood pressure. You cannot survive if your kidneys aren't functioning.

UTIs would be even more common if the urinary tract did not have safeguards that help protect against infection. The flow of urine helps wash bacteria out of the body. And the ureters and bladder usually prevent urine from backing up toward the kidneys. In men, secretions from the prostate gland also help slow the growth of bacteria.

Women have a higher risk for UTIs than men because their urethras are shorter. This makes it easier for bacteria to travel through the urinary tract. In fact, all women have a one in five chance of developing a UTI at some point.

For both men and women, the risk of developing a UTI increases with age. Having diabetes, a weak immune system, kidney stones or an enlarged prostate gland can also increase the risk. In addition, people who must use catheters -- tubes inserted into the bladder to empty it -- are more likely to experience a UTI.

Sexual activity can also increase the risk for a UTI. For both men and women, some UTIs have been linked to two sexually transmitted bacteria, chlamydia and mycoplasma.


Symptoms
Symptoms of a UTI include:
a painful, burning sensation during urination
frequent urge to urinate or urinary incontinence
blood in the urine
milky or cloudy urine
urine with an unpleasant odor
in women, an uncomfortable pressure around the pubic bone
in men, a feeling of fullness in the rectum
abdominal pain
back or side pain
fever
lethargy
Many people with UTIs delay getting treatment because they mistakenly blame their symptoms on other causes or assume the symptoms will subside on their own. If you develop any symptoms of a UTI, consult your doctor right away.


Treatment
To determine whether you have a UTI, a sample of your urine will be tested for bacteria. UTIs are generally treated with antibiotics. How long you take the antibiotics will depend on the severity of the infection, your age, your general health and other factors. If your doctor prescribes antibiotics, be sure to take them exactly as instructed. People who are severely ill with a UTI are sometimes hospitalized until they are able to take enough fluids and medications on their own.
If the infection does not improve with treatment, your doctor may ask you to come in for special X-ray or ultrasound tests. He or she may also recommend a cystoscopy. This test uses a hollow, lighted tube called a cystoscope to examine the inside of the bladder from the urethra.


Self-care tips
To help prevent a UTI or take care of yourself while you're recovering from an infection, drink plenty of water -- at least 1 to 2 quarts every day. It may also help to drink cranberry juice every day. It contains substances that keep E. coli bacteria from sticking to the lining of the bladder and other parts of the urinary tract. Be careful, however. Cranberry juice should not be taken with some medications, so make sure you have your doctor's OK.
Empty your bladder as soon as you feel the urge to urinate, and do not go for long periods without urinating. Empty your bladder at least once every four to five hours during the day and again after eight or more hours of sleeping. Also pay attention to your hygiene. Thoroughly clean your anal area after a bowel movement. It's especially important for women to wipe gently from front to back to avoid spreading bacteria from the rectum to the urethra. Thoroughly clean your genital area before sex. After sex, empty your bladder and clean your genital area again. Keep in mind that diaphragms and some spermicidal foams or agents have been linked to an increased risk of developing UTIs.

You may want to take showers instead of baths. It's also a good idea to wear cotton undergarments or undergarments with cotton crotches. Finally, avoid spicy foods, alcohol and any beverages that contain caffeine. They can irritate your bladder.