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What Causes Urinary Tract Infection And How Is It Treated?

Urinary Tract Infections are common in women, although they do occur in men as well. Almost 50-60% of all women experience at least one episode of urinary tract infection in their lifetime.


Urinary Tract Infections, or UTIs for short, are infections that can occur anywhere along the urinary tract, which includes the urethra, the bladder, and the kidneys. It is a common condition in women owing to their general anatomy, but there are other risk factors as well. While generally not life-threatening, UTIs can cause serious complications if left untreated as they ascend up the urinary tract to cause serious kidney infections.


The symptoms of UTIs may vary depending on where exactly the infection is located along the urinary tract. There are plenty of effective treatments available that successfully cure this condition, although recurrence is still very common.


CAUSES OF URINARY TRACT INFECTIONS

Urinary tract infections are usually bacterial in origin. These infections occur when bacteria enter the urinary tract and start to multiply. Although the urinary tract of both men and women is designed to protect natural protection against bacterial overgrowth, sometimes these defenses fail, and an infection develops.


The most common type of bacteria that causes urinary tract infections is E.coli. This bacteria is a natural member of the normal flora of the GI tract. E.coli can travel through the anus into the urethra and cause infections anywhere along the urinary tract.


E.coli can cause cystitis (inflammation of the bladder) and urethritis (inflammation of the urethra). However, E.coli more commonly causes cystitis. Urethritis can also be caused by pathogens coming from the vagina. Therefore, sexually transmitted diseases such as Gonorrhea, Herpes, and Chlamydia can cause urethritis.


WHAT ARE THE RISK FACTORS FOR DEVELOPING UTI?

Female urinary tract anatomy is one of the biggest risk factors for developing a urinary tract infection. 


Urinary tract infections are more common in women than in men. This is because women have a short urethra and, thus, bacteria have to cover a smaller distance to reach the bladder from the urethral opening. The female urethral opening is also much closer to the anus and, therefore, E.coli and other bacteria can easily travel from the anus to the urethra.


Some of the other major risk factors for developing urinary tract infections include:


Sexual intercourse – studies show that sexually active women experience more urinary tract infections than those who are not sexually active.


Birth control – While using birth control may be a good idea in general, some types of birth control, such as the female diaphragm and spermicides, put women at a greater risk of developing urinary tract infections.


Decreased estrogen – estrogen decline during menopause can also lead to frequent urinary tract infections.


Urinary tract obstruction – stones in the urinary tract and strictures can predispose both men and women to develop urinary tract infections.


Suppressed immune system – chronic illnesses such as diabetes, autoimmune disorders, and sexually transmitted diseases such as HIV also increase the risk of UTIs.


Other risk factors for UTIs include:

  • Congenital urinary tract abnormalities obstruct the urinary passage
  • Prolonged use of urinary catheters 
  • Instrumentation in the urinary tract, such as in medical examination or surgical procedures


SYMPTOMS OF URINARY TRACT INFECTIONS

Symptoms of urinary tract infections may vary depending on where the focus of infection is located. However, almost all types of urinary tract infections have some common symptoms, which may include:

  • Increased urge to urinate throughout the day
  • Burning sensation when peeing
  • Cloudy urine
  • Cola-colored urine
  • Urine with a strong, pungent smell
  • Pelvic pain


In the case of urethritis, it is common to experience a burning sensation during urination. There may also be a discharge through the urethral opening.


When the infection is localized to the bladder, it is known as cystitis. Common symptoms of cystitis include pelvic pain, discomfort in the lower abdomen, increased frequency of urination, and cloudy urine (indicative of blood in urine).


When the infection ascends all the way up to the kidneys, it is called pyelonephritis. Symptoms for acute pyelonephritis may include back or flank pain in addition to pelvic pain and a high fever. Rigors and chills are also common. Patients with acute pyelonephritis also present with nausea and multiple bouts of vomiting. Severe cases may also exhibit disorientation and confusion.


HOW ARE UTIS DIAGNOSED?

Apart from a careful history and physical examination, specialized diagnostic tests are often employed to confirm the diagnosis of a urinary tract infection.


Urine Analysis is the most commonly employed test for this diagnosis. This test measures different substances in your urine sample, including red blood cells and white blood cells. The presence of Leukocyte Esterase, an enzyme produced by white blood cells during an infection, confirms the diagnosis of UTI.


Urine Cultures are also helpful in establishing the specific bacteria that’s caused the infection. This test is most useful in directing appropriate antibiotic therapy for successful management.


In case of treatment-resistant or recurrent infections, your doctor may order some extra tests. These may include:


Ultrasound pelvis – it is a painless, non-invasive procedure that is used to obtain a radiographic image of the inside of the pelvis.


Cystoscopy – This test includes a camera-fitted tube that is passed from the urethra into the bladder to check for any pathology.


CT scan – when no confirmatory diagnosis can be reached, a CT scan may be warranted to rule out cancer and other such conditions.


HOW IS A UTI TREATED?

Urinary tract infections are caused by bacteria and are, therefore, treated with antibiotics. Antibiotics provide excellent outcomes in non-resistant cases. Some of the most commonly used antibiotics to treat UTIs are as follows:

  • Doxycycline
  • Nitrofurantoin
  • Cephalosporin
  • Quinolones 
  • Sulfonamides
  • Trimethoprim in conjunction with Sulfamethoxazole


Choosing the right antibiotic is essential to successfully treat the ongoing infection and avoid the development of antibiotic resistance. The choice of drug to be used for your condition will depend on both the culture results and your doctor's discretion.


Once prescribed, it is important to complete the course of antibiotics given for your condition to avoid the development of antibiotic resistance regardless of whether you have any symptoms or not.


HOW CAN I PREVENT URINARY TRACT INFECTIONS?

Prevention is the best protection against urinary tract infections, especially in women who suffer from multiple episodes of this infection in a year. Simple lifestyle changes can provide effective protection against the development of UTIs. These include:


Maintaining good hygiene – good hygiene is the pinnacle of prevention against urinary tract infections. A slight lapse in hygiene can easily predispose women to develop UTIs because of the short distance between the urethral opening and the anus. Frequently changing your pads or tampons can provide effective protection against any sort of infection.


Front-to-back wiping – Wiping your genital area front-to-back helps prevent the passage of bacteria from the anus to the vagina.


Increase intake of fluids – Fluid intake helps generate more urine which in turn flushes out all the bad bacteria in the urinary tract.


Washing genitals before and after sex – washing your vagina before and after sex can help prevent the buildup of any pathogens. Using water-based lubricants during sexual intercourse also prevents the vagina from drying out.


Considering other birth control options – if you use a diaphragm as your preferred birth control method but also suffer from frequent UTIs in a year, consider changing your birth control method.  

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