If you learn one new thing today, it should be about the function of the urinary tract system. “When you drink water, it sops up blood that goes to your kidneys. The kidneys act as a filter and remove the toxins and impurities in your blood and they go to the urethra, which is a tube that leaves from the kidneys and filters into the bladder,” explains Dr. Chinwe Ukaonu, family physician at Phoebe Putney Memorial Hospital in Albany. This fluid that is filtered out with all the toxins is called urine. “Urine is a continual filter that gets rid of the bad things in your blood,” reiterates Ukaonu.
If you feel pain or burning when you urinate, have frequency of urination or see blood in the urine, you should see a doctor. If you have back pain, nausea or fever, it may have gone to the kidneys and is serious. “Somehow bacteria found its way up the urethra and into the bladder which causes irritation and inflammation. Your body is trying to get rid of infection which is why you go to the bathroom a lot and have those symptoms,” explains Ukaonu. Sometimes the symptoms can be due to other troubles like a sexually transmitted disease, vaginal irritation, yeast or bacterial infection.
Causes vary. “In younger females, certain types of spermicides or diaphragms keep the bacteria around,” says Dr. Charity Wilson, family medicine doctor at Phoebe Putney Memorial Hospital in Albany. Even sex can push the bacteria into the urethra. “With older women, you worry that sometimes the bladder can hold onto urine and not empty it all the way. When it sits it can be the perfect spot for bacteria to grow,” says Wilson. The bladder can also drop, which makes you prone to recurrent infections.
Since men have a longer urethra, they are less likely to have infection but it is still possible. “When they get older, if their prostate is enlarged it can tighten around the urethra and make their bladder hold a lot of extra urine. Men who have not been circumcised can also hold more bacteria,” says Wilson. If you are constipated, you may have anal leakage which can cause more bacteria than usual and lead to infection. The worst bacteria to blame can be e-coli.
Older people may respond differently to the infection as their immunity decreases. “They come in confused and suddenly not acting right, and one of the first things we do is check their urine,” says Wilson. Postmenopausal women may have recurrent infections because their estrogen level is lower. “They may do vaginal estrogen treatments which helps keep tissues tight and in place and gives them less bladder problems and prolapsing,” says Wilson. It comes in cream and tablet form.
Prevention is simple. Be sure to stay hydrated. “Drinking a lot of fluids can help keep your bladder washed out,” says Ukaonu. Go to the bathroom after sex. Sometimes post-coital antibiotics may be used. “A homeopathic way is cranberry juice or cranberry tablets which are really good for the urinary tract,” says Wilson.
Diagnosis starts with a urinalysis. “We try to get a clean-catch specimen where you wipe the area and then try to collect the middle portion. We can tell if there are bacteria or white cells which are what help the body fight infections. When you have a urinary tract infection, there will be a lot of white cells in your urine,” explains Ukaonu. A urine dip may also be done. “We dip a paper strip and look for white blood cells which could be a sign of infection, red blood cells which tell us the bladder could be irritated and nitrates which are detected when there is a bacteria in the bladder,” says Wilson. Sometimes a culture is necessary. “We will grow bacteria. It takes a couple days and if it grows, it tests against some of the common antibiotics,” says Wilson.
Treatment is twofold. There are over-the-counter treatments for symptoms but they do not treat the infection. Examples are Pyridium and AZO. “They change the urine colors to blue or orange according to what you use and they work quickly,” says Wilson. Women will be prescribed antibiotics for 3 to 10 days depending on the severity.
Treatment is more complex for males. “Men have to be treated longer because their urethra and whole urinary tract is longer and more complicated. The urethra goes to the prostate, which is like a sponge and that can get infected and can cause prostatitis, so men have to take an antibiotic for 14 days,” says Wilson. Do not stop partway into treatment even if you feel better.
If you have frequent infections, it is a concern. “You probably need to get checked for diabetes because when sugars are elevated, you are more prone to infections,” says Wilson . Though it probably does not merit an emergency visit, you should see your doctor if you suspect you may have a urinary tract infection or if you do not feel well and do not have the symptoms, because urinary tract infections can sometimes be asymptomatic. “The very first time someone gets a urinary tract infection, they need to see their doctor because they need to have it tested,” expresses Wilson.
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