Clive Anderson - AT THE DERMATOLOGISTURINARY TRACT infections (UTIs), (sometimes called the honeymoon disease) are serious health problems. These infections are very common, affecting millions of people each year. Only respiratory infections occur more often. One woman in five will develop a UTI during her lifetime. Infections of the urinary tract are rare in men, but when they do occur they can be very serious.
The urinary system consists of the kidneys, the ureters (which are the tubes leading from the kidney to the next part of the system which is the bladder), and finally the tube leading from the bladder to the outside of the body called the urethra.
The kidneys, which are situated below the ribs in the back, remove excess liquid and wastes from the blood, maintain a stable concentration of salts in the blood and produce a hormone that aids in the formation of red blood cells. Urine contains the excess water and body wastes extracted by the kidney and is stored in the bladder before being excreted via the urethra. On average, we pass one and a half quart of urine a day. This volume will vary depending on the quantity of food and water consumed. The amount of urine passed during the night is half that passed during the day. Under normal conditions the urine is sterile, free from
bacteria, viruses and fungi.
COMMON GUT BACTERIA
An infection occurs when bacteria from the gut enters the opening to the urethra and begins to multiply. Usually the cause of the infection is the common gut bacteria Escherichia coli. If the infection is limited to the urethra it is called urethritis. Cystitis occurs when the bacteria move up to infect the bladder and if the infection is not promptly and adequately treated it may affect the kidneys (pyelonephritis).
The urinary tract is built in such a way as to prevent urine flowing back up towards the kidney. Additionally, the flow of the urine from the bladder helps to wash out bacteria from the body. The prostate gland in men produces secretions that slow bacterial growth. The body's immune system also works to prevent infection.
AT RISK
Some persons are particularly at risk for infection. These include persons with any abnormality of the urinary tract that obstructs the flow of the urine such as kidney stones or an enlarged prostate. A common source of infection is catheters or tubes placed in the bladder. People with diabetes have a greater risk of acquiring a urinary tract infection because of reduced immunity. Women may be particularly prone to urinary tract infections because the short length of their urethra allows bacteria to more easily spread to the bladder.
Another factor may be the close proximity of the urethral opening to the bacteria in the vagina and anus. Many women find that sexual intercourse may act as a trigger for a UTI -- the so-called honeymoon disease. The reason for the association with sex is unclear but it appears to be that bacteria are propelled down the urethra by the act of intercourse.
Many women have recurrent UTIs. Nearly 20 per cent of women who have a UTI will
have another, and 30 per cent
of those will have yet another episode. Fully 80 per cent of that last group will have recurrent episodes. Pregnant women are not more prone to a UTI, however when an infection occurs it is more likely to travel to the kidneys.
URGE TO URINATE
The symptoms of a UTI are frequent urges to urinate, a burning feeling in the bladder or urethra during urination and some pain or discomfort in the lower abdomen. Only small amounts are passed and the urine may appear cloudy or even reddish due to the presence of blood. If the infection reaches the kidneys, then fever, chills, back pain, nausea and vomiting may be present.
The diagnosis of a UTI is confirmed by sending a specimen of the urine to the lab for culture of the bacteria and determination of its sensitivity to different antibiotics. Often a UTI can be treated successfully with one to three days of treatment with an antibacterial drug. A woman who has frequent recurrences (more than three for the year) will require further investigation.
Dr. Clive Anderson is a dermatologist and venereologist; email: yourhealth@gleanerjm.com.
To avoid an infection:
Drink plenty of water daily.
Urinate when you feel the need, do not hold the urine.
Wipe from front to back to prevent bacteria from the anus entering the vagina and urethra.
Take showers instead of baths.
Cleanse the genital area before sex.
Avoid douches and feminine hygiene sprays.
Drink cranberry juice regularly.
