What is the cause of urinary tract infections?

Dear Readers,

L.J. writes from Spanish Town, St. Catherine. She has a 2 1/2 year history of frequent urination and pain in her sides. She was recently diagnosed with a urinary tract infection. She is still on medication but the pain in her sides and a burning sensation in her genitalia won't go away.

L.J. asks "what is the cause of urinary tract infections?" "How can she prevent this infection from recurring?" And how can she "relieve the painful symptoms in her sides?"

Urinary tract infections (UTIs) are a group of common occuring disorders which mainly affect women, especially those who are sexually active. By far the majority of all urinary tract infections in women are re-infections. Most of these infections are due to a bacterial organism, E-coli and a smaller percentage is due to the bacterium, proteus.

A common presentation of symptoms tends to occur in the presence of a UTI. These are:

Burning when passing urine

Frequency in passing urine

A sense of urgency to pass urine

Passing urine in small amounts

Pain over the lower abdomen

Blood in the urine

These symptoms most often occur in lower urinary tract infections and are also called cystitis.

When the upper urinary tract is involved, the infection can have more serious consequences and be associated with the additional symptoms of:

flank pain

fever

chills

nausea

Not every one with a UTI has symptoms. Some infected persons have few symptoms and might only complain of tiredness or fever.

Upper urinary tract infections are often due to infections such as pyelonephritis (bacterial infections) but can also be due to kidney stones which are causing partial obstruction to the flow of urine and therefore, urinary stasis.

Some established risk factors for UTIs are:

Structural defects in the uri-

nary tract

Recent sex

A delay in passing urine

after sex

Urinary catheterisation

Repeated episodes of UTI can be either relapses or reinfections. A relapse suggest either inadequate treatment due to the affected person using an unsuitable drug (antibiotic), that the drug was used for too short a period of time, or that an obstructive problem is present within the urinary tract.

The bladder is normally sterile. However, in females bacteria from the bowel area, can contaminate and grow over the vaginal region, vulva and the rear by urethra (the tube from which urine passes). These organisms can then migrate into the bladder, especially during sexual intercourse.

To determine if a UTI is present the person's urine should be examined. The infection can be investigated by:

Urine microscopy

Urine culture

Blood investigations

Abdominal x-rays

Abdomino-pelvic ultra

sound

Cystoscopy

Intravenous pyelogram

Investigations seek to determine the site and cause of the infection within the urinary tract. Treatment then endeavours to resolve the infection and prevent recurrence of infection and irreversible kidney damage.

Treatment is with suitable antibiotics and if necessary, medication for pain and fever. The duration of treatment depends on the site of the infection, shorter for the lower tract and longer for the upper tract. Adequate hydration is important to dilute and diurese (pass out in urine) the bacteria and at least eight glasses of water and juices should be ingested daily.

Cranberry juice is very useful as nature's "natural" antibiotic which prevents the bacteria from binding to the urinary tract epithelium.

Acidifying the urine by drinking several glasses of water with squeezed lemon juice each day, also assists in preventing growth of the bacteria. Urine should be voided regularly and voiding of urine after sexual intercourse should be practised. Participating urinary tract 'hygiene" does help to prevent the recurrence of urinary tract infections.

By Dr. A.J. MORGAN

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