It’s a reasonably well known fact that our bodies are made up of approximately 70% water. Another lesser known fact is that we can survive without food for long periods of time, but we cannot survive without water for more than a few days - then our kidneys shut down and we die! But each day, all of us go to the toilet to pass urine and we rarely give it a second thought: that is, until it HURTS!
Urinary Tract Infections - or UTIs as they are often called - are remarkably common! The hallmark of most UTIs is that it really stings when you pass urine - one patient described to me that it felt like passing broken glass! But not all UTIs present with pain on passing urine (or dysuria for those who like medical terms), urine infections can reveal themselves in many different ways, often depending on the age of the patient.
But first some facts:
- Most UTIs are caused by auto-infection - in a remarkably short period of time, bacteria from around the anus can swarm over moist skin to where the bladder opens to the outside world via the Urethra.
- It is an anatomical fact that the male urethra is much longer than the female one, and therefore any swarming bacteria have a much longer distance to travel in order to reach the bladder - hence UTIs are more common in females.
- The area between the male anus and the urethral opening is usually fairly dry, making it more difficult for bacteria to spread. But in the female, the opening of the urethra is at the front of the vaginal opening, and in the reproductive years this area is often quite moist. Another reason why UTIs are much more common in females than males. It also accounts for why UTIs are more common in sexually active women .
Symptoms of upper UTIs
if a bladder infection is not treated effectively, it can ascend to the kidneys causing:
- Upper back and loin pain
- High fevers
- Shaking and chills
- Nausea and vomiting
- Kidney damage
Symptoms of lower UTIs
Finally, although the majority of UTIs affect the lower urinary tract - the bladder and the urethra: the urinary tract also involves the ureters and the kidneys - the upper urinary tract. Infections that ascend from the bladder to the kidneys have the potential to leave scars in the kidneys and damage their ability to filter toxic waste from the body. That’s why we need to take recurrent UTIs seriously because it’s vitally important to protect our kidney function
- Stinging or burning when passing urine
- A strong, persistent urge to urinate
- Passing frequent, small amounts of urine
- Urine that appears cloudy
- Urine that appears red,bright pink coloured - a sign of blood in the urine
- Strong-smelling urine
- Pelvic pain, in women
- Rectal pain, in men
Which groups of people are at higher risk of getting a UTI?
- As mentioned being female and sexually active will increase the risk of getting an UTI.
- Using a diaphragm for contraceptive purposes can also increase the risk.
- Women in the post-menopausal age group are also at higher risk as the vagina’s natural defensive bacteria which normally block swarming e coli from the anal area, are no longer there.
- Infants with abnormalities of the lower urinary tract are also at greater risk of UTIs
- At the other end of the time scale, people who have stones in the bladder, kidneys or ureter, will be prone to higher infection rates. The same applies to males with enlarged prostate glands who are unable to fully empty their bladders.
- And there are a significant group of people - those with spinal injuries for example - who need to self catheterise by passing a tube into their bladders to drain the urine several times a day, and who are at higher risk of introducing bacteria into their bladders.
Diagnosis is often made on the story that the patient tells their doctor, but it is very important that a specimen of urine is obtained so that the identity of the invading bacteria can be ascertained and the appropriate antibiotic given to clear it up. In most cases, these are relatively short courses of medications and the patient after feels much better in just a couple of days.
BUT ALWAYS FINISH YOUR COURSE OF TREATMENT.
Missing out on the last few days can lead to antibiotic resistance, because you might feel ok, but not all the bacteria may have been killed!
Things that we can all do to reduce the risks of suffering from a UTI:
- When you clean yourself with a tissue after passing urine always wipe “Down and away”. The away meaning you drop the tissue away into the pan!
- Keep the area between the anus and the opening of the bladder as dry as you can - e.g. change out of wet bathers after swimming, dry thoroughly after showering and consider using a hair dryer to dry the skin.
- Empty your bladder soon after intercourse. Also, drink a full glass of water to help flush bacteria.
- Avoid potentially irritating feminine products. Using deodorant sprays or other feminine products, such as douches and powders, in the genital area can irritate the urethra.
- Drink plenty of water during the day. This helps to flush the system and makes it more difficult for bacteria to cling on inside the urethra.