Urinary tract infections are bacterial infections mostly caused by bacteria, but some are caused by fungi and in rare cases, caused by viruses. The infection takes place in the organs of the urinary tract which consists of the kidney, bladder, urethra, and ureter. Women are more susceptible to getting UTIs than men.
UNCOMPLICATED UTIs
Most UTIs occur in the bladder and urethra which are usually uncomplicated, they are known as cystitis or lower tract UTIs. The UTIs which are uncomplicated have no structural abnormality of the urinary tract. They also have no concurrent health conditions like compromised immune system, diabetes, recent urologic surgery or pregnancy, etc. The uncomplicated UTI does not need treatment and spontaneously resolves itself in about 20% of women but they still seek therapy so they might not reach the kidney to prevent upper tract disease like polynephritis and prevent the destruction of delicate structure in the nephrons.
COMPLICATED UTIs
Complicated UTIs take place in immunocompromised patients, pregnant women, and males. It also takes place in patients who are suffering from stones, sepsis, and catheters. In rare cases, it also occurs in the kidneys and ureters which are most severe. The duration of consuming antibiotics is longer. The probability of treatment failure, and morbidity is high.
UTI SYMPTOMS OF LOWER TRACT
The lower tract includes the urethra and bladder which are affected by UTIs. They are also known as Uncomplicated UTIs. Symptoms are listed below
- Although urine is not passed much each time but frequency of urination increases
- Urge to go for urination
- Urination with burning
- Cola or tea-like appearance of urine
- Blood in urine
- The cloudy-like appearance of urine
- Urine with a strong odor
- Pelvic pain in women
- Rectal pain in men
UTIs SYMPTOMS OF UPPER TRACT
They are also known as complicated UTIs. Symptoms are listed below
- Fever
- Nausea
- Vomiting
- Chills
- Softness and pain in the upper back and sides
EPIDEMIOLOGY
- In the United States, 40% of women will develop a UTI during their lifetime.
- UTIs happen at least 4 times more often in females than males.
- About 10% of women acquire a UTI annually.
- Once the infection is treated it is not necessarily that it will not come back within a year nearly half of patients get a second infection
- UTIs often take place between the ages of 16 to 35 years in women
RISK FACTORS
- Dysuria (abnormal urination) e.g. emptying bladder incompletely, neurogenic bladder
- Structural or functional abnormality of the urinary tract
- UTI occurs before the age of 15
- Diabetes
- Increases bacterial resistance by use of antibiotics
- Dehydration
- Diarrhea
- Menopause
- Copulation (sexual intercourse)
- New or multiple sex partners
- Unhygienic practices
- History of multiple UTIs in mother
- Irritable bowel syndrome
- Immunocompromised
TYPES OF URINARY TRACT INFECTION
1-Cystitis
It is also known as uncomplicated UTI or lower tract UTI. Cystitis is an infection in the bladder and it is the most common UTI in women. It is caused by when bacteria enter through the urethra and infect urine and is secondary to swell the lining of the bladder. While it is painful it is not that harmful unless reaches the kidneys and infects them which then requires serious medical attention and sometimes becomes the reason for kidney failure. Symptoms include the urge to urinate again and again while only passing a few drops of urine each time, burning, pain in urine, urine with a strong smell, urine with blood, and cloudy blood. For effective treatment drink lots of fluids or water, consume an alkaliser or add a teaspoon of baking soda in water and utilize it, avoid consuming acidic foods, wash your genital areas before sex, urinate after sex, wipe from front to back and use cotton underwear.
2-Polynephritis/Kidney Infections
It is the type of infection that starts in the bladder and then reaches the kidneys. If treatment is taken quickly it can prevent any complications further. It can even spread through the bloodstream and cause serious infections. Symptoms include fever, chills, back and side pain, nausea, vomiting, frequent urge to urinate, bloody and smelly urine, and groin pain. Seek medical attention when you experience these symptoms doctor prescribes you antibiotics. Some preventive measures are the same as cystitis like drinking lots of water, wipe from front to back, washing your genital area thoroughly, urinate when you feel the urge and after sexual intercourse.
Non-specific Urethritis (NSU)
It is characterized by the inflammation of the man's urethra which is not caused by gonorrhea. It can easily be transmitted by vaginal sex. Symptoms include white discharge through the penis, burning while urinating, pain, and swelling of the testicles. NSU is treated with antibiotics.
Vaginitis
It is not a type of UTI but it is possible that women with vaginitis might develop UTI. Vaginitis is the inflammation of the vagina. Symptoms include pain, itching, unpleasant vaginal odor. Preventions include skip baths and hot tubs, wiping thoroughly from front to back, using condoms for sex and limiting the number of sex partners, do not use douch for washing your vagina as it disturbs the normal flora there and exposes your vagina to other harmful pathogens.
TREATMENT/MANAGEMENT/ANTIBIOTICS
Management of uncomplicated UTIs
Treatment with antibiotics may take place from 3 days to 6 weeks. They just cure with mini dose therapy in 3 days. Uncomplicated UTIs are treated by First-line agents which include nitrofurantoin, sulfamethoxazole/trimethoprim, fosfomycin, and first-generation cephalosporins. Pivmecillinam is also considered first-line therapy outside the US
1-Nitrofurantoin
It must be used for 5 to 7 days and it is bacteriostatic not bactericidal. It has proved effective only for lower tract UTIs. In patients with recurrent UTIs. It is the preferred drug for low-dose long-term prophylaxis.
2-Sulfamethoxazole/trimethoprim
It is used for 3 days so is considered a good mini-dose therapy. When local bacterial resistance is>20% they should be avoided use or in case the patient has a sulfa allergy. In patients with recurrent UTIs they are effective and a good choice for long-term prophylaxis.
3-Fosfomycin
Fosfomycin is used in a single dose for 2 to 4 days for uncomplicated UTIs and is equivalent to those therapy that requires 7 to 10 days with other agents. It is FDA-approved and even shows its effectiveness when there is resistance to other antimicrobials
4-Pivmecillinam
Pivmecillinam is considered first-line therapy for uncomplicated UTIs in other parts of the world except the US as it is not available there. Due to inadequate tissue penetration, It is not recommended in pyelonephritis or suspected systemic infections.
5-First-generation cephalosporins
First-generation cephalosporins are good options for mini-dose therapy (3 days) but should not be overused to avoid resistance
Fluoroquinolones
As Fluoroquinolones have high tissue penetration levels they are used for polynephritis
and prostate preferably for prostate but not for uncomplicated UTIs. These are preferred when other drugs are not producing satisfactory results. Fluoroquinolones and nitrofurantoin are revealed as mutually antagonistic and should not be used together.
MANAGEMENT OF RECURRENT UTIs
It involves improvement of personal hygiene, taking preventive measures before sex, and taking Vitamin C as it acts as a urinary acidifier.
1-Nitrofurantoin
Nitrofurantoin includes prophylactic antibiotics or antiseptics. Low-dose long-term prophylaxis with nitrofurantoin is the recognized standard therapy for recurrent UTIs. This treatment has minimized side effects so treatment is well tolerated. Allergies are not usually seen by this treatment. It has multiple antibacterial activity so bacterial resistance is very low.
2-D-mannose
Due to the limitation of available data to formally recommend it some evidence showed the benefit of using it and used as a prophylactic agent.
3-Methenamine
Methenamine produces its effectiveness when converted into formaldehyde and for this conversation, it requires an acidic environment in the bladder so vitamin C is taken with it which makes urine more acidic and drops the pH below 5.5. Some evidence shows that it provides benefits for recurrent UTIs but some data is contradictory.
ATROPHIC VAGINITIS
When the estrogen level decreases thinning, drying and inflammation of the vaginal wall take place, particularly during menopause which creates problems or symptoms like dryness, discomfort, or pain in sexual intercourse. It is managed by topical medication and other treatments or therapies which is prescribed by healthcare professionals. In postmenopausal women, Estrogen vaginal cream is applied twice a week for atrophic vaginitis.
HOME REMEDIES
It is not always necessary you run after the drugstore for medication for the treatment of any disease. If you are suffering from relatively mild symptoms of urinary tract infections home remedies are there to relieve these symptoms and at cheaper costs. however, it is still necessary to take the advice of your healthcare professionals before self-administrating these home remedies.
1-Drink lots of water
If you are drinking 8 glasses of water per day and suffering from UTI then increase your water uptake as the water acts as a flush for bacteria which has reside in the urinary tract and is causing a problem.
In a 2020 randomized control trial 12-month study was taken 140 premenopausal women susceptible to UTIs participated to test if an intake of higher would decrease their risk of recurrent cystitis and consequently their risk of developing a UTI. Researchers found that a decrease in UTI was observed with an increase in fluid intake.
2-Cucumber
It is often recommended to consume cucumbers during UTIs as they contain more water content so consumption of them makes you hydrated. Consume them as a whole or soak them in water overnight to make a cucumber-flavored drink. Adding slices of lemon adds Vitamin C to this drink.
3- Heat packs
To relax your muscles when you are in abdominal discomfort caused by spasms and inflammation, Heat packs or even filling a water bottle with hot water and wrapping it with a towel to place over your abdomen helps relieve cramps and pain. Avoid large pressure on the bladder to avoid any further complications. You can use heat packs as long as necessary.
4-Vitamin C
Vitamin C can prevent urinary tract infection in two ways either it enhances your immune system or increases the acidity of your urine for eliminating bacteria that cause infection. To provide vitamin C to your body you need to take either supplements like oral tablets of vitamin C or foods rich in vitamin C like oranges, grapefruits, kiwifruits, red peppers, etc.
One study that took place in 2016 showed that when vitamin C was taken with cranberries and lactobacillus rhamnosus which are other two natural UTI remedies could effectively treat UTI.
However, there are still conflicts about whether Vitamin C can make your urine acidic and sufficient to eliminate those bacteria that are causing infection.
5-CRANBERRY JUICE OR CRANBERRY SUPPLEMENTS
Cranberry juice with no added sugar or cranberry in supplement forms can reduce UTI. Some research showed that it reduces UTIs by inhibiting the adherence of bacteria that cause UTIs.
In a study in 2022 (health line), some participants who were experiencing uncomplicated UTIs were given cranberry juice to consume over six months. They observed a reduction in the frequency or severity of UTIs.
Another study, a 2021 review of 23 showed that cranberry supplements in the form of juices, tablets, and capsules substantially decrease the probability of UTIs.
However, there are conflicts Cranberries contain A-type proanthocyanidins, an active component that prevents E.coli from adhering to the urinary tract lining but some studies show that cranberry juices might not contain a sufficient amount of this component so just rely on this is not enough. So there is a need to know the role of cranberry supplements in preventing UTIs through larger and higher-quality studies.
Spring Valley Cranberry Extract Capsule
A 500mg organic cranberry extract is present in each serving. Some reviewers said that they had observed improvement after taking these supplements that were suffering from frequent UTIs.
WHY DOES UTI CAUSE PERSISTENT/LONG-LASTING PAIN?
In a study by Science Immunology, it was studied that antibiotics have eliminated the infections but still, there is persistent pain due to excess growth of neurons in the bladder. Biopsies of the Bladder of unaffected people and people with recurrent UTIs even if no bacteria were traced in their urine were taken and then compared. It was revealed that patients with chronic pain (patients with recurrent UTIs) had more sensory neurons than unaffected individuals. This was proof of their chronic pain and frequent urination even though when their UTI were eliminated. When the epithelial cells are destroyed which are filled with bacteria each time UTI occurs it also destroys nerve cells nearby might be due to the reason that epithelial cells act as a barrier so when they are removed they expose nerve cells to other pathogens. As a result of this immune response gets triggered and brings immense regrowth of destroyed nerve cells. The immune cells release nerve growth factors which enhance neural sensitivity which lead lead to persistent pain.
CONCLUSION
In conclusion, urinary tract infections (UTIs) are the type of bacterial infections that are common, mainly affecting the bladder and urethra (uncomplicated UTIs), and can also be associated with kidneys and ureters (complicated UTIs) which are most severe. Symptoms show according to whether the infection involves the lower or upper urinary tract. It can occur both in women and men but is more prevalent in women. There are different types of UTIs complicated and uncomplicated ones, symptoms may vary according to each type but some of the preventive measures may same. For the management and treatment of uncomplicated and recurrent UTIs different antibiotics are prescribed by healthcare professionals and on the other side home remedies are also available for managing UTIs in more natural ways. there is persistent pain in UTIs, the study showed that it is due to the overgrowth of neurons in that region which is triggered by immune cells leading to increased neural sensitivity and ultimately long-lasting pain.
: Symptoms, Types, Treatment and Home Remedies){kind=link}
0 Comments